A recent OR Manager article explores how ambient artificial intelligence is transforming perioperative performance, with a spotlight on the groundbreaking work being led at Duke University using the OR Black Box®. The OR Black Box captures continuous, de-identified video, audio, and device data to create an objective record of each surgical case. Dr. J. James Jung and the Spae Lab team use this technology to identify safety threats, measure both technical and nontechnical skills, and provide structured, time-stamped insights that inform real-time learning and performance improvement. By helping teams recognize patterns such as environmental distractions, communication gaps, or resilience behaviors, the technology supports more effective debriefs and personalized coaching for clinicians and trainees.

The article underscores how this data-driven approach strengthens education, teamwork, and patient safety when anchored in just culture, nonpunitive assessment, and transparent governance. Beyond Duke, the piece highlights broader applications of ambient AI across major health systems—from optimizing OR utilization to improving documentation workflows. Together, these innovations demonstrate how intentional, well-governed AI adoption can elevate clinical performance, enhance safety culture, and support smarter, more efficient surgical care.