• Kirsten Gjeraa, Peter Dieckmann, Lene Spanager, René H Petersen, Doris Østergaard, Yoon S Park, and Lars Konge.
• Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark. Electronic address: kirsten.gjeraa@regionh.dk.
• Ann. Thorac. Surg. 2019 Mar 1; 107 (3): 954-961.

BackgroundNontechnical skills are important for safe and efficient surgery. Teams performing video-assisted thoracoscopic surgery (VATS) lobectomy express that it is of utmost importance to have a shared mental model (SMM) of the patient, current situation, and team resources. However, these SMMs have never been explored in a clinical setting. The aim of this observational study was to measure the similarity of SMMs within teams performing VATS lobectomy.MethodsIn this national, multicenter study, SMMs of teams performing VATS lobectomy (n = 64) were measured by preoperative and postoperative questionnaires that were completed by all team members (n = 172). Participants' responses were compared within each team to explore SMMs of risk assessment, familiarity, technical skills, nontechnical skills, and problems.ResultsAnalysis showed poor agreement between team members with respect to risk assessment, but higher levels of agreement were found for assessments of familiarity, technical skills, and nontechnical skills within the team (Cronbach's alpha = 0.90), most notably for surgical subteams (ie, surgeon plus assistant surgeon plus surgical nurses). During the surgical procedure, the most frequent problems were related to anesthesia, and these were most often recognized by the surgeons. The operating room nurses were the least aware of each other's and the surgeons' problems.ConclusionsSignificant variation exists in the SMMs among VATS team members, with poor agreement regarding the patient and current situation, but better agreement with respect to team resources. Focus on preoperative and perioperative team reflexivity, in addition to explicit communication within unfamiliar teams, may provide opportunities to enhance SMMs, with possible downstream effects on team performance.Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

This article appears in the collection: Decision Making in Anaesthesia & Critical Care.

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