“NON-TECHNICAL SKILLS FOR SURGEONS (NOTTS) was developed by a team in Scotland at the University of Aberdeen and funded by the Royal College of Surgeons of Edinburgh and NHS Education for Scotland; lead investigator Steven Yule, PhD, was a part of this team and now brings his experience and expertise to the United States with the Non-Technical Skills Lab at Brigham and Women’s Hospital and Harvard Medical School. NOTSS was developed from the bottom up with a panel of subject matter experts (consultant/attending surgeons/psychologists) in place of adapting an existing framework employed by other industries. The aim of the NOTSS project was to develop and test an educational system for assessment and training based on observable behavioral skills in the intraoperative phase of surgery (Yule et al. Surg Clin N Am 2012;92:37-50).
THE NOTSS SYSTEM
was written in surgical language for trained surgeons to observe, rate, and provide feedback on non-technical skills in a structured manner (Yule et al. Surg Clin N Am 2012;92:37-50). The NOTSS taxonomy is broken down into four distinct categories of non-technical skill: Situation Awareness, Decision Making, Communication and Teamwork, and Leadership (Yule et al. World J Surg 2008;32:548-556), each with associated elements. Good and poor behaviors were carefully written for each element. The Royal College of Surgeons of Edinburgh also provide resources for training non-technical skills. Click Here!“
|Fundamentals of Acceptable|
Behavior in the Operating Room
“As much as the culture and practice of surgery have changed and evolved over the last several hundred years, it remains true that the operating room (OR) can be an intimating place for medical students or junior residents. In the past, surgeons have often had the reputation of being arrogant or demeaning, with frequent stories akin to hazing of junior residents in the OR, or of impulsive, disruptive behavior aimed at team members such as nursing staff, anesthesia team, and support personnel. In fact, this type of “old-school” behavior is no longer acceptable, for many reasons. The OR is a special place, but it is still in the end a workplace, and workplace norms of mutual respect and polite behavior must apply. In the modern era, it is clear that surgeons must work in a respectful and collaborative fashion with all members of the patient care team. It is incumbent on the surgeon to create an atmosphere of mutual respect, trust, and communication. This is often called “OR etiquette,” as etiquette is defined as a code of conduct among a group or professionals that should dictate how we act and work with others. This is related to but distinct from manners—which are behaviors (good or bad) that reflect our attitude toward others. Etiquette, therefore, creates the structure within which manners exist.”