Michael Pfandler1, Philipp Stefan2, Christoph Mehren3, Marc Lazarovici4, Matthias Weigl4. 1. Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilians University, Munich, Germany. 2. Chair for Computer Aided Medical Procedures & Augmented Reality, Department of Informatics/I-16, Technical University of Munich, Munich, Germany. 3. Spine Center Schön Clinic Munich Harlaching, Munich, Germany; Academic Teaching Hospital Paracelsus Medical University (PMU), Salzburg, Austria. 4. Institute for Emergency Medicine and Management in Medicine (INM), University Hospital, Ludwig Maximilians University, Munich, Germany.
Abstract
STUDY DESIGN: Observational simulation study. OBJECTIVE: The goal of this study was to investigate the relationship between technical and nontechnical skills (NTS) in a simulated surgical procedure. SUMMARY OF BACKGROUND DATA: Although surgeons' technical and NTS during surgery are crucial determinants for clinical outcomes, little literature is available in spine surgery. Moreover, evidence regarding how surgeons' technical and NTS are related is limited. METHODS: A mixed-reality and full-scale simulated operating room environment was employed for the surgical team. Eleven surgeons performed the vertebroplasty procedure (VP). Technical skills (TS) were assessed using Objective Structured Assessment of Technical Skill scores and senior expert-evaluated VP outcome assessment. NTS were assessed with the Observational Teamwork Assessment for Surgery. Kendall-Tau-b tests were performed for correlations. We further controlled the influence of surgeons' experience (based on professional tenure and number of previous VPs performed). RESULT: Surgeons' NTS correlated significantly with their technical performance (τ = 0.63; P = 0.006) and surgical outcome scores (τ = 0.60; P = 0.007). This association was attenuated when controlling for surgeons' experience. CONCLUSION: Our results suggest that spine surgeons with higher levels of TS also apply better communication, leadership, and coordination behaviors during the procedure. Yet, the role of surgeons' experience needs further investigation for improving surgeons' intraoperative performance during spine surgery. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Observational simulation study. OBJECTIVE: The goal of this study was to investigate the relationship between technical and nontechnical skills (NTS) in a simulated surgical procedure. SUMMARY OF BACKGROUND DATA: Although surgeons' technical and NTS during surgery are crucial determinants for clinical outcomes, little literature is available in spine surgery. Moreover, evidence regarding how surgeons' technical and NTS are related is limited. METHODS: A mixed-reality and full-scale simulated operating room environment was employed for the surgical team. Eleven surgeons performed the vertebroplasty procedure (VP). Technical skills (TS) were assessed using Objective Structured Assessment of Technical Skill scores and senior expert-evaluated VP outcome assessment. NTS were assessed with the Observational Teamwork Assessment for Surgery. Kendall-Tau-b tests were performed for correlations. We further controlled the influence of surgeons' experience (based on professional tenure and number of previous VPs performed). RESULT: Surgeons' NTS correlated significantly with their technical performance (τ = 0.63; P = 0.006) and surgical outcome scores (τ = 0.60; P = 0.007). This association was attenuated when controlling for surgeons' experience. CONCLUSION: Our results suggest that spine surgeons with higher levels of TS also apply better communication, leadership, and coordination behaviors during the procedure. Yet, the role of surgeons' experience needs further investigation for improving surgeons' intraoperative performance during spine surgery. LEVEL OF EVIDENCE: 3.
Authors: AlleaBelle Gongola; Jared T Gowen; Rebecca J Reif; Carol R Thrush; Hamilton Newhart; Molly Peckham; Zachary Schwartz; David Davies; Mary Katherine Kimbrough Journal: Med Sci Educ Date: 2021-06-21