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Structured interventions—including debriefing with feedback, coaching, didactic workshops, and standardized checklists—remarkably enhance surgeons’ overall nontechnical skills.
According to a systematic review and meta-analysis, targeted interventions can substantially improve surgeons’ nontechnical skills (NTS), which are crucial for patient safety and surgical outcomes. Nontechnical skills, including communication, decision-making, teamwork, and leadership, play a fundamental role in preventing surgical adverse events. However, there has been limited evidence to guide training programs targeted at boosting these skills.
Therefore, this study scrutinized the effectiveness of various interventions in improving NTS overall and across individual domains. Researchers carried out a comprehensive search of Embase, Medline (including PubMed), and PsycINFO databases. The search yielded 2,682 studies, of which 65 were eligible for inclusion. These comprised 20 randomized controlled trials (RCTs) and 45 non-randomized studies or pre–post intervention cohort studies. Notably, 2 independent reviewers screened studies and extracted data in accordance with PRISMA and MOOSE guidelines, with a third reviewer resolving any disagreements.
Data were pooled using a random-effects model. The key outcome was the change in overall nontechnical skills, while secondary outcomes explored improvements in specific NTS domains.
Notably, 4 types of interventions were linked with improvements in overall NTS. These incorporated practice with debriefing or feedback (standardized mean difference [SMD]: 1.80), didactic training or workshops (SMD: 1.26), coaching (SMD: 0.82), and checklists or standardized procedures (SMD: 0.53).
The narrative review further indicated that interventions involving debriefing, coaching, and structured curricula exhibited a positive impact on individual NTS domains like communication, situational awareness, and leadership. These findings yield a strong evidence base for incorporating structured nontechnical skills training into surgical education. Hence, using simulation, real-time feedback, coaching, and standardized protocols can aid in fostering a safer and better surgical environment. Overall, the study supports the integration of evidence-based NTS interventions into real-world surgical settings to boost patient outcomes and minimize adverse events.
Journal of Surgical Education
Journal of Surgical Education
Jesse Ey et al.
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