Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room. - 2015

BACKGROUND: Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. CONCLUSIONS: Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes.Copyright (c) 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved. METHOD: A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. OBJECTIVE: To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). RESULTS: Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03).


English

1878-7452


*General Surgery/ed [Education]
*Internship and Residency
*Professional Competence
*Simulation Training
Operating Rooms
Single-Blind Method


MedStar Health Research Institute


Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't