Importance Of Non-technical Skills Research Articles

Data Preparation for Supervised Learning: Improving Nursing Situation Awareness to Reduce Healthcare-Acquired Urinary Tract Infection.

Situation awareness (SA) is an important non-technical skill for nurses. Nurses interact directly with patients and review their clinical signs. If we improve nurses' SA, they will likely detect clinical changes and prevent patient harm. A clinical endeavor that can benefit from improved nurses' SA is the prevention of Healthcare-Acquired Urinary Tract Infection (HAUTI). Electronic Health Records contain comprehensive nursing assessment data that researchers can use to analyze trends and provide a context-based understanding of the infection risk factors. We conducted a study that involved extracting nursing assessment data and preparing it for supervised learning algorithms and predicting HAUTI. In this paper, we share the methods we used to prepare the data for supervised learning algorithms and present the challenges related to data missingness.

The importance of non-technical skills in robot-assisted surgery in gynaecology.

Robot-assisted surgery (RAS) in gynaecology has undergone exponential growth in recent decades, with utility in treating both benign and malignant gynaecological conditions. The technological complexities and amended theatre dynamics that RAS demands mean that effective non-technical skills (NTS) are vitally important to overcome these unique challenges. However, NTS have been neglected in RAS-training programmes with focus placed instead on the exclusive acquisition of technical skills (TS). NTS include teamwork, communication, leadership, situational awareness, decision-making and stress management. Communication is the most frequently cited NTS impacted during RAS, as the physical limitations imposed by the robotic hardware make communication exchange difficult. The full immersion that RAS enables can contribute to situational awareness deficits. However, RAS can complement communication and teamwork when multidisciplinary (MDT) surgeries (such as complex endometriosis excisions) are undertaken; dual-console capabilities facilitate the involvement of specialties such as general surgery and urology. The development of NTS in RAS cannot be achieved with in-situ experience alone, and current training is poorly standardised. RAS-training programmes and curricula for gynaecology do exist, however the integration of NTS remain limited. Simulation is a viable tool to facilitate enhanced-NTS integration, yet cost implications form a barrier to its wider implementation. However, given that RAS will continue to occupy a greater proportion of the gynaecological caseload, integration of NTS within gynaecological RAS training curricula is necessary. Patients undergoing gynaecological RAS would benefit from the improved safety standards and enhanced surgical outcomes that would result.

Non-technical skills for neurosurgeons: An international survey

IntroductionNeurosurgery is considered a technically demanding specialty; nonetheless, it also requires non-technical skills (NTSs) to reach mastery. Research questionThis study seeks to understand how important NTSs are perceived by neurosurgeons across diverse roles and socio-economic backgrounds. The objective is to identify key NTSs and explore their role in surgical precision, teamwork, and collaboration. Material and methodAn international survey involving 372 neurosurgeons from various socio-economic and cultural contexts was conducted. The extensive sample and inclusive methodology provide a comprehensive perspective on the perceived importance of NTSs in neurosurgery. ResultsThe survey results highlight the universal significance of NTSs among neurosurgeons. Attention to detail, humility, and self-awareness are considered essential for surgical precision, effective teamwork, and collaboration. The findings underscore the necessity for integrated training programs that combine NTSs with technical skills. Discussion and conclusionThe study emphasizes the importance of effective training methods such as simulations, mentorship, and role-playing in equipping neurosurgeons to navigate the complexities of their profession. Future research should focus on optimizing teaching methods for NTSs, comparing traditional courses, online modules, and hybrid training programs. Addressing the global disparity in neurosurgical care, particularly in low- and middle-income countries, is crucial for improving patient outcomes worldwide.

