PT  - JOURNAL ARTICLE
AU  - Ahmed, Youseff
AU  - Lone, Zaeem
AU  - Hussein, Ahmed A
AU  - Feng, Yingdong
AU  - Khan, Hijab
AU  - Broad, Sierra
AU  - Kannappan, Renuka
AU  - Skowronski, Alicia
AU  - Cole, Adam
AU  - Wang, Derek
AU  - Stone, Kevin
AU  - Hasasneh, Adam
AU  - Sexton, Kevin
AU  - Gotsch, Amanda
AU  - Ali, Taimor
AU  - Braun, Jacob
AU  - Khan, Saira
AU  - Durrani, Ayesha
AU  - Durrani, Mohammad
AU  - Guru, Khurshid A
TI  - Do surgeon non-technical skills correlate with teamwork-related outcomes during robot-assisted surgery?
AID  - 10.1136/leader-2018-000128
DP  - 2019 Sep 01
TA  - BMJ Leader
PG  - 69--74
VI  - 3
IP  - 3
4099  - http://bmjleader.bmj.com/content/3/3/69.short
4100  - http://bmjleader.bmj.com/content/3/3/69.full
SO  - BMJ Leader BMJ Leader2019 Sep 01; 3
AB  - Introduction To evaluate the impact of non-technical skills (NTS) on team performance, workload and clinical outcomes.Methods The operating room (OR) environment of 20 robot-assisted radical prostatectomies performed by three different surgeons was recorded. Trained observers assessed NTS utilising the Non-Technical Skills for Surgeons (NOTSS) questionnaire. Associations between NOTSS scores, teamwork attributes (anticipation and inconveniences), workload (measured by National Aeronautics and Space Administration-Task Load Index (NASA-TLX)) and clinical outcomes (operative time, blood loss and surgical complexity) were determined using logistic regression and Pearson correlation.Results 1780 requests were observed, 703 (39%) were non-verbal. Utilisation of non-verbal requests differed significantly among surgeons (26%, 36% and 44%, p<0.001). Anticipation was significantly associated with ‘Situational Awareness’ (OR 2.59, 95% CI 1.52 to 4.38, p<0.001), ‘Decision Making’ (OR 0.42, 95% CI 0.33 to 0.55, p<0.001) and ‘Communication and Teamwork’ (OR 0.43, 95% CI 0.25 to 0.74, p=0.002) domains. Inconveniences were significantly associated with ‘Situational Awareness’ (OR 0.21, 95% CI 0.08 to 0.59, p=0.003), ‘Decision Making’ (OR 2.73, 95% CI 1.53 to 4.86, p<0.001), and ‘Leadership’ (OR 0.62, 95% CI 0.41 to 0.94, p=0.03). There was a significant positive correlation between NOTSS scores and perceived physical and mental workload measures of NASA-TLX, as well as self-perceived performance. There was no significant association between NOTSS scores and any of the investigated clinical outcomes.Conclusion NTS in the OR were associated with team efficiency, fewer surgical flow disruptions and an improved self-perceived performance.