Learning NOTSS While Tying Knots: Integrating the Nontechnical Skills for Surgeons Course With Technical Surgical Skills Training, A Mixed Methods Study. Issue 1 (25th March 2022)

• Record Type: Journal Article
• Authors: Abahuje, Egide; Bartuska, Andrew; Dias, Roger D.; Muneza, Eugène; Sibomana, Isaie; Williams, Wendy; Koch, Rachel; Robertson, Jamie M.; Ntakiyiruta, George; Evans, Faye; Riviello, Robert; Yule, Steven
• Is Part Of: Annals of surgery open. Volume 3:Issue 1(2022)
• Page Start: e133
• Publication Date: 2022-03-25
• Subjects: nontechnical skills -- crisis resource management -- communication -- teamwork -- global surgery -- patient safety -- surgical teams; Surgery -- Periodicals; Surgery -- History -- Periodicals; General Surgery; Surgery; History; Periodicals; 616
• DOI: 10.1097/AS9.0000000000000133
• Languages: English
• ISSNs: 2691-3593

Abstract

Abstract : Objective: The aims of this study were to describe the process of integrating 2 established training programs, Nontechnical skills for surgeons, and a traditional essential surgical skills course and to measure the impact of this integrated course on the behaviors of interprofessional surgical teams in Rwandan district hospitals. Background: Surgical errors and resulting adverse events are due to variability in both technical and nontechnical surgical skills. Providing technical and nontechnical skills training to the perioperative team may enhance the learning of both of these skills and promote safe intraoperative patient care. Methods: A quality improvement framework guided the process of integrating essential surgical skills and nontechnical skills into a single training program for surgical teams. The resulting 2-day training program was delivered to 68-person teams from 17 hospitals. Nontechnical skills for surgeons was taught through didactics and in the operating room, where preoperative briefing, intraoperative interactions, and postoperative debriefing were used as essential and nontechnical skills teaching moments. Postcourse surveys, follow-up interviews, focus groups, and direct observation of participants in the operating room were conducted to assess how participants implemented the knowledge and skills from the training into practice. Results: Ninety-seven percent of the participants reported that they were satisfied with the course. Follow-up participant interviews and focus groups reported that the course helped them to improve their preoperative planning, intraoperative communication, decision-making, and postoperative debriefing. Conclusions: It is possible to implement an integrated essential surgical skills and nontechnical skills training course. Integrating nontechnical skills into essential surgical skills courses may enhance learning of these skills. Abstract : Mini-Abstract : Effective technical and nontechnical skills are necessary for safe patient care. A quality improvement framework was developed to help integrate a nontechnical skills course with an essential surgical skills course for surgical care providers from Rwanda. After taking the course, participants demonstrated improved preoperative planning, intraoperative communication, decision-making, and postoperative debriefing.