Nobinobi Yomikaki: Teaching Materials for Japanese Reading and Writing Based on 21st Century Skills

This study aims to determine the use of "Nobinobi Yomikaki" teaching materials developed as teaching materials for beginner level reading and writing courses towards the formation of 21st century skills in elementary level students. This is based on the needs for reading and writing teaching materials for first semester students, especially students who have never studied Japanese at all. Efforts to form 21st century skills are the focus as well as the basis for developing teaching materials because the demands of students to be able to survive and perform in the digital world, especially after the Covid-19 pandemic, realize how important non-technical skills are as technical skills. The research method uses a mixed approach, quantitative and qualitative. The quantitative approach was used to measure reading speed, which is a basic literacy skill, while the qualitative approach was used to describe the results of observations of how the use of this teaching material on the formation of 21st century skills. The research population is the 2022 batch of students in the Japanese Language Education Study Program at Universitas Negeri Jakarta, with a sample of 24 people, namely students who have never studied Japanese at all. Based on the study, it is known that the structure of teaching materials supports the development of 21st century skills, namely the ability to think critically, creatively, communicatively, collaboratively, and succeeds in fostering positive character so that in this digital era students are ready to become part of global citizens or digital citizens. And as the impact of these skills development, through the activities that force students to communicate their ideas both orally and in writing, their Japanese reading and writing skills also improved.

Relationship between stress and resident non-technical skills during interdisciplinary trauma simulations

BackgroundNon-technical skills, such as communication and situation awareness, are vital for patient care and effective surgical team performance. Previous research has found that residents’ perceived stress is associated with poorer non-technical skills; however, few studies have investigated the relationship between objectively assessed stress and non-technical skills. Accordingly, the purpose of this study was to assess the relationship between objectively assessed stress and non-technical skills. MethodsEmergency medicine and surgery residents voluntarily participated in this study. Residents were randomly assigned to trauma teams to manage critically ill patients. Acute stress was assessed objectively using a chest-strap heart rate monitor, which measured average heart rate and heart rate variability. Participants also evaluated perceived stress and workload using the 6-item version of the State-Trait Anxiety Inventory and the Surgery Task Load Index. Non-technical skills were assessed by faculty raters using the non-technical skills scale for trauma. Pearson’s correlation coefficients were used to examine relationships between all variables. ResultsForty-one residents participated in our study. Heart rate variability (where higher values reflect lower stress) was positively correlated with residents’ non-technical skills overall and leadership, communication, and decision-making. Average heart rate was negatively correlated with residents’ communication. ConclusionHigher objectively assessed stress was associated with poorer non-technical skills in general and nearly all non-technical skills domains of the T-NOTECHS. Clearly, stress has a deleterious effect on residents’ non-technical skills during trauma situations, and given the importance of non-technical skills in surgical care, educators should consider implementing mental skills training to reduce residents’ stress and optimize non-technical skills during trauma situations.

Tying in Situational Awareness, Clinical Reasoning and Clinical Judgment through Cross-Training Using Case-Based Discussions in Emergency Medicine

Situational Awareness (SA) is knowing about what is going on around oneself, whether as an individual or as a team. It is the mental impression of where you are, what surrounds you and what lies ahead. SA has been noted to be one of the most important non-technical skills in medicine. It is a foundational concept in many high reliability organizations and industries for its importance in operational decision-making. Clinical Reasoning essentially summarises the process of making timely and accurate diagnosis. It goes through the steps of history taking, physical examination, performing diagnostic investigations, interpreting the results that are returned and planning management for patient care. It is a fundamental in the practice of medicine and even in today’s context of technology and Artificial Intelligence (AI) applications, these steps are incorporated into the algorithmic formulae. Clinical Judgment, on the other hand involves the process of “noticing, interpreting, responding and reflection” Just from the three definitions above, it can be seen that there may be overlaps between the three terms. They are also very often used almost interchangeably. Practitioners of academic medicine, educators and faculty, need to understand the similarities and differences between the three terms. They are often called upon to assess their learners in these domains. Thus, clarity on what each term exactly means is essential. In this paper, the author shares her experience as an educator and core faculty in Emergency Medicine Residency on the utilization of Case-Based Discussions (CBD) in the nurturing and inculcation as well as assessment of all these three domains. The ability to plan and use CBD in such a manner is time efficient and effective for emergency physicians, as it can be consciously prepared with the coverage of SA, CR and CJ skills all incorporated into the shared narrative or scenario management.

