This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Prospective observational study to evaluate NOTSS (Non‐Technical Skills for Surgeons) for assessing trainees’ non‐technical performance in the operating theatre. BJS 2011; 98: 1010-1020.
Published: 8th April 2011
Authors: J. Crossley, J. Marriott, H. Purdie, J. D. Beard
Background
Most surgical assessment has been aimed at technical proficiency. However, non‐technical skills also affect patient safety and clinical effectiveness. The NOTSS (Non‐Technical Skills for Surgeons) assessment instrument was developed specifically to assess the non‐technical skills of individual surgeons in the operating theatre. This study evaluated NOTSS as a real‐world assessment, with a mix of minimally trained assessors. The evaluation criteria were feasibility, validity and psychometric reliability.
Method
In a standard evaluation of NOTSS, 56 anaesthetists, 39 scrub nurses, two surgical care practitioners and three independent assessors provided 715 assessments of 404 surgical cases of 15 index procedures across six specialties performed by 85 surgical trainees.
Results
The assessment was feasible, but important implementation challenges were highlighted. Most respondents considered the method valid, but with reservations about assessing cognition. The factor structure of scores, and their positive relationships with other measures of experience and performance, supported validity. Trainees' non‐technical skill scores were relatively procedure‐independent and achieved good reliability (generalizability coefficient 0·8 or more) when six to eight assessors observed one case each.
Conclusion
Minimally trained assessors, who are typically present in operating theatres, were sufficiently discriminating and consistent in their judgements of trainee surgeons' non‐technical skills to provide reliable scores based on an achievable number of observations. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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