Related Experiment Video
Updated: Feb 12, 2026
Principles of Rodent Surgery for the New Surgeon
Published on: January 6, 2011
Construct and criterion validity testing of the Non-Technical Skills for Surgeons (NOTSS) behaviour assessment tool
S Yule1,2,3,4, A Gupta3, D Gazarian1
1STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Background:
Surgeons' non-technical skills are an important part of surgical performance and surgical education. The most widely adopted assessment tool is the Non-Technical Skills for Surgeons (NOTSS) behaviour rating system. Psychometric analysis of this tool to date has focused on inter-rater reliability and feasibility rather than validation.
Methods:
NOTSS assessments were collected from two groups of consultant/attending surgeons in the UK and USA, who rated behaviours of the lead surgeon during a video-based simulated crisis scenario after either online or classroom instruction. The process of validation consisted of assessing construct validity, scale reliability and concurrent criterion validity, and undertaking a sensitivity analysis. Central to this was confirmatory factor analysis to evaluate the structure of the NOTSS taxonomy.
Results:
Some 255 consultant surgeons participated in the study. The four-category NOTSS model was found to have robust construct validity evidence, and a superior fit compared with alternative models. Logistic regression and sensitivity analysis revealed that, after adjusting for technical skills, for every 1-point increase in NOTSS score of the lead surgeon, the odds of having a higher versus lower patient safety score was 2·29 times. The same pattern of results was obtained for a broad mix of surgical specialties (UK) as well as a single discipline (cardiothoracic, USA).
Conclusion:
The NOTSS tool can be applied in research and education settings to measure non-technical skills in a valid and efficient manner.
More Related Videos
Related Concept Videos
01:10In Vitro Drug Release Testing: Overview, Development and Validation
01:15Routh-Hurwitz Criterion I
To apply the Routh-Hurwitz criterion, a Routh table is constructed. The table's rows are labeled with powers of the complex frequency variable s, starting from the...
01:19Routh-Hurwitz Criterion II
The first scenario occurs when a singular zero appears in the first column of the Routh table. This situation creates a division by zero issues. To resolve this, a small positive or negative number, denoted as epsilon (∈), is substituted for the zero. The stability analysis proceeds by assuming a sign for ∈. If ∈ is positive, any sign change in the first...
01:29Reliability and Validity
01:26Pharmacokinetic Models: Comparison and Selection Criterion
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
01:16Potential-Energy Criterion for Equilibrium