Nontechnical skills training in cardiothoracic surgery: A pilot study

Juka S. Kim, Roland A. Hernandez, Douglas S. Smink, Steven Yule, Nicholas J. Jackson, Richard J. Shemin, Murray H. Kwon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective: The importance of nontechnical skills in surgery is widely recognized. We demonstrate the feasibility of administering and assessing the results of a formal Non-Technical Skills in Surgery (NOTSS) curriculum to cardiothoracic surgery residents. Methods: Eight cardiothoracic surgery residents participated in the NOTSS curriculum. They were assessed on their cognitive (situation awareness, decision-making) and social (communication and teamwork, leadership) skills based on simulated vignettes. The residents underwent pretraining NOTSS assessments followed by self-administered confidence ratings regarding the 4 skills. Subsequently, a formal NOTSS lecture was delivered and additional readings from the NOTSS textbook was assigned. A month later, the residents returned for post-training NOTSS assessments and self-administered confidence ratings. Changes across days (or within-day before vs after curriculum) were assessed using Wilcoxon signed rank test. Results: There was a significant improvement in the overall NOTSS assessment score (P = .01) as well as in the individual categories (situation awareness, P = .02; decision-making, P = .02; communication and teamwork, P = .01; leadership, P = .02). There was also an increase in resident self-perception of improvement on the post-training day (P = .01). Conclusions: We have developed a simulation-based NOTSS curriculum in cardiothoracic surgery that can be formally integrated into the current residency education. This pilot study indicates the feasibility of reproducible assessments by course educators and self-assessments by participating residents in nontechnical skills competencies.

Original languageEnglish
Pages (from-to)2155-2162.e4
Number of pages12
JournalJournal of Thoracic and Cardiovascular Surgery
Volume163
Issue number6
Early online date4 Feb 2021
DOIs
Publication statusE-pub ahead of print - 4 Feb 2021

Keywords / Materials (for Non-textual outputs)

  • cardiothoracic residency
  • nontechnical skills
  • NOTSS
  • patient safety
  • surgical education

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