Brunckhorst Oliver, Shahid Shahab, Aydin Abdullatif, Khan Shahid, McIlhenny Craig, Brewin James, Sahai Arun, Bello Fernando, Kneebone Roger, Shamim Khan Muhammad, Dasgupta Prokar, Ahmed Kamran
MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
Department of Urology, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom.
J Surg Educ. 2015 Sep-Oct;72(5):1039-44. doi: 10.1016/j.jsurg.2015.04.002. Epub 2015 May 14.
Little integration of technical and nontechnical skills (e.g., situational awareness, communication, decision making, teamwork, and leadership) teaching exists within surgery. We therefore aimed to (1) evaluate the relationship between these 2 skill sets within a simulation-based environment and (2) assess if certain nontechnical skill components are of particular relevance to technical performance.
A prospective analysis of data acquired from a comparative study of simulation vs nonsimulation training was conducted. Half of the participants underwent training of technical and nontechnical skills within ureteroscopy, with the remaining half undergoing no training. All were assessed within a full immersion environment against both technical (time to completion, Objective Structured Assessment of Technical Skills, and task-specific checklist scores) and nontechnical parameters (Nontechnical Skills for Surgeons [NOTSS] rating scale). The data of whole and individual cohorts were analyzed using Pearson correlation coefficient.
The trial took place within the Simulation and Interactive Learning Centre at Guy's Hospital, London, UK.
In total, 32 novice participants with no prior practical ureteroscopy experience were included within the data analysis.
A correlation was found within all outcome measures analyzed. For the whole cohort, a strong negative correlation was found between time to completion and NOTSS scores (r = -0.75, p < 0.001), with strong positive correlations identified when NOTSS scores were compared with Objective Structured Assessment of Technical Skills (r = 0.89, p < 0.001) and task-specific checklist scores (r = 0.91, p < 0.001). Similar results were observed when each cohort was analyzed separately. Finally, all individual nontechnical skill components demonstrated a strong correlation with all technical skill parameters, regardless of training.
A strong correlation between technical and nontechnical performance exists, which was demonstrated to be irrespective of training received. This may suggest an inherent link between skill sets. Furthermore, all nontechnical skill sets are important in technical performance. This supports the notion that both of these skills should be trained and assessed together within 1 curriculum.
外科学领域中技术技能与非技术技能（如情境意识、沟通、决策、团队合作和领导力）教学的整合较少。因此，我们旨在（1）在基于模拟的环境中评估这两种技能集之间的关系，以及（2）评估某些非技术技能组成部分是否与技术操作特别相关。
对从模拟训练与非模拟训练的比较研究中获取的数据进行前瞻性分析。一半参与者接受输尿管镜检查技术和非技术技能培训，另一半不接受培训。所有参与者在完全沉浸式环境中接受技术（完成时间、客观结构化技术技能评估和特定任务清单评分）和非技术参数（外科医生非技术技能[NOTSS]评级量表）评估。使用Pearson相关系数分析整体和个体队列的数据。
试验在英国伦敦盖伊医院的模拟与互动学习中心进行。
总共32名无输尿管镜检查实践经验的新手参与者纳入数据分析。
在所分析的所有结果指标中均发现相关性。对于整个队列，完成时间与NOTSS评分之间存在强负相关（r = -0.75，p < 0.001），将NOTSS评分与客观结构化技术技能评估（r = 0.89，p < 0.001）和特定任务清单评分（r = 0.91，p < 0.001）进行比较时发现强正相关。分别分析每个队列时观察到类似结果。最后，无论是否接受培训，所有个体非技术技能组成部分与所有技术技能参数均显示出强相关性。
技术和非技术操作之间存在强相关性，且与所接受的培训无关。这可能表明技能集之间存在内在联系。此外，所有非技术技能集在技术操作中都很重要。这支持了在同一课程中应同时培训和评估这两种技能的观点。
