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Observational Study
. 2021 Jun;39(6):2231-2237.
doi: 10.1007/s00345-020-03406-6. Epub 2020 Aug 18.

Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale

Abdullatif Aydın #  1 , Cora M Griffin #  2 , Oliver Brunckhorst  2 , Ahmed Al-Jabir  2 , Nicholas Raison  2 , Haleema Aya  2 , Craig McIlhenny  3 , James Brewin  4 , Majid Shabbir  2   5 , Joan Palou Redorta  6   7 , Muhammad Shamim Khan  2   5 , Prokar Dasgupta  2   5 , Kamran Ahmed  2   8
Affiliations
Observational Study

Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale

Abdullatif Aydın et al. World J Urol. 2021 Jun.

Abstract

Objective: In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale.

Methods: This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed.

Results: 62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability.

Conclusions: The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.

Keywords: NOTSS; NoTSUS; Non-technical skills; Simulation; Urology.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
A view from training sessions within the Full Immersion Simulation ‘Igloo’ environment
Fig. 2
Fig. 2
Correlation between the Non-technical Skills for Surgeons (NoTSS) and Non-technical Skills for Urological Surgeons (NoTSUS) scales amongst both raters A and B
Fig. 3
Fig. 3
Inter-rater reliability of all NoTSUS domains and total between the two expert raters
Fig. 4
Fig. 4
Improvement in mean NoTSUS scores over consecutive scenarios (p = 0.02)
Fig. 5
Fig. 5
Post-training evaluation survey of educational value (Likert scale 1–5)
See this image and copyright information in PMC

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