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Observational Study
. 2017 Jan 30;7(1):e014480.
doi: 10.1136/bmjopen-2016-014480.

Correlates of non-technical skills in surgery: a prospective study

Brigid M Gillespie  1   2   3 , Emma Harbeck  4 , Evelyn Kang  1 , Catherine Steel  5 , Nicole Fairweather  5 , Wendy Chaboyer  3
Affiliations
Observational Study

Correlates of non-technical skills in surgery: a prospective study

Brigid M Gillespie et al. BMJ Open. .

Abstract

Background: Communication and teamwork failures have frequently been identified as the root cause of adverse events and complications in surgery. Few studies have examined contextual factors that influence teams' non-technical skills (NTS) in surgery. The purpose of this prospective study was to identify and describe correlates of NTS.

Methods: We assessed NTS of teams and professional role at 2 hospitals using the revised 23-item Non-TECHnical Skills (NOTECHS) and its subscales (communication, situational awareness, team skills, leadership and decision-making). Over 6 months, 2 trained observers evaluated teams' NTS using a structured form. Interobserver agreement across hospitals ranged from 86% to 95%. Multiple regression models were developed to describe associations between operative time, team membership, miscommunications, interruptions, and total NOTECHS and subscale scores.

Results: We observed 161 surgical procedures across 8 teams. The total amount of explained variance in NOTECHS and its 5 subscales ranged from 14% (adjusted R2 0.12, p<0.001) to 24% (adjusted R2 0.22, p<0.001). In all models, inverse relationships between the total number of miscommunications and total number of interruptions and teams' NTS were observed.

Conclusions: Miscommunications and interruptions impact on team NTS performance.

Keywords: NOTECHS; interruptions; miscommunications; non-technical skills; surgical team; teamwork.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Total number of miscommunications across eight specialties. GI, gastrointestinal.
Figure 2
Figure 2
Total number of interruptions across eight specialties. GI, gastrointestinal.
See this image and copyright information in PMC

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