Advances in Teaching and Assessing Nontechnical Skills - 24/07/15

Doi : 10.1016/j.suc.2015.04.003

Louise Hull, PhD ^a,^⁎ , Nick Sevdalis, PhD ^b
^a Department of Surgery and Cancer, Patient Safety Translational Research Center, St Mary’s Hospital, Imperial College London, Wright Fleming Building, Norfolk Place, London W2 1PG, UK
^b Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, PO29 David Goldberg Centre, De Crespigny Park, Denmark Hill, London SE5 8AF, UK

^∗Corresponding author.

Résumé

The importance of surgeons’ nontechnical skills is gaining widespread recognition as a critical element of high-quality and safe surgical care. This article reviews the knowledge base on training and assessing surgeons, and operating room (OR) teams, in nontechnical aspects of their performance. Nontechnical skills are defined in the context of the OR and key assessment instruments that have been developed to capture these skills are reviewed. Key developments that have taken place in the past decade on formal skills training are discussed, and recommendations to further advance nontechnical skills and team-based training and assessment in surgery are presented.

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Keywords : Nontechnical skills, Teamwork, Training, Education, Assessment

Plan

Key points

Introduction

Nontechnical skills in the operating room and perioperative care: what are they and how can they be evaluated?

The paradox of nontechnical skills: clinicians know what they are but assessing the quality of nontechnical performance is difficult

Faculty development: a cornerstone for meaningful nontechnical skills training and evaluation

Observational teamwork assessment for surgery faculty development workshop

Other faculty development programs: nontechnical skill for surgeons masterclass

Instructional strategies for training in nontechnical and teamwork skills: information, demonstration, and practice-based education and training

Information-based skills training

Critical Evaluation

Demonstration-based skills training

Critical Evaluation

Practice-based skills training

Critical Evaluation

Instructional strategies: is there a best approach?

Current practices in nontechnical and teamwork skills training: overview and case studies

Case study 1: The Royal College of Surgeons of Edinburgh training modules

Case study 2: justifying the cost of nontechnical skills and teamwork training: the Veterans’ Health Administration’s Medical Team Training program

The benefits of the training

Looking to the future: addressing the challenges and barriers in widespread, systematic nontechnical skills training

Barriers and Challenges

Facilitators and Opportunities

Summary

Funding: L. Hull is affiliated with the Imperial Patient Safety Translational Research Center; N. Sevdalis research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Conflicts of interest: L. Hull and N. Sevdalis provide team skills training and advice on a consultancy basis in the United Kingdom and internationally.