Nontechnical Skills in Neurosurgery: A Systematic Review of the Literature

Abstract

BackgroundUndesirable events in the neurosurgery operating theatre are surprisingly less often the result of a technical error than of a dysfunction linked to non-technical skills (NTS). The essential aim of our study was a systematic literature study published on NTS in neurosurgery. The secondary objective was identification of a list of NTS more specific to neurosurgery in order to define on that basis the training needs of neurosurgery trainees. Methods MEDLINE andThe Cochrane Database of Systematic Reviews were searched according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement.Research initially identified 2132 articles. 21 were eligible for systematic study. Data were extracted from the articles regarding study design, sample size, NTS assessed, assessment tools and the key results were collected. ResultsInterpersonal skills (communication, teamwork), cognitive skills (decision making, situation awareness) and personal resource factors (coping with stress or fatigue) were specifically identified. No article used assessment tools such as NOTECHS, NOTSS or OTAS. They were carried out in a real environment in 11 cases, in a simulated environment in 9 cases and during theoretical teaching in 1 case. ConclusionsVery few studies have been carried out concerning neurosurgical NTS, despite increasing numbers of articles over the last few years on NTS in other domains of surgery. Society today is concentrating more and more on the quality and safety of medical care. The development and 14-15Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. FUNDINGFunding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

Reporting of patient safety incidents in minimally invasive thoracic surgery: a national registered thoracic surgeons experience for improvement of patient safety

“…The term ‘human factors’ is used to describe interactions between individuals at work, the task at hand and the workplace itself. Including physical and psychological behaviour in a specific environment, some authors highlight that human factors are the main cause of PSI, representing up to 70% of events [ 19 , 20 ]. The opportunity to learn from error represents a valuable source of information that can be used to teach surgical decision-making, risk management, error recovery mechanisms and team training.…”

Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature

“…For more information, see https://creativecommons.org/licenses/by/4.0/ surgeons efficiently control their brain activation under stress while young trainees tend to use beta-blockers to overcome anxiety [22], [23]. Therefore, studies focusing on quality and safety as two main markers of surgical procedures address the need for improvement of technical and non-technical skills [24], [25], identification of stress factors, assessment of acute stress, and implementation of stress-coping strategies using, for example, closed-loop human-computer systems for simulating surgical situations [26], [27] and technology-assisted meditation/relaxation [28], [29].…”

“…Timeliness of a New Systematic Review. Among the growing pool of systematic reviews on intraoperative nontechnical skills [25] and states such as fatigue [57] and workload [17], and effects of distractions [58] and music [59] on surgical performance, we identified four major reviews related to our scope on intraoperative assessment of acute mental stress and workload. In two 2006 and 2010 systematic reviews of morbidity syndromes in minimal access surgery [31] and effects of stress on performance [30], adopted stress measures included questionnaires, electrocardiogram (ECG), heart rate (HR), heart rate variability (HRV), skin conductance level (SCL), electromyogram (EMG), electrooculogram (EOG), salivary cortisol, performance scores, and communication frequencies.…”

Non-technical skills and otolaryngology: systematic review

“…5,11,12 Research into the assessment and training of non-technical skills has developed in other surgical specialties, including orthopaedics, urology, cardiothoracic and neurosurgery. 13–16…”