Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises

Abstract

A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment.

Construct and criterion validity testing of the Non-Technical Skills for Surgeons (NOTSS) behaviour assessment tool using videos of simulated operations

“…This study was conducted using simulated videos of general and cardiothoracic surgery, which, although realistic and standardized, are not real operative events. Recent analyses have demonstrated that NOTSS can predict improved performance in simulated surgical crises and the modality of simulation continues to be of interest for researchers to test patient safety innovations before implementation in the real clinical environment. The videos were scripted to show the full range of behaviours, modelled from clinical events, but a limitation of using a single video per group is that participants may have found it too easy or difficult to rate.…”

“…However, despite being the most used tool for assessment of surgeons' non‐technical skills and substantial reliability testing in different contexts around the world, validity evidence for the underpinning skills taxonomy is limited to studies conducted to develop the tool. Two recent studies utilizing NOTSS have demonstrated that the tool can be used by surgical assessors to detect incremental improvements in behaviour, and to predict effective crisis resolution during simulated surgical emergencies. Adapted versions for surgery in different contexts have been developed.…”

Observational Tools That Quantify Nontechnical Skills in the Operating Room: A Systematic Review

“…Most frequently, two observers collected data (n ¼ 7). [40][41][42]44,48,49,55 Fourteen studies involved an observer with a clinical background, 9,42,[44][45][46]48,50,[52][53][54][55][56][57][58] and eight studies involved a nonclinical observer. 41,42,44,45,[47][48][49][50] Fourteen of the 19 studies reported details of observer training.…”

“…41,42,44,45,[47][48][49][50] Fourteen of the 19 studies reported details of observer training. 9,41,42,[44][45][46][47][48]50,52,53,56,58 Validity and reliability. Validity for NOTSS was established by 13 studies (nine of which were conducted in a simulation environment).…”

Raising awareness of non-technical skills in operating theatres

“…Although action must be taken to educate and if possible rescue poor performers, they may sometimes need to be removed from the clinical frontline—often a difficult and painful process for everyone. Better understanding of appropriate non-technical skills makes such assessment easier, facilitates rescue in many cases,2 and is more overt for all concerned.…”