MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, King's College London, London, UK.
Int Urol Nephrol. 2012 Jun;44(3):701-10. doi: 10.1007/s11255-011-0101-0. Epub 2012 Feb 26.
Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft.
The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality.
Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees.
Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.
非技术技能是泌尿科医生必须完全胜任的重要行为方面，以最大限度地减少对患者的伤害。现在已知大多数手术错误是由于判断和决策错误，而不是技术方面的错误。
作者回顾了关于决策理论以及与泌尿科实践相关的已发表文献，以及评估决策技能的现有工具。局限性包括研究数量有限，并且可用的研究质量较低。
决策是在替代行动方案之间进行选择的心理过程。在手术环境中，这通常是在可变的时间框架和动态环境中在利益和风险之间进行复杂的平衡。近年来，新的外科学课程的重点已经转向非技术外科技能；然而，现有的评估工具远非客观、可靠和有效。外科模拟器和视频辅助问卷是评估学员的有用方法。
需要在泌尿科的培训和决策技能评估中实施设计良好、可靠和有效的工具。只有做出安全有效的决策，才能确保患者的安全。
