A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre

Moorthy, Krishna; Munz, Yaron; Adams, Sally E.; Pandey, Vikas; Darzi, Ara

doi:10.1097/01.sla.0000186298.79308.a8

Cited by 226 publications

(147 citation statements)

References 22 publications

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“…NOTECHS showed superior statistical measures of inter‐rater reliability (ICC = 0·73–0·88)28, with relatively small ranges in the statistical measures of inter‐rater reliability, compared with OTAS (ICC = 0·42–0·90)40 and NOTSS (ICC = 0·12–0·83)47. Inter‐rater agreement was strong for NOTECHS (Rwg = 0·96)27, Simultaneous Observation of Distractions and Communication in the Operating Room (SO‐DIC‐OR) (κ = 0·74–0·90) and a study‐specific survey (κ = 0·77)50, but less strong for OTAS (κ > 0·40) and Mayo‐HPTS (κ > 0·46).…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the observational tools had been developed using theatre experts, or adapted from existing tools by theatre experts. Exceptions include the Mayo High Performance Teamwork Score (HPTS) and the Modified Human Factors Rating Scale (HFRS‐M), which comprised elements taken directly from crew resource management without translation44 47, 49, and the Cannon‐Bowers scale based on psychological theory46 48. NOTECHS has also been validated in vascular, orthopaedic and general surgery27 28, 31.…”

Section: Resultsmentioning

confidence: 99%

“…Common settings included: crew resource management43 47, 49, medical as opposed to surgical teams4 22, ICU and trauma24. Some authors1 5, 9 25, 42 used study‐specific tools without reporting processes of development and validation.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

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BackgroundTeamwork in the operating theatre is becoming increasingly recognized as a major factor in clinical outcomes. Many tools have been developed to measure teamwork. Most fall into two categories: self‐assessment by theatre staff and assessment by observers. A critical and comparative analysis of the validity and reliability of these tools is lacking.MethodsMEDLINE and Embase databases were searched following PRISMA guidelines. Content validity was assessed using measurements of inter‐rater agreement, predictive validity and multisite reliability, and interobserver reliability using statistical measures of inter‐rater agreement and reliability. Quantitative meta‐analysis was deemed unsuitable.ResultsForty‐eight articles were selected for final inclusion; self‐assessment tools were used in 18 and observational tools in 28, and there were two qualitative studies. Self‐assessment of teamwork by profession varied with the profession of the assessor. The most robust self‐assessment tool was the Safety Attitudes Questionnaire (SAQ), although this failed to demonstrate multisite reliability. The most robust observational tool was the Non‐Technical Skills (NOTECHS) system, which demonstrated both test–retest reliability (P > 0·09) and interobserver reliability (Rwg = 0·96).ConclusionSelf‐assessment of teamwork by the theatre team was influenced by professional differences. Observational tools, when used by trained observers, circumvented this.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

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“…The so-called "surgical robots" or otherwise called "computer-assisted telemanipulators" have been introduced to overcome these "limits" in the practice of surgery (Mirnezami et al, 2009;Weber et al, 2002;Cadiere et al, 2001;Garcıa-Ruiz et al, 1998;Lanfranco et al, 2004;Morino et al, 2006;Horgan et al, 2001;Hanly et al, 2004;Moorthy et al, 2005;Baik et al, 2008;Ballantyne et al, 2001). …”

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confidence: 99%

Minimally Invasive Robot – Assisted Colorectal Resections

D’Annibale¹,

Pernazza²,

Pende³

et al. 2012

Colorectal Cancer - From Prevention to Patient Care

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“…To both teach and assess non-technical and technical aspects of performance, virtual operating rooms have been developed. 4,[20][21][22] These rooms consist of an operating table, lights, suction equipment and an anesthesia machine. They contain a simulator (either synthetic or virtual reality) and a control room, which is separated from the operating room by a one-way mirror.…”

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confidence: 99%

Simulation in surgical education

Palter

Grantcharov²

2010

Canadian Medical Association Journal

121

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Key points• Both technical and non-technical skills are essential for surgeons in training.• Technical skills learned on low-fidelity benchtop models, video-based trainers and virtual-reality models are transferable to the operating room.• Current evidence does not show a clear advantage of either virtual reality or synthetic models in teaching technical skills.• Evidence is lacking on how best to integrate each type of simulator into a holistic, proficiency-based curriculum. Simulation in surgical educationVanessa N. Palter MD, Teodor P. Grantcharov MD PhDPreviously published at www.cmaj.caReview those used for teaching minimally invasive procedures (referred to as tower trainers or video-box trainers). Numerous benchtop models are available for the simulation of a variety of procedures, including knot-tying, fascial closure, and suturing 14 (Figure 1). The most obvious limitation of such models is that they teach only one surgical technique rather than an entire operation. 5 Their use requires the presence of an expert to demonstrate the procedure and provide feedback on performance. 1,5 Tower trainers include a box with slits on the superior surface for trocar insertion. Real laparoscopic instruments are inserted through the trocars into the box, where the procedure is simulated. A camera inside the box provides video output to a monitor on which trainees can watch their own movements. These models can simulate a variety of techniques, including laparoscopic suturing, knot-tying, clip-applying and coordination drills.14 One of the most well-described tower trainers is the physical laparoscopy trainer known as the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills. This system consists of five tasks performed on an endotrainer box. 16 The tasks include peg transfer, cutting, placing a ligating loop and intracorporeal suturing. Virtual-reality simulationTraining by virtual-reality simulation encompasses systems designed to teach laparoscopic, endoscopic and percutaneous interventions. 13 The fidelity of virtual-reality simulators ranges widely, from the Minimally Invasive Surgical Trainer -Virtual Reality (MIST-VR) system, which is a low-fidelity system designed to teach general laparoscopic proficiency, to systems that teach component procedural skills and other systems that replicate entire operations 17 ( Figure 2 and Videos 1 and 2, available at www .cmaj .ca /cgi /content /full /cmaj .091743 /DC1). Unlike bench-model learning, the presence of an expert is not necessary when virtual-reality simulation is used. Such models allow for practice at varying levels of difficulty, can simulate complications and automatically provide objective measures of assessment, allowing for both formative and summative trainee assessment.18 Virtual-reality models have been criticized, however, for high initial cost of system acquisition, limited force-feedback with use of surgical instruments and lack of realism of graphics. 14,19The virtual operating room Benchtop models, virtual-reality models, and an...

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A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre

Cited by 226 publications

References 22 publications

Systematic review of methods for quantifying teamwork in the operating theatre

Systematic review of methods for quantifying teamwork in the operating theatre

Minimally Invasive Robot – Assisted Colorectal Resections

Simulation in surgical education

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