Reliability of a revised NOTECHS scale for use in surgical teams.
BACKGROUND
Recent developments in the surgical literature highlight the need for assessment of nontechnical skills in surgery. We report a revision of the NOn-TECHnical Skills (NOTECHS) scale of the aviation industry for use in surgery and detailed analysis on its reliability.


METHODS
The original NOTECHS scale assesses (1) Cooperation, (2) Leadership and Managerial Skills, (3) Situation Awareness and Vigilance, and (4) Decision Making. We added a Communication and Interaction dimension and adapted all subscales for use in surgical context. Reliability was assessed in simulation-based training for trainee clinicians.


RESULTS
Satisfactory reliability (Cronbach's alpha) was obtained (1) across professional groups and trainers and trainees, (2) in separate analyses for trainers and trainees, (3) in successive administrations of the scale, and (4) in surgical, anaesthetic and nursing groups analyzed separately. In the operating department practitioners group, Situation Awareness and Vigilance and Cooperation and Team Skills exhibited lower reliability.


CONCLUSIONS
Assessment of surgical nontechnical skills is becoming a training priority. The present evidence suggests that the revised NOTECHS scale exhibits good reliability. Further empirical research should assess the validity of the scale.
Sevdalis
Nick
N
Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK. n.sevdalis@imperial.ac.uk
Davis
Rachel
R
Koutantji
Mary
M
Undre
Shabnam
S
Darzi
Ara
A
Vincent
Charles A
CA
D002983:Clinical Competence; D003198:Computer Simulation; D013502:General Surgery / Q000193:education*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D015203:Reproducibility of Results