RT Journal Article
SR Electronic
T1 Do surgeon non-technical skills correlate with teamwork-related outcomes during robot-assisted surgery?
JF BMJ Leader
JO BMJ Leader BMJ Leader
FD BMJ Publishing Group Ltd
SP 69
OP 74
DO 10.1136/leader-2018-000128
VO 3
IS 3
A1 Ahmed, Youseff
A1 Lone, Zaeem
A1 Hussein, Ahmed A
A1 Feng, Yingdong
A1 Khan, Hijab
A1 Broad, Sierra
A1 Kannappan, Renuka
A1 Skowronski, Alicia
A1 Cole, Adam
A1 Wang, Derek
A1 Stone, Kevin
A1 Hasasneh, Adam
A1 Sexton, Kevin
A1 Gotsch, Amanda
A1 Ali, Taimor
A1 Braun, Jacob
A1 Khan, Saira
A1 Durrani, Ayesha
A1 Durrani, Mohammad
A1 Guru, Khurshid A
YR 2019
UL http://bmjleader.bmj.com/content/3/3/69.abstract
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.