Shabnam Undre1,2, Maria Koutantji3, Nick Sevdalis3, Sanjay Gautama3, Nowlan Selvapatt3, Samantha Williams3, Parvinderpal Sains3, Peter McCulloch3, Ara Darzi3, Charles Vincent3. 1. Department of Bio-Surgery and Surgical Technology, Imperial College and St, Mary's Hospital, 10th floor QEQM building, Praed Street, London, W2 1NY, United Kingdom. s.undre@imperial.ac.uk. 2. Department of Anaesthesia, St. Mary's Hospital, London, W2 1NY, United Kingdom. s.undre@imperial.ac.uk. 3. Department of Bio-Surgery and Surgical Technology, Imperial College and St, Mary's Hospital, 10th floor QEQM building, Praed Street, London, W2 1NY, United Kingdom.
Abstract
BACKGROUND: High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. METHODS: Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. RESULTS: Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. CONCLUSIONS: Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.
BACKGROUND: High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. METHODS: Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. RESULTS: Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. CONCLUSIONS: Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.
Authors: Erika Palagonia; Elio Mazzone; Geert De Naeyer; Frederiek D'Hondt; Justin Collins; Pawel Wisz; Fijs W B Van Leeuwen; Henk Van Der Poel; Peter Schatteman; Alexandre Mottrie; Paolo Dell'Oglio Journal: World J Urol Date: 2019-08-19 Impact factor: 4.226
Authors: Helen W L Wong; Damien Forrest; Andrew Healey; Hanieh Shirafkan; George B Hanna; Charles A Vincent; Nick Sevdalis Journal: Surg Endosc Date: 2010-12-07 Impact factor: 4.584
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