Abstract
BACKGROUND AND AIMS: Communication failures in operating rooms contribute to 30% surgical errors. This systematic review evaluates whether personalized surgical caps improve teamwork and communication, addressing both clinical outcomes and professional inclusivity. METHODS: We followed PRISMA guidelines, searching PubMed, CINAHL, and Google Scholar (February 2024-April 2024). Five studies met inclusion criteria (three randomized controlled trials and two observational studies). Methodological quality was assessed using the ROB-2 tool for randomized trials and JBI checklists for observational studies. A narrative synthesis was conducted due to heterogeneity in outcome measures. RESULTS: The review found consistent evidence that personalized surgical caps enhance communication and teamwork in the operating room. Studies reported improved name and role recognition among team members, with labeled caps reducing misidentification errors by 65%-78%. Notably, female and underrepresented minority staff experienced disproportionately greater benefits, including higher rates of role recognition and reduced microaggressions. Teamwork perceptions improved significantly in three studies, with one pilot study documenting a median score increase of 1-2 points. However, the magnitude of effects varied across professional roles, suggesting contextual influences. CONCLUSION: Personalized surgical caps demonstrate promise for improving communication dynamics and fostering inclusivity in the operating room, particularly for marginalized groups. While the evidence base is limited by study heterogeneity, all included studies reported positive outcomes. Future implementation should account for institutional policies and staff preferences to maximize effectiveness. Further research with standardized outcome measures is needed to strengthen these findings.