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Br J Surg. 2017 May;104(6):777-785. doi: 10.1002/bjs.10493. Epub 2017 Mar 13.

Non-technical skills of surgical trainees and experienced surgeons.

Author information

1
Division of Surgery, University of Adelaide, Queen Elizabeth Hospital, Woodville, Australia.
2
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, Australia.
3
Westwood-Thomas Associates, Norton Summit, South Australia, Australia.
4
Statistical Process Improvement Consulting and Training, Gumeracha, South Australia, Australia.

Abstract

BACKGROUND:

In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees.

METHODS:

Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared.

RESULTS:

For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year).

CONCLUSION:

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.

PMID:
28295215
DOI:
10.1002/bjs.10493
[Indexed for MEDLINE]

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