Prior research has implicated poor communication between team members as a possible factor in adverse events during surgery. This study attempted to further characterize suboptimal communication patterns by using psychologists to directly observe general surgery cases. "Small talk" and other communications not directly related to the case were common, although some of these were not irrelevant (ie, comments related to teaching or organizational matters). Although the study did not directly link the quality of communication to errors, the authors speculate that the large number of "case-irrelevant communications" could lead to a distracting work environment.