Clinical reviewNon-technical skills for surgeons in the operating room: A review of the literature
Section snippets
Material and methods
The literature search was carried out by consulting a number of different sources:
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Databases and University library catalogues, including BioMed Central, Medline, Web-of-Knowledge, EDINA BIOSIS, PsychLit, and ScienceDirect.
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Proceedings from recent applied health care, psychology, and human factors conferences.
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The Library of the Royal College of Surgeons of Edinburgh.
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Bibliographies from relevant research articles and book chapters.
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Previous research on non-technical skills in aviation, nuclear
The Surgical Team Assessment Record (STAR)
The STAR questionnaire was designed to study the role of human factors in surgical outcomes18 and measure the organizational, situational, team, and personal factors thought to contribute to surgical performance. Questions on team factors cover dealing with unexpected events, communication between theater teams, preoperative briefings, confidence in other team members' abilities, and the level of harmony or disharmony among team members. Personal factors include technical skill, mental
Discussion
This review attempted to identify surgeons' non-technical skills from the surgical and psychological literature and then establish whether there was a valid and reliable taxonomy and associated behavioral marker system available for the assessment of surgeons' non-technical skills.
Conclusions and strategy for further research
The current state of assessment of surgeons' non-technical skills is in its infancy. Although imperfect, the studies reviewed here have sought to identify, develop, and rate surgeons' non-technical skills and established important groundwork in this field. Because the systems assessed in this review do not conform to the suggested criteria for behavioral marker systems, a project sponsored by the Royal College of Surgeons of Edinburgh and NHS Education for Scotland (NES) is now underway to
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