title: Correlates of non-technical skills in surgery: a prospective study.
abstract: Communication and teamwork failures have frequently been identified as the root cause of adverse events and complications in surgery. Few studies have examined contextual factors that influence teams' non-technical skills (NTS) in surgery. The purpose of this prospective study was to identify and describe correlates of NTS.
  
  
  
  We assessed NTS of teams and professional role at 2 hospitals using the revised 23-item Non-TECHnical Skills (NOTECHS) and its subscales (communication, situational awareness, team skills, leadership and decision-making). Over 6 months, 2 trained observers evaluated teams' NTS using a structured form. Interobserver agreement across hospitals ranged from 86% to 95%. Multiple regression models were developed to describe associations between operative time, team membership, miscommunications, interruptions, and total NOTECHS and subscale scores.
  
  
  
  We observed 161 surgical procedures across 8 teams. The total amount of explained variance in NOTECHS and its 5 subscales ranged from 14% (adjusted R20.12, p<0.001) to 24% (adjusted R20.22, p<0.001). In all models, inverse relationships between the total number of miscommunications and total number of interruptions and teams' NTS were observed.
  
  
  
  Miscommunications and interruptions impact on team NTS performance.
authors.affiliation: School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.|Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.|National Centre for Research Excellence in Nursing (NCREN), Menzies Health Institute Qld (MHIQ), Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Gillespie
authors.affiliation: School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Harbeck
authors.affiliation: School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Evelyn
authors.identifier: 0000-0001-8253-1638
authors.initials: E
authors.lastname: Kang
authors.affiliation: Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Steel
authors.affiliation: Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fairweather
authors.affiliation: National Centre for Research Excellence in Nursing (NCREN), Menzies Health Institute Qld (MHIQ), Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
mesh_terms: D001364:Awareness; D003142:Communication; D003657:Decision Making; D006126:Group Processes; D006801:Humans; D007400:Interprofessional Relations; D007431:Intraoperative Complications / Q000209:etiology; D007857:Leadership; D019300:Medical Errors; D061646:Operative Time; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative
keywords: NOTECHS; interruptions; miscommunications; non-technical skills; surgical team; teamwork