Abstract

General surgery education research is an important topic as work-hour restrictions continue to change.Most of the literature has focused on how simulation affects trainees’ procedural skills. The article by Nicksa and colleagues1 focuses on the nontechnical skills that the Accreditation Council for Graduate Medical Education requires that general training programs monitor and teach. Nicksa and colleagues1 are to be commended for providing an example of how programs can use simulation to teach nontechnical material, the so-called soft skills in surgery. In today’s world of team training, team science, and interprofessional education, the importance of these soft skills cannot be understated. A general surgeon no longer works in an environment in which he or she can expect to have the same scrub nurse, the same circulating nurse, and the same team for up to 30 years ofprofessionalpractice. It ismorecommonly thesituation that every singleday there is anew teamand, in fact, that teamcan change throughout the course of the day. For an administrator, that is theequivalentofhavinganewassistanteverymorning when they come to work. This changing work environment requires an additional degree of flexibility on thepart of the surgeonwho, in addition to doing the operation, needs to simultaneously train the team in assisting with the operation. Soft skills matter! How onemotivates the team around them and how they deal with adversity are not just the tools needed to execute a successful operation efficiently, but they are also the tools to achieving long-term success in our increasingly complex and interrelated work environments. The American College of Surgeons now regularly teaches courses on emotional intelligence. The business and scientific worlds are full of books on leadership development and communication. One might even make the argument that in today’sworldof roboticandtechnology-assistedclinicalwork, the surgeonneedsdevelopmentof their leadership skillsmore than their technical skills, as their technical skillsmaybe augmented by advances in technology. Leadership development and emotional intelligence are even more difficult things to learn and to teach. The Joint Commission has identified that failures in communication, human factors, and leadership are themost common issues thought to be the root causes in sentinel events. As thework-hour limitations continue to squeeze the time allotted to training young surgeons, it is important that we do not lose sight of training these soft skills and identifying efficient ways to do so. The clinical scenarios identified in these high-fidelity simulations and the focus on communication, leadership, teamwork,problemsolving,andsituationalawareness presented in this article1 serve as a provocative roadmap for those charged with training the next generation of surgeon leaders.

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