Learning from accidents: Nontechnical skills deficiency in the European process industry

AbstractSafety‐critical industries have long been subjected to extensive research and development to enhance operator performance to improve their efficiency. From a human factors perspective, much of the work in process industries is related to either enhancing technical training of operators or related to improving the physical ergonomics of hazardous workplaces. The importance of Nontechnical Skills (NTS) in the process industries have traditionally been less emphasized, while other domains (e.g., aviation, healthcare) have led the development of investigating and improving NTS for the sharp‐end operators. This study aims to investigate the association of NTS deficiencies to the major accidents from the past 5 years in the process industries within the European Union by analyzing the accident reports from The Major Accident Reporting System (MARS) database. The accident analysis results reveal potential NTS deficiencies in 27% (17 out of 64) of the cases involving the lack of situational awareness, decision making, problem‐solving, communication, leadership, and time management issues. Based on the results of the analysis, a few implications, as well as future research directions, are proposed, which could facilitate the stakeholders in addressing NTS deficiencies of European process industry operators.

Effects of shared mental models in teams performing video-assisted thoracoscopic surgery lobectomy.

Important non-technical skills enable operating teams to establish shared mental models (SMMs). The importance of SMMs in regards to surgical performance and peri-operative outcomes remains to be investigated. The aim of this study was to explore whether shared mental models (SMMs) of team resources and the current situation, respectively, were predictive of technical skills, duration of surgery, and amount of intra-operative bleeding in video-assisted thoracoscopic surgery (VATS). A prospective multi-center observational study was conducted at four tertiary academic hospitals during VATS lobectomy procedures. Data included pre-operative and post-operative questionnaires answered by each of the six team members to measure the SMMs; thoracoscopic video recordings assessed using the previously validated VATS lobectomy Assessment Tool (VATSAT); surgery-related time stamps; and amount (volume) of intra-operative bleeding. Linear regression analyses were conducted to adjust for confounders. Fifty-eight lobectomy procedures were included. Median (interquartile range) VATSAT score was 33.3 (scale 8-40) duration of surgery 101min (88-123), and amount of intra-operative bleeding 100ml (20-150). The mean (± SD) of teams' SMMs of the current situation was 20 (± 5). They were not predictive of the surgeons' technical skills, but every one point increase in SMM score significantly predicted a 1min 52s decrease in duration of surgery and an 11% decrease in amount of bleeding. The SMMs of team resources were not predictive of any outcomes. VATS teams' superior SMMs of the current situation related to significantly shorter duration of surgery and decreased intra-operative bleeding, indicating an effect on team performance and patient care. NCT02999113 at http://www. gov .

Importance of non-technical skills in anaesthesia education.

Rising concern about patient safety has resulted in growing interest in non-technical skills (NTS) among anaesthesiologists. Growing evidence suggesting the use of good NTS training in patient safety in simulated as well as real-world environment made them important in medical education. Both technical skills (TS) and NTS are interdependent. Successful task performance depends on effective integration of both TS and NTS for any given situation. Development of tools for assessing the NTS of an anaesthesiologist in improving health care outcomes is challenging. Teaching, understanding and evaluating NTS among anaesthesiologists in improving health care outcomes is a domain which is supposed to be a rich seam for future studies.

