Surgeons’ Non-technical Skills

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Behavioral marker systems

Behavioral marker systems such as NOTECHS are methods to identify behaviors that contribute to superior or substandard performance based on a taxonomy of skills. A rating scale is also used in conjunction with the taxonomy. These marker systems are context-specific and must be developed for the situation in which they are to be used. For example, the NOTECHS system was developed and evaluated with subject matter experts from civil aviation.16 If a high level of validity is required, it is no

The NOTSS project

Just as the behavioral marker system for pilots13 was systematically developed and subjected to experimental and practical evaluation for the aviation industry, a similar technique was used in the NOTSS project to develop a skills taxonomy for surgeons. The project was run by the University of Aberdeen, with a multidisciplinary steering group of surgeons, psychologists, and an anesthetist. The research drew on previous work in Scotland on surgical competence, professionalism, and the skills

Breaking down NOTSS

The next sections discuss the 4 NOTSS categories (SA, decision making, communication and teamwork, and leadership), some of the problems associated with carrying them out correctly, and various solutions.

Summary

The appreciation of the importance of non-technical skills to surgical performance is now gaining wider acceptance. This article describes the core cognitive and social skill categories in this area. Several tools have been developed to rate these non-technical skills in the OR, focusing on observational methods as a means of assessment. These tools are being used informally by research groups and interested clinicians, but if the increase of non-technical skills appreciation in surgery mirrors

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