gms | German Medical Science

14. Internationales SkillsLab Symposium 2019

29.03. - 30.03.2019, Brandenburg an der Havel/Neuruppin

NoTSS – Non-Technical Skills for Surgeons, and how to debrief. A workshop

Meeting Abstract

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14. Internationales SkillsLab Symposium 2019. Brandenburg (Havel)/Neuruppin, 29.-30.03.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocWS02-05

doi: 10.3205/19isls029, urn:nbn:de:0183-19isls0291

Veröffentlicht: 25. März 2019

© 2019 Walker.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: In meta-analyses, about 15% of hospital in-patients come to some form of unintended harm (50% of surgical). The causes of adverse events are more often rooted in non-technical (cognitive and social) skills (NTS), than in a failure of technical ability. In previous decades we have lacked an evidence-based framework and language to discuss and assess non-technical skills in surgery. Therefore the Royal College of Surgeons of Edinburgh (RCSEd) collaborated with the Industrial Psychology unit of Aberdeen University to analyse adverse and non-adverse episodes in the operating theatre, producing the “NoTTS taxonomy” (Non-Technical Skills for Surgeons). This details the cognitive and social skills required to optimise surgical performance, within 4 categories – situation awareness, decision-making, communication & teamwork, and leadership. This is now taugfht in 5 continents and has been adopted into surgical training and assessment in the UK, US and Australia.

Materials and methods: This workshop will be preceded by a keynote lecture exploring the science of non-technical skills, using aviation and surgical examples to explain common errors and biases that occur, as well as giving tools, tips and tricks for avoiding these.

In the workshop, there will be whole-room work and groupwork. For each of the four categories, Prof Walker will fist recap and take questions from the whole room, then play a video scenario of an operating room episode (from the RCSEd’s “NoTSS Masterclass” material). In small groups, participants will discuss the behaviours and how they would rate these using the NoTTS taxonomy.

Finally, we will discuss giving feedback and debrief in NTS, using “debrief with integrity”, and teaching NTS in simulation. He will use the Scottish Surgical Boot Camp experience as a worked example.

Learning Outcomes:

By the end of the keynote lecture and workshop, participants will be able to:

1.
describe the NoTTS taxonomy and list common types of error and bias that result in risk to patients;
2.
begin to use the NoTSS taxonomy to assess a surgeon’s non-technical skills in the operating theatre;
3.
describe “debrief with integrity”.

Some participants will be able to undertake debrief a trainee after an operating room or ward round simulation.

Conclusion: This is an abstract with a view to a workshop, as described.


References

1.
Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons' non-technical skills. Med Educ. 2006;40(11):1098-1104. DOI: 10.1111/j.1365-2929.2006.02610.x Externer Link
2.
Yule S, Flin R, Maran N, Rowley DR, Youngson GG, Paterson-Brown S. Surgeons' non-technical skills in the operating room: Reliability testing of the NOTSS behaviour rating system. World J Surg. 2008;32(4):548-556. DOI: 10.1007/s00268-007-9320-z Externer Link
3.
Crossley J, Marriott J, Purdie H, Beard JD. Prospective observational study to evaluate NOTSS (Non-Technical Skills for Surgeons) for assessing trainees' non-technical performance in the operating theatre. Br J Surg. 2011;98(7):1010-1020. DOI: 10.1002/bjs.7478 Externer Link