By Don Sadler
The surgical technologist career is one of the operating room’s most essential — and most rapidly evolving — roles. A safe, smoothly run operating room depends on coordinated teamwork among a number of different healthcare specialists. These include the surgeon, anesthesiologist, OR nurse and surgical technologist.
Also sometimes known as a scrub tech or surgical tech, the surgical technologist closely collaborates with surgeons and members of the perioperative team while maintaining the integrity of the sterile field throughout surgical procedures.
“The surgical technologist functions as the sterile member of the surgical team while anticipating the needs of the surgeon throughout a procedure,” says Timothy Gregus, BS, CST, director of the surgical technology program at CT State Manchester Hartford Hospital.
Ensuring Surgical Precision and Efficiency
“At its core, the surgical technologist’s role is to ensure that every surgical procedure unfolds with precision, sterility and efficiency,” says TC Parker, CST, BS, FAST, surgical technology program director at Gwinnett Technical College. “Surgical techs are responsible for preparing and maintaining the sterile field, managing surgical instrumentation and supplies, and directly assisting the surgeon during the procedure.”
Other duties of surgical techs include preparing the OR for surgery; performing the surgical scrub; performing surgical counts with the circulating nurse; identifying breaks in sterile technique; passing instruments and supplies to the surgeon; preparing and labeling surgical specimens; helping prep and drape patients; and taking patients into recovery after surgery.
“Certified surgical technologists (CST) are the vital link between precision and performance,” says Michelle Payne, MAEd, CST, FAST, president of the National Board Surgical Technology and Surgical Assisting (NBSTSA). “They keep the entire surgical team ready for anything.”
According to Kristen Parker, MSN, RN, NPD-BC, CCRN, manager, nursing professional development & practice excellence perioperative services at Hartford HealthCare, the value of surgical technologists extends far beyond scrub time.
“Many surgical technologists serve as formal and informal leaders in the operating room by providing education to other scrub personnel, acting as subject matter experts within specialty service lines and helping drive operational efficiency,” says Parker. “Their expertise can help reduce waste, improve efficiency and realize significant cost savings without compromising patient care.”
According to Daniel Kunath, TS-C, the role of the surgical tech varies greatly by specialty, experience and employer. “A new tech will likely work mostly on the inventory management of the OR, providing instruments to the surgeon,” he says. “As techs gain more experience, they take on an advisory aspect by ‘thinking ahead’ of surgeons and offering alternative instruments or products if needed.”
For example, Kunath specializes in burn surgery. “A big part of my job is education: teaching techs, nurses, med students and residents about the unique procedures we perform and tools we use and introducing them to the peculiar flavors in our OR that differentiate us from the other services,” he says.
Surgical Tech vs. OR Nurse
The main difference between surgical techs and OR nurses is that the surgical tech works to maintain sterile field integrity while the OR nurse works outside the sterile field. “The surgical tech is trained to be the expert of the sterile field,” says Kunath.
“The surgical tech and OR nurse roles converge in patient safety,” says Payne. “They both participate in the ‘Time Out’ and perform surgical counts and both are accountable for identifying and correcting breaks in sterile technique.
“The shared goal – a safe procedure with optimal patient outcomes – demands that these two roles operate as genuine partners, not parallel tracks,” says Payne.
Sidebar
How AI Is Transforming Surgical Tech Training
Training for surgical technologists is undergoing a fundamental shift as artificial intelligence moves beyond back-end support directly into the learning process. Training is evolving from fixed scenarios to adaptive environments where AI-powered assistants guide technologists through procedures in real time, offering immediate coaching instead of post-session feedback.
“Healthcare organizations face a growing challenge: training more professionals to higher standards while reducing pressure on clinical environments,” says Richard Vincent, the co-founder and CEO of FundamentalXR, an AI-based training solution and advanced platform for clinical teams in MedTech.
According to Vincent, FundamentalXR allows surgical technologists to build procedural knowledge, instrument familiarity and OR workflow skills in an immersive environment before entering a live surgical setting.
“Learners can repeatedly practice critical tasks and scenarios while educators gain objective insights into competency and readiness,” he says.
Vincent stresses that AI-powered training tools like FundamentalXR are not designed to replace clinical experience. “Instead, they enhance it by ensuring learners arrive better prepared,” he says. “The strongest approach combines immersive simulation with mentorship and real-world clinical exposure.”
AI can make the biggest training difference by providing guidance and assessment without the need for faculty oversight.
How to Become a Surgical Technologist
According to Payne, candidates must graduate from a CAAHEP or ABHES accredited surgical technology program in order to be eligible to sit for the NBSTSA CST exam.
“This requirement ensures that clinical training actually happens before anyone enters an OR professionally,” she says.
The CST certification is the most nationally recognized surgical technology credential in the country.
“When coupled with an associate’s degree in surgical technology, this represents the gold standard for surgical techs,” says Kunath. “Any facility anywhere in the country recognizes this credential, and most vastly prefer it.”
TC Parker calls the CST exam “rigorous by design. It ensures that technologists possess the knowledge and judgment necessary to protect patients in the high‑stakes environment of the operating room. Many employers now require CST certification and several states mandate certification or registration.”
Payne says that she continually hears from hospitals, clinics and directly from surgeons that when uncredentialed people or those who do not have a CST certification arrive in the operating room, they can immediately tell who is prepared and who is a liability.
“Only the CST credential requires verified, documented clinical training,” says Payne. This includes a minimum of 120 in-person patient cases in actual operating rooms, completed and reviewed by NBSTSA before exam eligibility is granted.
“Credentials that skip this may look equivalent on paper, but the gap shows up on day one,” says Payne.
Common Misconceptions About Surgical Techs
There are a few common misconceptions among OR nurses about the role of surgical techs. One of the biggest is the belief that they just “pass instruments.”
