• Danish medical journal · Nov 2012

    Customization of a tool to assess Danish surgeons´ non-technical skills in the operating room.

    • Lene Spanager, Helle Teglgaard Lyk-Jensen, Peter Dieckmann, André Wettergren, Jacob Rosenberg, and Doris Ostergaard.
    • Dansk Institut for Medicinsk Simulation, Herlev Hospital, Herlev, Denmark. lene.spanager@regionh.dk
    • Dan Med J. 2012 Nov 1;59(11):A4526.

    IntroductionErrors in surgery often stem from failure related to non-technical skills such as communication and teamwork. Tools for training and assessment of non-technical skills are needed to ensure safe surgery. The aim of this study was to customize the Non-Technical Skills for Surgeons (NOTSS) rating system for Danish general surgeons.Material And MethodsEight group interviews were conducted at two hospitals with consultant general surgeons, trainee surgeons, scrub nurses and anaesthesia staff (n = 72). Interviews were transcribed and analysed by two coders identifying surgeons´ non-technical skills. Skills were sorted according to NOTSS and behavioural examples were written. The prototype of NOTSSdk was discussed with a panel of surgeons (n = 12) to ensure face validity.ResultsThe skills identified in a Danish context fitted NOTSS's four categories: situation awareness, decision making, leadership, communication and teamwork and the 12 underlying elements. Only one element was added to the NOTSSdk; "monitoring own performance." A total of 3-8 good and 3-6 poor behavioural examples were written for each element. Respecting team members, creating a good working atmosphere and discussing options in the surgical team were distinct themes.DiscussionThe tool, which was customized for Danish surgeons, comprises four categories, 13 elements and numerous behavioural examples. The distinct themes regarding respect, discussing options and creating a good working atmosphere are more prominent than in the Scottish NOTSS, which may be explained by cultural differences or the fact that the present study included the perspectives of the entire surgical team.ConclusionNOTSSdk holds potential as a tool for the guiding of assessment and feedback on surgeons´ non-technical performance.Fundingnot relevant.Trial RegistrationThe study was registered with clinicaltrials.gov (NCT01334411).

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