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Nontechnical skills training in cardiothoracic surgery: A pilot study.

Juka S Kim1, Roland A Hernandez2, Douglas S Smink3

  • 1Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, Calif.

The Journal of Thoracic and Cardiovascular Surgery
|March 7, 2021
PubMed
Summary

A new Non-Technical Skills in Surgery (NOTSS) curriculum significantly improved cardiothoracic surgery residents' cognitive and social skills. This pilot study shows the curriculum is feasible and assessments are reproducible for surgical education.

Keywords:
NOTSScardiothoracic residencynontechnical skillspatient safetysurgical education

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Area of Science:

  • Medical Education
  • Surgical Training
  • Human Factors in Medicine

Background:

  • Nontechnical skills are crucial for surgical performance and patient safety.
  • Formal assessment and training of nontechnical skills are increasingly important in surgical residency programs.

Purpose of the Study:

  • To assess the feasibility and impact of a formal Non-Technical Skills in Surgery (NOTSS) curriculum for cardiothoracic surgery residents.
  • To evaluate resident performance and self-perceived confidence in nontechnical skills before and after the curriculum.

Main Methods:

  • Eight cardiothoracic surgery residents participated in a simulation-based NOTSS curriculum.
  • Residents underwent pre- and post-training assessments of cognitive (situation awareness, decision-making) and social (communication, teamwork, leadership) skills.
  • Self-administered confidence ratings were collected, and changes were analyzed using the Wilcoxon signed rank test.

Main Results:

  • Significant improvements were observed in overall NOTSS scores (P=.01) and all individual skill categories (P=.01–.02).
  • Residents reported increased self-perceived improvement in nontechnical skills post-curriculum (P=.01).

Conclusions:

  • A simulation-based NOTSS curriculum can be effectively integrated into cardiothoracic surgery residency.
  • The study demonstrates the feasibility of reproducible assessments for nontechnical skills competencies in surgical trainees.