Session Design Submission Review

No

Yes

Decades of research has now demonstrated the vast importance of nontechnical skills (NTS) for surgeons in improving outcomes in surgical teams. NTS are defined as the cognitive and social skills that underpin knowledge and expertise in high demand workplaces, and categorized for surgery as situation awareness, decision making, leadership, communication and teamwork. More than half of surgical adverse events are preventable, and the breakdown of NTS (e.g. communication) during surgery leads to a higher risk of major complication or death compared to technical errors (Flin et al, 2015).  In a recent prospective study, higher NTS scores were associated with decreased rate of any post operative complication (Abahuje et al, 2024). Fortunately, team training can improve NTS in surgeons and lead to improvements in patient safety. It can reduce the risk of litigation and patient complaints, and improve morale of the team. In studies of interdisciplinary teams providing cardiopulmonary resuscitation (CPR), the teams that receive leadership skills training had significantly better performance in a CPR simulation than a group that received only technical skills training (Capella et al, 2010). 

Situation awareness involves being fully present in the moment; gathering and understanding information on the patient’s condition and the environment; projecting its importance into the future. It is influenced by how much cognitive bandwidth you have in the moment. Decision making is a specific skill in which options are considered, selected and communicated. Communication/teamwork includes the ability to exchange critical information, foster a shared understanding with colleagues, and build a team that acts in a coordinated way. The ability of team members to speak up and actually be heard, rather than dismissed or discouraged, is critical to these NTS domains. Finally, leadership is well known to be critically important for surgeons and involves setting and maintaining high standards, supporting others, and coping with pressure. 

This workshop will introduce practical tools that participants will take back to their institution, often utilizing steps that are already in the workflow of a typical OR day. These include the practice of self checking/cross checking with the team to help surgeons and trainees regroup after intraoperative surprises or variation. The HALT mnemonic (Hungry, Angry, Late, Tired) is an approach to improve participants’ decision making state before entering the OR. The CUSS mnemonic (C – “I am concerned” U – “I am uncomfortable” S – “This has become a safety concern” S – ” I think this procedure needs to stop”) is a technique of graded assertiveness that can be used to speak up in the operative setting despite steep hierarchy.  The Surgical Safety Checklist is a tool commonly used for patient safety in the OR, and is also be framed as a Leadership tool for setting the tone of psychological safety.

During this workshop, didactic teaching, tabletop simulations, and engaging breakout sessions will be used to equip surgeons, trainees and educators to use these tools to both improve their own outcomes and as pedagogical approaches to teach NTS to trainees and colleagues at their respective institutions.

90-minute workshop

Yes

Yes

Articulate the 4 nontechnical skills for surgeons categories and their importance in surgical care

Implement practical tools to manage optimal communication and other nontechnical skills in the OR setting

Identify surgical scenario examples and breakout activities that can be adapted for use in simulation or didactic teaching at their own institution