Kitty Y Wu1, Stephanie Kim2, Kevin Fung3, Kathryn Roth3. 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, 128:2301-2306, 2018.
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, 128:2301-2306, 2018.
Authors: Axel Sahovaler; David E Eibling; Ida Bruni; Uma Duvvuri; S Danielle MacNeil; Anthony C Nichols; John Yoo; Kevin Fung; Kathryn Roth Journal: J Robot Surg Date: 2019-01-23
Authors: Babak Givi; Michael G Moore; Arnaud F Bewley; Charles S Coffey; Marc A Cohen; Amy C Hessel; Scharukh Jalisi; Steven Kang; Jason G Newman; Liana Puscas; Maisie Shindo; Andrew Shuman; Punam Thakkar; Donald T Weed; Ara Chalian Journal: Head Neck Date: 2020-05-08 Impact factor: 3.147