Non-technical skills: a review of training and evaluation in urology

Abstract

Purpose With non-technical skills (NTS) deficits being recognised as a major cause for error in surgery, there is an increasing interest in their training and evaluation. A growing number of training courses are emerging and some NTS curricula have also been created. Many different training methods are described in the literature but there is still uncertainty with regards to their optimum combination within a curriculum. Methods A literature review of the electronic database Medline was performed. All articles published before December 2018 were screened by abstract and included if deemed relevant by the author. The included articles' reference lists were also screened for further relevant studies. Results Simulation training is accepted as the most effective way to train NTS. Within simulation training, it is shown that the 'igloo' full immersion/distributed simulation environment is appropriate for teaching NTS in urological scenarios where a designated operating room or space is not available. The use of multiple settings, for example wards and clinics as well as the operating room, is advantageous, as is training in an interprofessional team. Classroom teaching also plays a role in NTS training as an adjunct to simulation, with evidence that it improves some parameters of NTS. All levels, including qualified surgeons, benefit from NTS training; however, adaptation to both trainee level and specialty is important. Although less time consuming, training juniors and seniors together mainly benefits juniors, and training NTS at the same time as technical skills detracts from the quality of teaching. Debriefing is an important part of training and should be well structured; there are many debriefing models in existence, allowing for choice of method based on examiner preference and participant demographic. Furthermore, examiners should be well briefed in their task and trained in NTS assessment. Conclusion To move forward, studies should combine tried and tested learning techniques into a curriculum covering all training levels, which should then be validated and followed up long term to ensure a positive impact on patient safety.

COVID-19 outbreak situation and its psychological impact among surgeons in training in France

“…Several options could help mitigating the negative effects of the current situation: webinar as well as e-learnings including practical surgical videos [4,5], could have the potential to create a supportive educational environment [6]. Updates on COVID-19 and guidelines on upper respiratory tract infections (URTI) should also be promoted by our institutions through webinar sessions, or even on social media [7].…”

COVID19 pandemic impacts on anxiety of French urologist in training: Outcomes from a national survey

“…On the other hand, it is urgently needed to provide courses on COVID 19 and on upper respiratory tract infec-tions (URTI) management among trainees. This should be performed and promoted by our scientific associations through e-learning and webinar [20][21][22] and could create a supportive educational environment [23].…”

Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale

“…Non-technical skills (NTS) are the cognitive and social abilities that complement a clinician's technical ability, comprising decision-making, leadership, team work, and situational awareness [1,2]. They are often grouped into social skills, cognitive skills, and personal resource factors.…”

“…A standardised and validated NTS training program is currently lacking in the literature for urologists to achieve better training [1,4,5]. With the hypothesis that a urologyfocused NTS training course would be well received and provide transferrable skills, the aims of this study are: (1) to develop a simulation-based NTS curriculum for the training and assessment of urological surgeons and (2) assess the validity and reliability evidence, as well as the educational impact, of the developed curriculum.…”

“…Improvement in mean NoTSUS scores over consecutive scenarios (p = 0.02) Post-training evaluation survey of educational value (Likert scale[1][2][3][4][5] …”