Anesthesia Program Students' Perceptions of the Operating Room: A Metaphor Analysis

Background Clinical learning environments play a critical role in shaping students’ professional perceptions, emotional responses, and learning experiences. The operating room is a high-risk, complex, and multidisciplinary setting that involves patient safety, life-sustaining interventions, and active participation in teamwork. Understanding anesthesia program students’ perceptions of this environment before and after clinical practice is essential for the improvement of clinical education. This study aims to examine changes in anesthesia program students’ perceptions of the operating room before and after their first clinical practice through metaphor analysis. Methods This study is a qualitative descriptive phenomenological study conducted using metaphor analysis. The study was carried out with 54 first-year anesthesia program students who had no prior clinical experience and were enrolled at a state university during the 2023–2024 academic year. Data were collected in two phases: before clinical practice and after a 14-week operating room clinical training period. Participants were asked to complete the statement, ‘The operating room is like … because …”. A total of 108 metaphors were obtained and analyzed using content analysis. The metaphors were categorized based on shared meanings, and perceptions before and after clinical practice were compared. Results The analysis identified four main categories: professional environment, life-preserving setting, educational environment, and critical environment. Before clinical practice, students’ metaphors were predominantly emotional and abstract, reflecting perceptions of mystery, fear, hope, and idealized healing (e.g., “closed box,” “light of hope,” “mystery”). After clinical practice, the metaphors became more concrete, realistic, and profession-oriented, emphasizing themes of systematic work, responsibility, teamwork, and continuous learning (e.g., “clock,” “puzzle,” “school,” “being alert”). Metaphors associated with fear and uncertainty decreased, while those reflecting professional awareness and structured learning increased. Conclusions Clinical practice was found to transform anesthesia program students’ perceptions of the operating room from emotional and fear-based approaches to a more professional, realistic, and learning-oriented perspective. These findings highlight the importance of structured, supportive, and role model–based clinical education in fostering professional identity development and emotional adaptation. Enhancing the quality of clinical learning environments may contribute to the effectiveness and sustainability of anesthesia education.