Emotional and psychological challenges faced by students in the operating room: a scoping review

The operating room (OR) is widely recognized as one of the most demanding learning environments in healthcare education, characterized by high technical complexity, strict hierarchies, and limited tolerance for error. In this context, students are frequently exposed to emotional and psychological challenges that influence learning, well-being, and professional identity development. This scoping review aimed to map and synthesize qualitative evidence on healthcare students’ emotional and psychological experiences in OR-based clinical education. A comprehensive search of electronic databases and supplementary sources identified 454 records published between January 2000 and June 2025. After systematic screening and eligibility assessment, 22 qualitative studies involving medical, nursing, and surgical technology students were included in the final synthesis. Thematic analysis identified six interrelated themes: anxiety and fear during early OR exposure; experiences of exclusion and diminished belonging; interpersonal and communication-related stress; conflicts in professional identity formation; coping and resilience strategies; and tension between technical skill acquisition and emotional burden. Students commonly reported distress linked to hierarchical interactions, fear of errors, limited feedback, and marginal participation in clinical activities. Although some students employed coping strategies such as peer support, emotional distancing, or self-reflection, these efforts were often informal and inadequately supported at an institutional level. The findings emphasize the ethical and educational importance of recognizing emotional experiences as integral to OR learning. This review highlights the need for structured mentorship, reflective debriefing practices, and psychologically supportive educational cultures to promote student well-being, resilience, and professional identity development.