98 ‘AOSim’: A Decision-Making Simulation Course for Acute Oncology Nurses

Simulation-based education (SBE) as a learning tool is becoming more prevalent, as is the recognition of the importance of non-technical skills. With this insight comes a desire to improve clinical practice using these techniques. ‘AOSim’ has arisen from an intrinsic desire to achieve this from within an Acute Oncology Service (AOS). Wishes to improve confidence, decision-making and teamwork have guided the design and implementation of a novel simulation course in this field.The purpose of the course has been guided by the candidates. The hope is to be able to provide a safe learning environment to explore decision-making, improve confidence in clinical practice and strengthen teamwork.The course design was informed by direct stakeholder analysis. Pre-course surveys aided in planning the course and scenario design. The course would run over half a day and comprise three scenarios, each followed by a debrief. The candidates invited were nurses working in the local AOS and the AOS coordinator. Each scenario was designed with a particular focus in mind; ‘Respectful Challenging’, ‘Clinical Prioritisation’ and ‘Treatment Escalation’. The clinical context of the scenarios was based on oncology to provide a familiar environment for the candidates. This would also enable the focus to be paid to the non-technical skills related to the aims of the course. The scenarios were to be run in a high-fidelity setting using a mixture of role players, mannikins and plants. Faculty roles had been assigned prior to the course date.A course overview was sent to the candidates including the planned date for running the course to allow the candidates to plan for handover of their clinical duties; this allowed protected time for the course to run. ‘AOSim’ was run in a simulation suite in the high-fidelity setting with an experienced faculty. The candidates were introduced to the simulated environment and the importance of psychological safety was explained. The three scenarios ran as planned to include subsequent informative debriefs. Immediate and post-course feedback were positive, particularly with increased confidence levels and team-working ability. This has led to aspirations to run the course again for a different candidate group in the future.

Identifying Non-Technical Skill Gaps in Software Engineering Education: What Experts Expect But Students Don’t Learn

As the importance of non-technical skills in the software engineering industry increases, the skill sets of graduates match less and less with industry expectations. A growing body of research exists that attempts to identify this skill gap. However, only few so far explicitly compare opinions of the industry with what is currently being taught in academia. By aggregating data from three previous works, we identify the three biggest non-technical skill gaps between industry and academia for the field of software engineering: devoting oneself to continuous learning , being creative by approaching a problem from different angles , and thinking in a solution-oriented way by favoring outcome over ego . Eight follow-up interviews were conducted to further explore how the industry perceives these skill gaps, yielding 26 sub-themes grouped into six bigger themes: stimulating continuous learning , stimulating creativity , creative techniques , addressing the gap in education , skill requirements in industry , and the industry selection process . With this work, we hope to inspire educators to give the necessary attention to the uncovered skills, further mitigating the gap between the industry and the academic world.

Assessment of communication skill during process of preoperative visit and informed consent by anesthesiology residents.

Background and Aims:Anaesthesiologists have few opportunities to communicate with patients especially in preoperative period for various reasons. If these opportunities are not well utilized, anesthesiologists may not be able to educate patients about anaesthesia related issues. The aim of this study was to assess communication skill (CS) exhibited by the anesthesiology residents during the process of preoperative visit and informed consent.Material and Methods:This was a pre and post intervention questionnaire based study carried out in a presurgical ward of a tertiary hospital. During the process of preoperative visit and informed consent, fourteen of the second year anesthesia residents were assessed by faculty members for various aspects of CS using validated questionnaire on 3-point Likert’s scale, before and after CS workshop. Residents’ perception about workshop and patient satisfaction with regards to the preoperative visit and process of informed consent was assessed. Results were described in percentage value and a qualitative analysis was carried out.Results:While none of the residents exhibited ‘excellent CS score’ in the pre-workshop phase, six (42.86%) achieved the same after the workshop. One resident, who had ‘poor CS score’ moved to higher category score post workshop. The behavioural traits of professionalism, empathy, risk explanation and written consent showed statistically significant improvements post intervention by Wilcoxon Signed Rank Test, with P value < 0.05. All residents felt that good communication can improve patient satisfaction and CS training should be part of the post graduate curriculum.Conclusion:Conduct of CS workshop for anesthesia residents improved certain behavioral traits during anaesthesia preoperative visit and informed consent process. This important nontechnical skill of CS, may not be uniformly acquired during clinical training and should be specifically taught and evaluated as part of post graduate curriculum.

Value of Nontechnical Skills in Minimally Invasive Surgery.

