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

Abstract

Objective In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale. Methods This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A posttraining evaluation survey was distributed. Results 62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability. Conclusions The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.

Simulation-based education in urology – an update

“…93 However, the Non-Technical Skills for Urological Surgeons (NoTSUS) has been an effort to develop a standardized curriculum and assessment scale in this area. 94 This programme, adapted from the Non-technical Skills for Surgeons programme, involves using fully immersive simulation scenarios to train the non-technical skills of urology trainees. The NoTSUS scale was validated in this programme as a reliable assessment of non-technical skills, assessing participants across five domains: communication and team skills, management skills, decision-making, situational awareness and resource skills.…”

The Use of Formative Assessment in Postgraduate Urology Training: A Systematic Review

“…The studies included in this review looked at the training program from varying perspectives. The majority were conducted from the point of view of the trainees, but studies by Sebesta et al [ 19 ], Fitzpatrick et al [ 20 ], Aydin et al [ 21 ], and Sibert et al [ 22 ] considered the faculty perspective, while de Vries et al [ 23 ] and Alkhayal et al [ 24 ] included program directors. The number of participants varies between the studies.…”

“…Lastly, in their article, Aydin et al [ 21 ] described the NoTSUS (nontechnical skills for urological surgeons). These "encounters" chiefly involved two-hour training blocks, followed by a feedback session focused on, as the name suggests, the nontechnical aspects of training.…”

“…Some of the more popular ones include NoTSS (nontechnical skills for surgeons), NoTECHS (nontechnical skills), and OSATS [ 35 ]. In this review, a tool called NoTSUS was identified, which is essentially a more urology-specified adaptation of the NoTSS scale [ 21 ].…”

Editorial Commentary: Simulation-Based Training in Orthopaedic Surgery: Current Evidence and Limitations

“…NTS training must include sufficient debriefing as well as feedback, which has shown clear benefits. 20 Surgical simulation is an ever-growing field with an exciting future. New developments in technology such as 3-dimensional printing and augmented reality will inevitably lead to greater adoption of SBT.…”