title: Training Tools for Nontechnical Skills for Surgeons-A Systematic Review.
abstract: OBJECTIVE
  Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools.
  
  
  METHODS
  A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria.
  
  
  METHODS
  Systematic review was performed fully at King's College London.
  
  
  RESULTS
  A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question.
  
  
  CONCLUSIONS
  Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program.
authors.affiliation: Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
authors.forename: Thomas Charles
authors.initials: TC
authors.lastname: Wood
authors.affiliation: MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom. Electronic address: nicholas.raison@kcl.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Raison
authors.affiliation: Department of Opthalmology, Stoke Mandeville Hospital, Aylesbury, United Kingdom.
authors.forename: Shreya
authors.initials: S
authors.lastname: Haldar
authors.affiliation: MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Brunckhorst
authors.affiliation: Department of Urology, NHS Forth Valley, Larbert, United Kingdom.
authors.forename: Craig
authors.initials: C
authors.lastname: McIlhenny
authors.affiliation: MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D006801:Humans; D066231:Surgeons / Q000193:education*
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; nontechnical; skills; surgeons; surgery; tools; training