Pena Guilherme, Altree Meryl, Field John, Sainsbury David, Babidge Wendy, Hewett Peter, Maddern Guy
Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia; Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia.
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, Australia.
Surgery. 2015 Jul;158(1):300-9. doi: 10.1016/j.surg.2015.02.008. Epub 2015 Mar 31.
The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment.
The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system.
There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted.
This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training.
优秀的外科医生所展现出的技能超出了技术上胜任手术所需的技能。这些技能被统称为非技术技能。在这些领域的失误与手术室中的不良事件相关。在外科手术培训期间，这些非技术技能通常不会以结构化的方式进行学习。本研究的主要目的是探讨参与基于模拟的培训，无论是作为单一策略还是作为综合方法的一部分，对外科医生和外科实习生在模拟环境中非技术技能表现的影响。
该研究包括一项单盲前瞻性比较试验。招募了40名参与者，他们都参加了2次挑战非技术技能的模拟课程，包括3个手术场景。17名参与者在模拟课程之间参加了为期1天的非技术技能研讨会。为了评估和汇报的目的，对场景进行了视频录制。由2名观察者使用外科医生非技术技能（NOTSS）评分系统进行评估。
在3个场景中的2个场景中，两组从第一次模拟课程到第二次模拟课程的非技术技能表现都有显著提高。模拟组和模拟加研讨会组之间的表现没有差异。
本研究提供了证据，表明非技术技能的正规培训是可行的，并且可以对参与者在模拟环境中的非技术表现产生积极影响。作为非技术技能培训的单一策略，增加为期1天的理论研讨会似乎并没有比基于模拟的培训提供额外的益处。
