Table 4.

Observation protocol.

Observation stage	Number of observations	Description
Orientation	1	Trainee and trainer observe one full RASa procedure together. This serves to orient the trainee to the ORb Trainer demonstrates the following behaviors: Checking in with the charge nurse before entering OR Checking in with circulating nurse on entry to OR Where to stand in the OR and what to avoid Discuss different personnel and steps of the procedure Trainer engages in postobservation discussion Discussion of individuals in the room Answers any questions the observer had
Practice	3	Trainee and trainer observe 3 full RAS procedures together, each using the data collection tool but without discussing their observations with one another Debrief after surgery Trainer to read off their observations and times at which they observed FDsc. Concurrently, trainee checks observations they caught and discussion of those that they did not
Interrater reliability	5	Trainee and trainer observe 5 observations for interrater reliability If IRRd (kappa>0.7) observers were considered trained and they could observe independently

^aRAS: robotic-assisted surgery.

^bOR: operating room.

^cFD: flow disruption.

^dIRR: interrater reliability.