Non-technical skills of surgical trainees and experienced surgeons

Abstract

The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience.

Surgical safety checklist training: a national study of undergraduate medical and nursing student teaching, understanding and influencing factors

“…One study suggested that adequate patient safety education could equip qualifying healthcare professionals with the same safety skillset as their seniors 42. Another recent study evaluating the non-technical skills of surgeons at various levels of training concluded that these skills peak around fellowship and then decline with years postfellowship experience, highlighting the importance of interventions that facilitate continued professional development 43. Undergraduates have proven to be valuable team members in error prevention44 and are well placed to spread patient safety culture throughout training rotations; students have not developed their own routine practice and often engage with initiatives through social media and technological advancements 45…”

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

“…Studies which do follow up participants show NTS retention for at least 2 months in current training programmes, in which some claiming trainees are still benefitting at 6 months, but others note that there is no significant difference between the NoTSS scores of surgeons who have previously undertaken NTS training versus those who have not. These studies often employ a second simulation session to record improvement and do not look at real performance in the OR [23,26,35]. The longer-term effects of any courses are yet to be shown, but repeat training is necessary to maintain skills after they are learnt initially and make sure they translate to practice [35].…”

“…These studies often employ a second simulation session to record improvement and do not look at real performance in the OR [23,26,35]. The longer-term effects of any courses are yet to be shown, but repeat training is necessary to maintain skills after they are learnt initially and make sure they translate to practice [35]. This poses two unanswered questions: how frequent should NTS training be and how should 'refresher' courses be structured [23,26]?…”

“…To aid assessment, a 'talk-aloud' protocol can be adopted where participants narrate their considerations and decisions throughout the simulation [39]. Assessors are also able to take NoTSS as an independent course for training in scoring participants [35]. Both these elements can make assessment fairer and help standardise it.…”

“…It is widely accepted that the main opportunity for long-lasting and deep learning of NTS takes place during debriefing after simulation [40]. A structured debriefing session with a skilled facilitator is thought to be vital for the acquisition of NTS, as it encourages self-reflection [10,35]. Debriefing after real events is also beneficial but should be structured differently [41].…”