Interventions to improve technical and non-technical skills of nurses working in operating theatres: A scoping review with evidence gap mapping

Background Operating room nurses must master a wide spectrum of technical and non-technical skills to ensure patient safety and high-quality care. Although numerous interventions have been developed and implemented, evidence is fragmented and inconsistent. Aim To map interventions aimed at improving technical and non-technical competencies of operating room nurses, describe outcome measures, and identify evidence gaps. Design Scoping review following the Arksey and O'Malley framework. Methods We searched PubMed, CINAHL, Scopus, and EMBASE for primary studies and reviews involving registered operating room nurses (scrub, circulating, perioperative). Data extraction covered study characteristics, interventions, competencies targeted, instruments used, and outcomes. We applied vote-counting to summarize direction of effects and used a harvest plot and evidence gap map to visualize findings and research gaps. Results 21 studies met the inclusion criteria. Most evaluated educational interventions ( n = 19), with 16 (84.2%) positive and three (15.8%) mixed results, while behavioral (n = 1) was positive (100%) and the organizational study (n = 1) showed a mixed effect. By competency domain, technical skills ( n = 7) were mainly positive (85.7%), non-technical skills ( n = 3) showed more variability (33.3% positive, 66.7% mixed), and studies addressing both domains ( n = 11) were largely positive (90.9%); no null effects were reported. Outcome and instruments heterogeneity were common limitations. Conclusion Evidence indicates that educational interventions, particularly simulation-based training and blended curricula, effectively improve operating room nurses' competencies. However, organizational and system-level strategies remain underexplored, and evaluations of non-technical skills are inconsistent. Future research should prioritize rigorous comparative designs, standardized outcome measures, and long-term, multicenter evaluations to strengthen the evidence base. Implications for the profession and patient care Targeted educational interventions can enhance operating room nurses' competencies, while greater attention to non-technical and organizational skills is needed to further improve patient safety and quality of care. Reporting method PRISMA-ScR guidelines. Patient or public contribution No patient or public contribution.