Nontechnical skills are of increasing importance in surgery and surgical training. The main studies on its impact on the safety and effectiveness of surgical interventions were mainly published in the first decade of the 2000s. Due to the significant technical complexity and great diversity of instruments for nontechnical skills evaluation, the interest in training and in measuring the impact on surgical safety has relatively decreased. However, the advent of minimally invasive surgery and its peculiar technical characteristics of sophisticated technique and constant innovation through the adoption of new materials and drugs has rekindled interest in this expertise area. In the present review, we have revisited the main instruments available to measure nontechnical skill of surgical teams and analyzed the role of the main competencies on which they are based, such as situational awareness, leadership and communication skills, and the consistency of the intraoperative decision-making process. We conclude that despite the great consensus that exists among all members of the health team on the importance of nontechnical skills for the surgical team in minimally invasive surgery, the reproducible evidence on the subject is scarce and laborious to obtain. To the extent that protecting and expanding nontechnical skills is fundamental to the path toward the high reliability of health institutions, it is possible to anticipate here the role of these institutions as promoters of continuity and new research models in this area of knowledge, especially in minimally invasive surgery, an access route to which more and more patients undergoing surgical treatment in these same institutions are submitted.

Nontechnical skills training in cardiothoracic surgery: A pilot study

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. 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. 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). 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.

Simulation of Pediatric Life-Threatening Emergency Scenarios (SimPLES): The Development, Implementation, and Evaluation of an Undergraduate Immersive Simulation-Based Educational Intervention

Background: Clinical exposure to acutely unwell pediatric patients is often limited during undergraduate medical training. Although limited within undergraduate pediatric curricula, simulation-based education (SBE) offers a tool with which such exposure can be achieved in a safe and effective learning environment. This study describes the development, implementation, and evaluation of an undergraduate multi-center immersive pediatric SBE course. Objectives: We sought to increase medical students’ exposure to acutely unwell pediatric patients and provide practical experience to improve their understanding of the importance of non-technical skills within the clinical workplace, such as teamwork, communication skills, leadership, and situational awareness. Furthermore, we sought to evaluate the impact on students’ confidence in assessing and managing acutely unwell pediatric patients while exploring their perceptions and opinions of the course. Methods: The present study included all final-year students who were on a pediatric clinical placement during the study period. Tutorials on pediatric A-E assessment and fluid management were followed by a series of immersive simulation scenarios and structured debriefs, concentrating on the importance of non-technical skills in the clinical workplace. Also, some mini-tutorials were incorporated into the course design, focussing on the technical and pathophysiological aspects of each presentation. We employed a mixed-method research methodology to evaluate the impact of the course. Also, anonymized post-course and free-text feedback was sought to explore students’ experiences and perceptions of the course. Results: All 80 students completed the pre and post-course confidence questionnaires, reporting statistically significant improvements in confidence across all 11 domains tested. Thematic analysis of the qualitative data identified six core themes: knowledge acquisition, the value of debriefing, the importance of non-technical skills, the value of faculty expertise, the value of repeated practice, and opportunities for exposure to pediatrics. The innovative post-scenario mini-tutorials were favorably received. Conclusions: Our study shows that immersive SBE can improve medical students’ confidence in managing pediatric emergency scenarios. Also, incorporating mini-tutorials within an immersive simulation course design in an undergraduate setting can be helpful and well received by students.

The Importance of Non-Technical Skills in Accounting Graduates

The purpose of this study is to look at the quality issue from the perspective of one of the most important customers of higher education institutions-employers that hire the accounting graduates. Specifically, this study determines how well skill requirements match skill preparedness of accounting graduates. Results re­vealed that. five most important non-technical skills required by employers were the ability to perform assigned tasks, having initiative, teamwork, computer literacy, and problem solving. Employers, however; perceived that higher education institutions do not seem to prepare accounting graduates with all the skills required. The majority of employers agree that quality differences exists between accounting graduates ,from public and pri­vate institutions, and accounting graduates with and without professional qualifications. Finally, the study highlights suggestions to improve the quality of accounting graduates, and also recommendations for future research.

The safety of urologic robotic surgery depends on the skills of the surgeon.

