title: Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.
abstract: BACKGROUND
  The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment.
  
  
  METHODS
  The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system.
  
  
  RESULTS
  There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted.
  
  
  CONCLUSIONS
  This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training.
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia; Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Pena
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia.
authors.forename: Meryl
authors.initials: M
authors.lastname: Altree
authors.affiliation: John Field Consulting Pty Ltd, Adelaide, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Field
authors.affiliation: Women's and Children's Hospital, Adelaide, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Sainsbury
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia; Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Babidge
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Hewett
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia; Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia. Electronic address: guy.maddern@adelaide.edu.au.
authors.forename: Guy
authors.initials: G
authors.lastname: Maddern
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004493:Education; D005260:Female; D006801:Humans; D008297:Male; D009873:Operating Rooms / Q000592:standards*; D011446:Prospective Studies; D016037:Single-Blind Method