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Technical and Nontechnical Skills in Surgery: A Simulated Operating Room Environment Study.

Michael Pfandler1, Philipp Stefan2, Christoph Mehren3

  • 1Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilians University, Munich, Germany.

Spine
|November 15, 2019
PubMed
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This study found that spine surgeons with better technical skills also exhibit superior nontechnical skills (NTS) like communication and leadership during simulated procedures. Surgeon experience influences this relationship, warranting further investigation.

Area of Science:

  • Surgical Simulation and Performance Analysis
  • Spine Surgery Outcomes Research
  • Human Factors in Medicine

Background:

  • Limited literature exists on the relationship between technical skills (TS) and nontechnical skills (NTS) in spine surgery.
  • Understanding this relationship is crucial as both skill types impact clinical outcomes.

Purpose of the Study:

  • To investigate the correlation between technical and nontechnical skills in spine surgeons during a simulated vertebroplasty procedure.
  • To explore the influence of surgeon experience on the relationship between TS and NTS.

Main Methods:

  • An observational simulation study using a mixed-reality operating room environment.
  • Eleven surgeons performed a simulated vertebroplasty (VP), with TS assessed via Objective Structured Assessment of Technical Skill and expert evaluation, and NTS via Observational Teamwork Assessment for Surgery.

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  • Statistical analysis included Kendall-Tau-b tests, controlling for surgeon experience.

    • Main Results:

    • A significant positive correlation was observed between surgeons' NTS and their technical performance (τ = 0.63) and surgical outcome scores (τ = 0.60).
    • The association between NTS and performance was attenuated when surgeon experience was factored in.

    Conclusions:

    • Higher technical skills in spine surgeons are associated with better nontechnical skills, including communication, leadership, and coordination.
    • The role of surgeon experience in intraoperative performance requires further research to optimize surgical outcomes.