To assess the available literature evidence that discusses the effect of surgical experience on patient outcomes in robotic setting. This information is used to help understand how we can develop a learning process that allows surgeons to maximally accommodate patient safety. A literature search of the MEDLINE/PubMed and Scopus database was performed. Original and review articles published in the English language were included after an interactive peer-review process of the panel. Robotic surgical procedures require high level of experience to guarantee patient safety. This means that, for some procedures, the learning process might be longer than originally expected. In this context, structured training programs that assist surgeons to improve outcomes during their learning processes were extensively discussed. We identified few structured robotic curricula and demonstrated that for some procedures, curriculum trained surgeons can achieve outcomes rates during their initial learning phases that are at least comparable to those of experienced surgeons from high-volume centres. Finally, the importance of non-technical skills on patient safety and of their inclusion in robotic training programs was also assessed. To guarantee safe robotic surgery and to optimize patient outcomes during the learning process, standardized and validated training programs are instrumental. To date, only few structured validated curricula exist for standardized training and further efforts are needed in this direction.

Priming healthcare students on the importance of non-technical skills in healthcare: How to set up a medical escape room game experience

Background: Non-technical skills (NTS) are essential for healthcare professionals. Earlier the students are made aware of this, the more time they have to acquire these skills. Escape rooms have been introduced in the medical literature but a detailed published manual on setting up and running such a learning modality is lacking. The purpose of this paper is to describe the use of an escape room to create learning opportunities, including detailed instructions, as well as an evaluation from two settings.Methods: A medical escape room focusing on NTS was developed and run in two different settings: a university summer school – EMSS17, and an international healthcare congress – EMS2018. Questionnaire data investigating entertainment value, self-evaluated use of NTS and ideas for further use of the escape room concept was obtained. Further, video analyses were conducted to triangulate self-rated analyses.Results: Majority of the participants found the escape room psychologically safe and enjoyable and would recommend the concept to other students and healthcare professionals. Video analyses showed the same tendencies regarding the use of NTS as reported by participants.Conclusions: This paper presents a fully applicable escape room manual, ready to implement, adapt, and modify. Evaluation data support the proof of concept.

Amalan Berkesan bagi Ulasan terhadap Simulasi Kemahiran Bukan Teknikal dalam kalangan Profesional Penjagaan Kesihatan: Satu Kajian Sistematik

The importance of non-technical skills among healthcare professionals is gaining a widespread recognition as critical elements complementing the technical skills used for improving patients’ safety. These skills are typically acquired through simulation training, which emerged as an effective way to complement clinical training. Non-technical skills frequently use high-fidelity simulation followed by a facilitated discussion known as debriefing. Debriefing by a skilled facilitator is thought to be essential for effective learning through reflective processes. Unfortunately, evidence to support the elements which contributes towards the effectiveness of debriefing remains sparse. We review the studies where elements of debriefing that have been manipulated and its effectiveness on the acquisition of non-technical skills among healthcare professionals through eight publications across four different databases. Non-technical skills performance improved after manipulated debriefing such as multimedia debrief, self-led debrief or no debrief. Besides, there was no added performance when video recording was added to facilitator-led debriefing. The application of learning theory on specific elements together with the application of selected debriefing models is highly encouraging for effective debriefing. DOI : http://dx.doi.org./10.17576/JSKM-2019-1702-06

How to manage the study-to-work transition? a comparative study of Hungarian and French graduate engineering students’ perception of their employability

ABSTRACT The purpose of this article is to explore graduate engineering students’ perception of their employability perspectives, strategy and the skills and competencies they require for their career. We have applied qualitative methodology to obtain a better understanding of the students’ transition from studies to professional life and conducted 28 semi-structured interviews in France and Hungary. Our results indicate that the engineering students have a markedly different perception of their employment prospects, strategy and the role of technical and non-technical skills to this end. The Hungarian students have short-term employability perspectives with a mainly informal job-seeking approach and they mostly consider technical skills as being of importance for their employability. On the contrary, the French students have a long-term employability vision applying a formal job-seeking approach with a considerably higher level of engagement in the engineering profession and consideration of the importance of non-technical skills in obtaining the desired work position.