Assessment tools for team and nontechnical skills
Project summary
Background
Failures in teamwork skills in the operating room (OR) have been frequently implicated in adverse events to surgical patients. In contrast, empirical evidence has found that superior teamwork is associated with fewer errors in the OR.
Non-technical skills reflect the interpersonal (e.g. communication, teamwork, and leadership) and cognitive skills (i.e. decision-making and situational awareness), that complement clinician’s technical skills. In the OR, non-technical aspects of performance are effectively captured by the way a team works together to deliver care safely.
Until recently, robust (i.e., psychometrically reliable and valid) assessment tools for nontechnical skills in ORs were lacking. Our research Group has developed and validated the Observational Teamwork Assessment for Surgery (OTAS ) tool to capture nontechnical skills in ORs – including surgical, anaesthetic, and nursing personnel.
Aims
A series of inter-related projects under this research stream are aiming to expand the evidence base on assessment tools for nontechnical skills in the OR. These studies are addressing the following aims:
- Provide ongoing validation evidence for OTAS
- Investigate assessor learning curves and training requirements in the use of OTAS and similar tools
- Investigate skills required for safe care delivery within and outside ORs (including nontechnical skills but not limited to them)
Methods
A range of methods and approaches are being used within these projects, including:
- Qualitative methods (to elicit content validation evidence for skills domains, and assessment tools)
- Quantitative methods (to assess learning curves and training requirements for OTAS and other team skills assessment tools users; to quantify skills evident in clinical practice via observation)
Project team
- Nick Sevdalis (PI and key contact)
- Sonal Arora
- Louise Hull
- Stephanie Russ
- Ara Darzi
- Charles Vincent
Project outputs
Peer-reviewed papers
- Long S, Arora S, Moorthy K, Sevdalis N, Vincent CA. Qualities and attributes of a safe practitioner: identification of safety skills in healthcare. Quality and Safety in Health Care 2011;in press
- Hull L, Arora S, Kassab E, Kneebone RL, Sevdalis N. Observational Teamwork Assessment for Surgery (OTAS): Content validation and tool refinement. Journal of the American College of Surgeons 2011;212:234-43.
- Mitchell E, Lee DY, Sevdalis N, Partsafas AW, Landry GJ, Liem TK, Moneta GL. Evaluation of distributed practice schedules on retention of a newly acquired surgical skill: A randomized trial. American Journal of Surgery 2011;201:31-9.
- Arora S, Sevdalis N, Suliman I, Athanasiou T, Kneebone RL, Darzi A. What makes a competent surgeon? Experts' and trainees' perceptions of the roles of a surgeon. American Journal of Surgery 2009;198:726-32.
- Sevdalis N, Lyons M, Healey AN, Undre S, Darzi A, Vincent CA. Observational Teamwork Assessment for Surgery: Construct validation with expert vs. novice raters. Annals of Surgery 2009;249:1047-51.
- Sevdalis N, Brett S. Improving care by understanding the way we work: Human factors and behavioural science in the context of intensive care. Critical Care 2009;13(2):139.
- Sevdalis N, Undre S, Henry J, Sydney E, Koutantji M, Darzi A, Vincent CA. Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses. International Journal of Nursing Studies 2009;46:1187-93.
- Undre S, Arora S, Sevdalis N. Surgical performance, human error, and patient safety in urological surgery. British Journal of Medical and Surgical Urology 2009;2:2-10.
- Undre S, Sevdalis N, Vincent CA. Observing and assessing surgical teams: The Observational Teamwork Assessment for Surgery© (OTAS)©. In R Flin, L Mitchell (Eds.) Safer Surgery: Analyzing Behaviour in the Operating Theatre (pp. 83-102; Ch. 6). Ashgate. 2009.
- Arora S, Sevdalis N. HOSPEX and concepts of simulation. Journal of the Royal Army Medical Corps 2008;154:202-5.
- Sevdalis N, Davis RE, Koutantji M, Undre S, Darzi A, Vincent CA. Reliability of a revised NOTECHS scale for use in surgical teams. American Journal of Surgery 2008;196:184-90.
- Sevdalis N, Forrest D, Undre S, Darzi A, Vincent CA. Annoyances, disruptions, and interruptions in surgery: The Disruptions in Surgery Index (DiSI). World Journal of Surgery 2008;32:1643-50.
Talks and presentations
- Sevdalis N. Complex skills, complex technologies: Simulation-based research and training of surgeons’ non-technical skills. Royal College of Surgeons of Edinburgh. “Surgical simulation: Problems and pitfalls with ‘pretending’” meeting. Edinburgh, UK. February 2011.
- Sevdalis N. A psychologist in the operating theatre: The art and science of assessing and training behavioural skills in medicine and surgery. Institute of Social Psychology, London School of Economics and Political Science. London, UK. January 2011.
- Sevdalis N. Human behaviour, human performance, and patient safety. Royal Society of Medicine, “Improving Safety in Maternity Care” Seminar. London, UK. April 2010.
- Sevdalis N. Systems approach to safety in surgery and anaesthesia. Aberdeen Royal Infirmary. Aberdeen, UK. February 2009.
- Sevdalis N. Medical error and patient safety. Royal College of Anaesthetists and Intensive Care Society joint Intensive Care Symposium, London, UK. June 2008.
- Sevdalis N. Behavioural aspects of safety in surgical care. Vrije University Medical Center and Netherlands Institute for Health Services Research (NIVEL), Amsterdam, Netherlands. February 2008.
- Sevdalis N. Assessment of frontline safety skills. NPSA 2nd Annual Patient Safety Research Workshop: Patient Safety Research into Practice. London, UK. November 2008.
- Sevdalis N. Assessment of nontechnical skills in healthcare: The state of the art. European Trauma Course Faculty meeting. Vienna, Austria. September 2008.
- Sevdalis N. Observational Teamwork Assessment for Surgery and Failure Modes and Effects Analysis in the assessment of surgical teamworking. International Workshop on Teamwork and Safety in Surgery. Oxford, UK. September 2008.
- Sevdalis N. Non-technical skills in medicine: State of the art in assessment and training. Territorial Army Medical Services, 2nd Medical Brigade, Faculty meeting, York, UK. February 2008.
Workshops
- Hull L, Sevdalis N. Assessment of nontechnical skills of surgical teams in simulation. International Meeting for Simulation in Healthcare, Florida, January 2010.
- Arora S, Sevdalis N. Non-technical skills training and assessment. Association of Surgical Education Annual Meeting, Utah, April 2009.
- Sevdalis N, Arora S, Manser T, Flin R: Non-technical skills for Operating Room Teams. International Meeting for Simulation in Healthcare, Orlando, January 2009.
- Sevdalis N. Assessing and improving teamwork in the operating theatre. Royal College of Obstetricians and Gynaecologists. Risk Management and Medico-legal Issues in Women’s Health Meeting, London, April 2008.
