BACKGROUND: Failures in nontechnical and teamwork skills frequently lie at the heart of harm and near-misses in the operating room (OR). The purpose of this systematic review was to assess the impact of nontechnical skills on technical performance in surgery. STUDY DESIGN: MEDLINE, EMBASE, PsycINFO databases were searched, and 2,041 articles were identified. After limits were applied, 341 articles were retrieved for evaluation. Of these, 28 articles were accepted for this review. Data were extracted from the articles regarding sample population, study design and setting, measures of nontechnical skills and technical performance, study findings, and limitations. RESULTS: Of the 28 articles that met inclusion criteria, 21 articles assessed the impact of surgeons' nontechnical skills on their technical performance. The evidence suggests that receiving feedback and effectively coping with stressful events in the OR has a beneficial impact on certain aspects of technical performance. Conversely, increased levels of fatigue are associated with detriments to surgical skill. One article assessed the impact of anesthesiologists' nontechnical skills on anesthetic technical performance, finding a strong positive correlation between the 2 skill sets. Finally, 6 articles assessed the impact of multiple nontechnical skills of the entire OR team on surgical performance. A strong relationship between teamwork failure and technical error was empirically demonstrated in these studies. CONCLUSIONS: Evidence suggests that certain nontechnical aspects of performance can enhance or, if lacking, contribute to deterioration of surgeons' technical performance. The precise extent of this effect remains to be elucidated.
BACKGROUND: Failures in nontechnical and teamwork skills frequently lie at the heart of harm and near-misses in the operating room (OR). The purpose of this systematic review was to assess the impact of nontechnical skills on technical performance in surgery. STUDY DESIGN: MEDLINE, EMBASE, PsycINFO databases were searched, and 2,041 articles were identified. After limits were applied, 341 articles were retrieved for evaluation. Of these, 28 articles were accepted for this review. Data were extracted from the articles regarding sample population, study design and setting, measures of nontechnical skills and technical performance, study findings, and limitations. RESULTS: Of the 28 articles that met inclusion criteria, 21 articles assessed the impact of surgeons' nontechnical skills on their technical performance. The evidence suggests that receiving feedback and effectively coping with stressful events in the OR has a beneficial impact on certain aspects of technical performance. Conversely, increased levels of fatigue are associated with detriments to surgical skill. One article assessed the impact of anesthesiologists' nontechnical skills on anesthetic technical performance, finding a strong positive correlation between the 2 skill sets. Finally, 6 articles assessed the impact of multiple nontechnical skills of the entire OR team on surgical performance. A strong relationship between teamwork failure and technical error was empirically demonstrated in these studies. CONCLUSIONS: Evidence suggests that certain nontechnical aspects of performance can enhance or, if lacking, contribute to deterioration of surgeons' technical performance. The precise extent of this effect remains to be elucidated.
Authors: Susannah M Wyles; Danilo Miskovic; Zhifang Ni; Ara W Darzi; Roland M Valori; Mark G Coleman; George B Hanna Journal: Surg Endosc Date: 2015-06-24 Impact factor: 4.584
Authors: Anna H de Vries; Arno M M Muijtjens; Hilde G J van Genugten; Ad J M Hendrikx; Evert L Koldewijn; Barbara M A Schout; Cees P M van der Vleuten; Cordula Wagner; Irene M Tjiam; Jeroen J G van Merriënboer Journal: Surg Endosc Date: 2018-06-05 Impact factor: 4.584
Authors: Anthony Manuguerra; Charles Mazeaud; Nicolas Hubert; Pascal Eschwège; Mathieu Roumiguié; Julia Salleron; Jacques Hubert Journal: Surg Endosc Date: 2020-09-23 Impact factor: 4.584
Authors: Elisa M Müller; Eva Herrmann; Thomas Schmandra; Thomas F Weigel; Ernst Hanisch; Alexander Buia Journal: World J Surg Date: 2020-06 Impact factor: 3.352
Authors: Daniel A Hashimoto; Ernest D Gomez; Laura Beyer-Berjot; Ankur Khajuria; Noel N Williams; Ara Darzi; Rajesh Aggarwal Journal: J Surg Educ Date: 2015-07-11 Impact factor: 2.891