title: The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment.
abstract: OBJECTIVE
  Little integration of technical and nontechnical skills (e.g., situational awareness, communication, decision making, teamwork, and leadership) teaching exists within surgery. We therefore aimed to (1) evaluate the relationship between these 2 skill sets within a simulation-based environment and (2) assess if certain nontechnical skill components are of particular relevance to technical performance.
  
  
  METHODS
  A prospective analysis of data acquired from a comparative study of simulation vs nonsimulation training was conducted. Half of the participants underwent training of technical and nontechnical skills within ureteroscopy, with the remaining half undergoing no training. All were assessed within a full immersion environment against both technical (time to completion, Objective Structured Assessment of Technical Skills, and task-specific checklist scores) and nontechnical parameters (Nontechnical Skills for Surgeons [NOTSS] rating scale). The data of whole and individual cohorts were analyzed using Pearson correlation coefficient.
  
  
  METHODS
  The trial took place within the Simulation and Interactive Learning Centre at Guy's Hospital, London, UK.
  
  
  METHODS
  In total, 32 novice participants with no prior practical ureteroscopy experience were included within the data analysis.
  
  
  RESULTS
  A correlation was found within all outcome measures analyzed. For the whole cohort, a strong negative correlation was found between time to completion and NOTSS scores (r = -0.75, p < 0.001), with strong positive correlations identified when NOTSS scores were compared with Objective Structured Assessment of Technical Skills (r = 0.89, p < 0.001) and task-specific checklist scores (r = 0.91, p < 0.001). Similar results were observed when each cohort was analyzed separately. Finally, all individual nontechnical skill components demonstrated a strong correlation with all technical skill parameters, regardless of training.
  
  
  CONCLUSIONS
  A strong correlation between technical and nontechnical performance exists, which was demonstrated to be irrespective of training received. This may suggest an inherent link between skill sets. Furthermore, all nontechnical skill sets are important in technical performance. This supports the notion that both of these skills should be trained and assessed together within 1 curriculum.
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Brunckhorst
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Shahab
authors.initials: S
authors.lastname: Shahid
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Abdullatif
authors.initials: A
authors.lastname: Aydin
authors.affiliation: Department of Urology, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom.
authors.forename: Shahid
authors.initials: S
authors.lastname: Khan
authors.affiliation: Forth Valley Royal Hospital, NHS Forth Valley, Larbet, United Kingdom.
authors.forename: Craig
authors.initials: C
authors.lastname: McIlhenny
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Brewin
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Arun
authors.initials: A
authors.lastname: Sahai
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bello
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom.
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shamim Khan
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom. Electronic address: kamran.ahmed@kcl.ac.uk.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D003657:Decision Making; D004521:Educational Measurement; D006801:Humans; D007857:Leadership; D008131:London; D010348:Patient Care Team; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D018666:Ureteroscopy / Q000193:education*
keywords: Interpersonal and Communication Skills; Patient Care; Practice-Based Learning and Improvement; nontechnical skills; simulation; surgical training; ureteroscopy; urology