Abstract
ObjectiveIn the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale.MethodsThis international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed.Results62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability.ConclusionsThe NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.
Highlights
Non-technical skills (NTS) are the cognitive and social abilities that complement a clinician’s technical ability, comprising decision-making, leadership, team work, and situational awareness [1, 2]
The Non-technical Skills for Urological Surgeons (NoTSUS) assessment scale was adapted into a 5-point Likert scale by experts for ease of marking and further expanded into five sections (Supplementary Appendix)
62 participants received NoTSUS training consisting of trainees (n = 43) and specialist (n = 19) surgeons with a wide range of experience (1–7 years of training and 1–20 years of specialist practice) from all over the globe
Summary
Non-technical skills (NTS) are the cognitive and social abilities that complement a clinician’s technical ability, comprising decision-making, leadership, team work, and situational awareness [1, 2]. They are often grouped into social skills, Department of Urology, Guy’s and St, Thomas’ NHS Foundation Trust, London, UK. World Journal of Urology (2021) 39:2231–2237 cognitive skills, and personal resource factors. Within cognitive skills lie decision-making, planning and situational awareness. Personal resource factors include the capacity of an individual to cope with stressors and fatigue, which have been shown to negatively impact technical skills in the operating room (OR)
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