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Laryngoscope. 2018 Mar 24. doi: 10.1002/lary.27174. [Epub ahead of print]

Assessing nontechnical skills in otolaryngology emergencies through simulation-based training.

Author information

1
Division of Plastic and Reconstructive Surgery, Department of Surgery, London, Ontario, Canada.
2
Schulich School of Medicine and Dentistry, London, Ontario, Canada.
3
Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.

Abstract

OBJECTIVE:

Nontechnical skills (NTS) are essential to emergency crisis management. Due to the rarity of true emergencies, they are challenging to teach and assess within a competency-based curriculum. Our purpose is to evaluate the utility of the Non-Technical Skills in Surgery (NOTSS) scale in NTS assessment in simulated otolaryngology and head and neck surgery (OTO-HNS) emergencies and identify common challenges that residents encounter.

METHODS:

Mixed methods analysis of 15 junior OTO-HNS resident teams in four simulated emergency scenarios. Six raters rated resident NTS performance using the NOTSS score. Constructivist-grounded theory was used to analyze scenario video transcripts to identify areas of learner difficulty to guide future simulation development.

RESULTS:

Residents scored highest in situational awareness and lowest in leadership domains. Raters showed good consistency and reliability overall (Cronbach's alpha = 0.885). There was no statistical difference in ratings between surgical experts and nonexperts. Qualitative analysis demonstrated challenges with closed-loop communication and handling transitions of leadership with the scenarios.

CONCLUSION:

Simulation-based training is an effective modality to teach NTS in crisis resource management. The NOTSS rating scale is a reliable instrument for assessing NTS in simulated OTO-HNS emergencies. Incorporating the NOTSS scale for NTS assessment within a competency-based curriculum is recommended.

LEVEL OF EVIDENCE:

NA Laryngoscope, 2018.

KEYWORDS:

Nontechnical skills; competency-based medical education; emergency management; otolaryngology; simulation-based training

PMID:
29573429
DOI:
10.1002/lary.27174

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