TY - JOUR
T1 - The impact of nontechnical skills on technical performance in surgery
T2 - a systematic review
AU - Hull, Louise
AU - Arora, Sonal
AU - Aggarwal, Rajesh
AU - Darzi, Ara
AU - Vincent, Charles
AU - Sevdalis, Nick
N1 - Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2012/2
Y1 - 2012/2
N2 - BACKGROUND: Failures in nontechnical and teamwork skills frequently lie at the heart of harm and near-misses in the operating room (OR). The purpose of this systematic review was to assess the impact of nontechnical skills on technical performance in surgery.STUDY DESIGN: MEDLINE, EMBASE, PsycINFO databases were searched, and 2,041 articles were identified. After limits were applied, 341 articles were retrieved for evaluation. Of these, 28 articles were accepted for this review. Data were extracted from the articles regarding sample population, study design and setting, measures of nontechnical skills and technical performance, study findings, and limitations.RESULTS: Of the 28 articles that met inclusion criteria, 21 articles assessed the impact of surgeons' nontechnical skills on their technical performance. The evidence suggests that receiving feedback and effectively coping with stressful events in the OR has a beneficial impact on certain aspects of technical performance. Conversely, increased levels of fatigue are associated with detriments to surgical skill. One article assessed the impact of anesthesiologists' nontechnical skills on anesthetic technical performance, finding a strong positive correlation between the 2 skill sets. Finally, 6 articles assessed the impact of multiple nontechnical skills of the entire OR team on surgical performance. A strong relationship between teamwork failure and technical error was empirically demonstrated in these studies.CONCLUSIONS: Evidence suggests that certain nontechnical aspects of performance can enhance or, if lacking, contribute to deterioration of surgeons' technical performance. The precise extent of this effect remains to be elucidated.
AB - BACKGROUND: Failures in nontechnical and teamwork skills frequently lie at the heart of harm and near-misses in the operating room (OR). The purpose of this systematic review was to assess the impact of nontechnical skills on technical performance in surgery.STUDY DESIGN: MEDLINE, EMBASE, PsycINFO databases were searched, and 2,041 articles were identified. After limits were applied, 341 articles were retrieved for evaluation. Of these, 28 articles were accepted for this review. Data were extracted from the articles regarding sample population, study design and setting, measures of nontechnical skills and technical performance, study findings, and limitations.RESULTS: Of the 28 articles that met inclusion criteria, 21 articles assessed the impact of surgeons' nontechnical skills on their technical performance. The evidence suggests that receiving feedback and effectively coping with stressful events in the OR has a beneficial impact on certain aspects of technical performance. Conversely, increased levels of fatigue are associated with detriments to surgical skill. One article assessed the impact of anesthesiologists' nontechnical skills on anesthetic technical performance, finding a strong positive correlation between the 2 skill sets. Finally, 6 articles assessed the impact of multiple nontechnical skills of the entire OR team on surgical performance. A strong relationship between teamwork failure and technical error was empirically demonstrated in these studies.CONCLUSIONS: Evidence suggests that certain nontechnical aspects of performance can enhance or, if lacking, contribute to deterioration of surgeons' technical performance. The precise extent of this effect remains to be elucidated.
KW - Adaptation, Psychological
KW - Humans
KW - Outcome Assessment (Health Care)
KW - Patient Care Team
KW - Professional Competence
KW - Quality of Health Care
KW - Surgical Procedures, Operative
U2 - 10.1016/j.jamcollsurg.2011.10.016
DO - 10.1016/j.jamcollsurg.2011.10.016
M3 - Article
C2 - 22200377
SN - 1072-7515
VL - 214
SP - 214
EP - 230
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 2
ER -