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Nontechnical skills

Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
Anna B Newcomb, Amber W Trickey, Melissa Porrey, Jeffrey Wright, Franco Piscitani, Paula Graling, Jonathan Dort
OBJECTIVES: The Accreditation Council for Graduate Medical Education milestones provide a framework of specific interpersonal and communication skills that surgical trainees should aim to master. However, training and assessment of resident nontechnical skills remains challenging. We aimed to develop and implement a curriculum incorporating interactive learning principles such as group discussion and simulation-based scenarios to formalize instruction in patient-centered communication skills, and to identify best practices when building such a program...
November 4, 2016: Journal of Surgical Education
Matthew M Tomaino, Janet Thirlby
Effective, collaborative leadership is one of the most credible and important predictors of team performance. This is relevant to us as surgeons because teamwork is now a common part of the vernacular in health care, we do not operate in a vacuum without a team, and we are well positioned to assume a leadership role on our teams. However, our standing as experts, our training and the way we were mentored, an insufficient concept of leadership as a process as opposed to a position, and inadequate nontechnical skills may disadvantage us as surgeons as collaborative members of teams...
November 2016: Journal of Hand Surgery
Shady A Rehim, Stephanie DeMoor, Richard Olmsted, Daniel L Dent, Jessica Parker-Raley
BACKGROUND: Hospital action teams comprise interdisciplinary health care providers working simultaneously to treat critically ill patients. Assessments designed to evaluate communication effectiveness or "nontechnical" performance of these teams are essential to minimize medical errors and improve team productivity. Although multiple communication tools are available, the characteristics and psychometric validity of these instruments have yet to be systematically compared. OBJECTIVE: To identify assessments used to evaluate the communication or "nontechnical" performance of hospital action teams and summarize evidence to develop and validate these instruments...
October 19, 2016: Journal of Surgical Education
Isabelle Bragard, Nesrine Farhat, Marie-Christine Seghaye, Oliver Karam, Arthur Neuschwander, Yasaman Shayan, Katharina Schumacher
OBJECTIVES: Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. METHODS: Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval...
October 18, 2016: Pediatric Emergency Care
Peter Szasz, Esther M Bonrath, Marisa Louridas, Andras B Fecso, Brett Howe, Adam Fehr, Michael Ott, Lloyd A Mack, Kenneth A Harris, Teodor P Grantcharov
OBJECTIVES: The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. BACKGROUND: Scores on performance assessments are difficult to interpret in the absence of established standards...
July 28, 2016: Annals of Surgery
Peter L Jernigan, Matthew C Wallace, Christine S Novak, Travis W Gerlach, Dennis J Hanseman, Timothy A Pritts, Bradley R Davis
BACKGROUND: Critical Care Air Transport Teams (CCATTs) are integral to the U.S. Air Force aeromedical evacuation paradigm. The current study was conducted to evaluate predictors of nontechnical skills (NOTECHS) in CCATT trainees. METHODS: Sixteen CCATTs were studied over a 6-month period. Team members completed a biographical survey and teams were videotaped during a simulated CCATT mission. Teams and individuals were assigned a "red flag score" using a validated assessment tool for NOTECHS...
October 2016: Military Medicine
Emma Stewart-Parker, Robert Galloway, Stella Vig
BACKGROUND: Possessing adequate nontechnical skills (NTS) in operating theaters is of increasing interest to health care professionals, yet these are rarely formally taught. Teams make human errors despite technical expertise and knowledge, compromising patient safety. We designed a 1-day, multiprofessional, multidisciplinary course to teach, practice, and apply these skills through simulation. METHODS: The course, "S-TEAMS," comprised a morning of lectures, case studies, and interactive teamworking exercises...
September 20, 2016: Journal of Surgical Education
John M Green
PURPOSE: Timely performance evaluation and feedback are critical to resident development. However, formulating and delivering this information disrupts physician workflow, leading to low participation. This study was designed to determine if a locally developed smartphone platform would integrate regular evaluation into daily processes and thus increase faculty participation in timely resident evaluation. METHODS: Formal, documented resident operative and patient interaction evaluations were compiled over an 8-month study period...
November 2016: Journal of Surgical Education
Marilù Giacalone, Cédrick Zaouter, Stefano Mion, Thomas M Hemmerling
The international anaesthesia community is getting older, in line with trends worldwide, and as men and women age there is the risk that psychophysiological decline could have an impact on clinical practice. Impairment of technical and nontechnical skills could have a negative impact on patients' safety and outcomes. The ageing process may not necessarily go hand-in-hand with a predictable pattern of decreased competence as not all aspects of functional decline are affected at the same rate and to the same extent...
November 2016: European Journal of Anaesthesiology
Paolo Mannella, Giulia Palla, Armando Cuttano, Antonio Boldrini, Tommaso Simoncini
OBJECTIVE: To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. METHODS: A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario...
December 2016: International Journal of Gynaecology and Obstetrics
Marina Yiasemidou, Daniel Glassman, James Tomlinson, David Song, Michael J Gough
OBJECTIVES: Assess expert opinion on the current and future role of simulation in surgical education. DESIGN: Expert opinion was sought through an externally validated questionnaire that was disseminated electronically. PARTICIPANTS: Heads of Schools of Surgery (HoS) (and deputies) and Training Program Directors (TPD) (and deputies). RESULTS: Simulation was considered a good training tool (HoS: 15/15, TPD: 21/21). The concept that simulation is useful mostly to novices and for basic skills acquisition was rejected (HoS: 15/15, TPDs: 21/21; HoS: 13/15, TPDs: 18/21)...
