Teaching and assessing non-technical skills.

The terms human factors and non-technical skills have recently been introduced to the language of surgical education. Both tend to be used interchangeably and yet each has a specific definition. More importantly, however, is the fact that the attributes and qualities contained within these headings relate to behaviours, attitudes and cognitive skills. They are recognised as crucially important in the practice of surgery, but are often poorly articulated during surgical performance, during training, during any assessment process and, indeed, seldom measured with reference to any metric in any of these activities. Most research in this area addresses non-technical skills in the operating theatre and it remains to be seen whether the same attributes and skills are used outwith theatre, particularly in the ward setting. However, the contribution that these aspects of performance make to a safe and successful outcome following surgery is being increasingly appreciated and there is increasing recognition of the need to train and assess.