Introduction <p>Effective teamwork in the operating theatre is essential for safety and optimal patient outcomes. Extensive research has examined this topic from the perspectives of anaesthesiology consultant and surgeons; however, limited attention has been given to anaesthesiology trainees. Hence, this study explores anaesthesiology trainees’ attitudes towards communication and leadership in the operating theatre.</p> Methods <p>A questionnaire-based study was conducted among anaesthesiology trainees in Irish hospitals. The questionnaire was adapted from the Operating Room Management Attitudes Questionnaire (OMRAQ). Data collected included demographics, trainee attitudes toward communication and leadership, perceptions of team dynamics and communication-related errors. Responses were analysed through descriptive statistical analysis.</p> Results <p>A total of 74 trainees responded. The majority expressed a strong preference for collaborative leadership and open communication, with 95% of trainees supporting junior staff participation in decision making. However, 69% reported a lack of pre-operative briefings and 84% stated that post-operative debriefings were uncommon, demonstrating pitfalls in theatre communication. Furthermore, 85% acknowledged making errors due to poor communication, with over half reporting witnessing such errors from other members of theatre. Trainees supported the need for confidential error-reporting systems but expressed hesitation about openly reporting incidents.</p> Conclusion <p>Anaesthesiology trainees value teamwork and communication but perceive significant gaps between best practices and current hospital procedures. These findings highlight the need for systemic interventions, including structured communication training, leadership development, and the promotion of psychological safety within theatre. Addressing these areas could improve communication dynamics, reduce medical errors, and enhance patient safety.</p>