September 8, 2016: Journal of Surgical Education
Abdullatif Aydin, Nicholas Raison, Muhammad Shamim Khan, Prokar Dasgupta, Kamran Ahmed
Simulation has become widely accepted as a supplementary method of training. Within urology, the greatest number of procedure-specific models and subsequent validation studies have been carried out in the field of endourology. Many generic-skills simulators have been created for laparoscopic and robot-assisted surgery, but only a limited number of procedure-specific models are available. By contrast, open urological simulation has only seen a handful of validated models. Of the available modalities, virtual reality (VR) simulators are most commonly used for endourology and robotic surgery training, the former also employing many high-fidelity bench models...
September 2016: Nature Reviews. Urology
Patricia L Hart, LeeAnna Spiva, Lonnie Dolly, Kristen Lang-Coleman, Nadia Prince-Williams
AIM AND OBJECTIVE: To explore and understand the experiences of medical-surgical nurses as first responders during clinical deterioration events. BACKGROUND: Nurses are key players in identifying and responding to deterioration events to escalate the level of care essential to address specific needs of patients. Delays in recognising signs and symptoms of patient deterioration and activation of Rapid Response Teams have been linked to a lack of nontechnical skills (leadership, teamwork, situational awareness) resulting in increased patient morbidity and mortality...
November 2016: Journal of Clinical Nursing
Ken J Kubota, Jason A Chen, Max A Little
For the treatment and monitoring of Parkinson's disease (PD) to be scientific, a key requirement is that measurement of disease stages and severity is quantitative, reliable, and repeatable. The last 50 years in PD research have been dominated by qualitative, subjective ratings obtained by human interpretation of the presentation of disease signs and symptoms at clinical visits. More recently, "wearable," sensor-based, quantitative, objective, and easy-to-use systems for quantifying PD signs for large numbers of participants over extended durations have been developed...
September 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Raghavendra Rao, Kristoffel R Dumon, Christopher J Neylan, Jon B Morris, Elijah W Riddle, Richard Sensenig, Yangseon Park, Noel N Williams, Daniel T Dempsey, Ari D Brooks
OBJECTIVE: The purpose of this study was to understand the effect of a team-based surgical skills intervention on the technical and nontechnical skills of surgery residents. DESIGN: This was a prospective cohort study with pretesting or posttesting. We designed basic tasks for the assessment and learning of nontechnical skills in the operating room (OR). A total of 15 postgraduate year 1 residents performed an open gastrojejunostomy in a simulated OR setting (pretest), followed by training in the 3 team-based tasks designed to teach communication and teamwork, followed by performance of a gastrojejunostomy in the simulated OR (posttest)...
November 2016: Journal of Surgical Education
Donna P Phillips, Joseph D Zuckerman, Adina Kalet, Kenneth A Egol
The Accreditation Council of Graduate Medical Education requires that residency programs teach and assess trainees in six core competencies. Assessments are imperative to determine trainee competence and to ensure that excellent care is provided to all patients. A structured, direct observation program is feasible for assessing nontechnical core competencies and providing trainees with immediate constructive feedback. Direct observation of residents in the outpatient setting by trained faculty allows assessment of each core competency...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Marcel Winkelmann, Lars Friedrich, Christian Schröter, Andreas Flemming, Hendrik Eismann, Lion Sieg, Philipp Mommsen, Christian Krettek, Christian Zeckey
OBJECTIVE: Christoph Life is a simulator-based air medical training program and a new and innovative educational concept. Participants pass different scenarios with a fully equipped and movable helicopter simulator. Main focuses of the program are crew resource management (CRM) elements and team training. Information about expectations end effectiveness of the training is sparse. METHODS: During a 2-day training, participants learn CRM basics and complete various emergency medical scenarios...
July 2016: Air Medical Journal
Alicia Ponton-Carss, John B Kortbeek, Irene W Y Ma
BACKGROUND: Surgical competence encompasses both technical and nontechnical skills. This study seeks to evaluate the validity evidence for a comprehensive surgical skills examination and to examine the relationship between technical and nontechnical skills. METHODS: Six examination stations assessing both technical and nontechnical skills, conducted yearly for surgical trainees (n = 120) between 2010 and 2014 are included. RESULTS: The assessment tools demonstrated acceptable internal consistency...
November 2016: American Journal of Surgery
Helle Teglgaard Lyk-Jensen, Peter Dieckmann, Lars Konge, Rikke Malene H G Jepsen, Lene Spanager, Doris Østergaard
Nontechnical skills are critical for good anesthetic practice but are seldom addressed explicitly in clinical training. The purposes of this study were (1) to evaluate the reliability and validity of the observation-based assessment tool Nurse Anaesthetists' Non-Technical Skills system (N-ANTS) and (2) to evaluate the effect of training nurse anesthetist supervisors in the use of N-ANTS. This system comprises a global rating score, 4 categories, and 15 elements to rate nurse anesthetists' nontechnical skills...
April 2016: AANA Journal
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