“This could not be further from the truth,” says TC Parker. “Passing instruments is the visible tip of a much larger iceberg of knowledge, anticipation and technical mastery.”
Another misconception is that surgical techs are interchangeable.
“In reality, specialties such as orthopedics, neurosurgery, cardiovascular surgery and robotics require years of focused practice,” says TC Parker. “A technologist who excels in total joints may not be immediately prepared for a complex craniotomy or a robotic prostatectomy.”
The Skills That Define a Great Surgical Tech
Beyond content knowledge, Payne believes that the most important qualities for surgical techs are anticipation and composure. “A surgical technologist who can read a procedure in real time, stay three steps ahead of the surgeon and respond calmly to the unexpected is invaluable,” she says.
Gregus believes that situational awareness and anticipation are what separate a good surgical tech from a great one. “Surgical techs should be two steps ahead rather than reactive,” he says. “Communication skills matter more than most people expect, both with the surgeon (often nonverbal) and the rest of the team.”
Kristen Parker agrees.
“Communication is one of the most underappreciated competencies in the operating room. Surgical technologists work closely with multidisciplinary teams in high-stakes situations where communication breakdowns can have significant consequences. They must be confident in speaking up when concerns arise and skilled in providing and receiving feedback,” she says.
Kunath points to adaptability, humility and quick pattern recognition as key attributes for surgical techs. “Anyone with OR experience has something unique to teach and a successful tech should be able to notice and incorporate good practices from others,” he says.
TC Parker has been training surgical techs for 30 years. She lists the following attributes as the biggest keys to a surgical tech’s success:
- Procedural anticipation, or the ability to know the next step before the surgeon verbalizes it.
- Technical fluency with instruments, robotics, energy devices and specialty equipment.
- Uncompromising sterile technique with zero tolerance for breaks in asepsis.
- Strong communication, especially under pressure.
- Adaptability because no two surgeries or surgeons are alike.
- Emotional resilience in a fast‑paced, high‑stakes environment.
“These skills cannot be memorized,” says TC Parker. “They must be cultivated through experience, mentorship and reflection.”
The Surgical Tech of Tomorrow
The surgical technologist role is poised to evolve as technology continues to revolutionize the operating room. “Robotic and minimally invasive surgery continue to expand and surgical technologists are already adapting to manage robotic systems, laparoscopic towers and complex energy platforms at the sterile field,” says Payne.
Kunath concurs.
“I’ve seen a greater emphasis placed on robotics and developments in minimally invasive surgeries, so I expect that surgical techs will need to become familiar with a far greater range of robotic and endoscopic platforms. This emphasis on robotics will likely be accompanied by an expansion of the surgical tech’s role,” Kunath says.
“The surgical tech’s role is increasingly intersecting with technology,” says Gregus. “Robotic-assisted surgery, advanced imaging integration and increasingly complex single-use and reusable device systems all require techs to be comfortable learning new equipment quickly and continuously.
“Also, as surgical volume shifts toward outpatient and ambulatory settings, surgical techs may need to be more cross-trained across specialties and more adaptable to smaller-team environments,” Gregus adds.
With continuing advancements in surgical techniques, digital technologies and artificial intelligence, Kristen Parker believes surgical techs must be comfortable learning new equipment, adapting to new workflows and supporting increasingly complex procedures. “Lifelong learning and a willingness to embrace change will be essential for future success in the profession,” she says.
“The surgical technologist’s role is expanding rapidly as robotics, hybrid ORs and advanced imaging are transforming the landscape,” says TC Parker. “Tomorrow’s technologists will need deeper technical expertise, stronger critical‑thinking skills and greater comfort with digital systems.”
TC Parker also sees increased opportunities for surgical techs to advance into roles such as surgical first assistants, sterile processing leaders, educators and clinical coordinators. “The profession is moving toward higher standards, greater autonomy and broader recognition,” she says.
Kunath says he often hears people worrying about the future and its implications for their jobs. “But I’m not worried about the future of the OR,” he says. “The surgical tech of tomorrow might be different, but a different endoscope doesn’t mean the end of a profession. Surgical techs have always been highly adaptable.”
A Hybrid Clinical-Technical Role
Gregus believes the future surgical tech role will be more of a hybrid clinical-technical professional. “This will require individuals who are comfortable with both traditional sterile technique and emerging surgical technology while still being grounded in the fundamentals that have always defined the role: anticipation, integrity and an unwavering commitment to patient safety,” he says.
What would experienced surgical technologists say to someone who is considering entering the field? “If you’re a fast learner and like to be in the action, then go for it,” says Kunath. “At best, you’ll fall in love with it. At the very least, you’ll have learned or seen something you never could have otherwise.”
“This is a career where the learning never really stops, which is part of what makes it rewarding,” says Gregus. “Every day, you’re part of something that genuinely changes a patient’s life. If you thrive on being part of a high-functioning team and enjoy hands-on, technical work with real purpose behind it, there’s nothing quite like it.”
“If you’re drawn to hands‑on work, thrive under pressure and want a career where your actions directly impact patients’ lives, surgical technology may be your calling,” says TC Parker. “It’s demanding, but profoundly rewarding. You will witness life‑changing moments, contribute to healing and become part of a team that performs miracles every day.”
Kristen Parker believes that the future of the surgical technology profession is bright. “The surgical tech’s impact on surgical care will only continue to grow,” she says.
Whether at a traditional sterile field or alongside a surgical robot, the surgical technologist career is being redefined by the very technologies transforming the operating room. Yet the fundamentals its practitioners keep returning to — anticipation, sterile integrity and an unwavering focus on the patient — are exactly what will carry the profession into its next chapter.
