Skip to main content

Advertisement

Log in

Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the “non-technical skills for surgeons” (NOTSS) rating system in a major Japanese cancer center.

Methods

Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and “observational teamwork assessment for surgery” (OTAS) rating systems, before and after their education.

Results

Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees’ education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the “teamwork and communication” and “leadership” categories.

Conclusion

These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Flin R, Yule S, Paterson-Brown S, Maran N, Rowley D, Youngson G. Teaching surgeons about non-technical skills. Surgeon. 2007;5(2):86–9.

    Article  CAS  PubMed  Google Scholar 

  2. Ellis O. Putting safety on the curriculum. BMJ. 2009;339:b3725.

    Article  PubMed  Google Scholar 

  3. Dietz AS, Pronovost PJ, Benson KN, Mendez-Tellez PA, Dwyer C, Wyskiel R, et al. A systematic review of behavioural marker systems in healthcare: what do we know about their attributes, validity and application? BMJ Qual Saf. 2014;23(12):1031–9.

    Article  PubMed  Google Scholar 

  4. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists’ non-technical skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580–8.

    Article  CAS  PubMed  Google Scholar 

  5. Yule S, Flin R, Maran N, Rowley D, Youngson G, Paterson-Brown S. Surgeons’ non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system. World J Surg. 2008;32(4):548–56.

    Article  PubMed  Google Scholar 

  6. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Evaluation of the scrub practitioners’ list of intraoperative non-technical skills system. Int J Nurs Stud. 2012;49(2):201–11.

    Article  PubMed  Google Scholar 

  7. Undre S, Healey AN, Darzi A, Vincent CA. Observational assessment of surgical teamwork: a feasibility study. World J Surg. 2006;30(10):1774–83.

    Article  PubMed  Google Scholar 

  8. Robertson ER, Hadi M, Morgan LJ, Pickering SP, Collins G, New S, et al. Oxford NOTECHS II: a modified theatre team non-technical skills scoring system. PLoS One. 2014;9(3):e90320.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons’ non-technical skills. Med Educ. 2006;40(11):1098–104.

    Article  CAS  PubMed  Google Scholar 

  10. Spanager L, Lyk-Jensen HT, Dieckmann P, Wettergren A, Rosenberg J, Ostergaard D. Customization of a tool to assess Danish surgeons non-technical skills in the operating room. Dan Med J. 2012;59(11):A4526.

    PubMed  Google Scholar 

  11. Dickinson I, Watters D, Graham I, Montgomery P, Collins J. Guide to the assessment of competence and performance in practising surgeons. ANZ J Surg. 2009;79(3):198–204.

    Article  PubMed  Google Scholar 

  12. Koike S, Shimizu A, Matsumoto M, Ide H, Atarashi H, Yasunaga H. Career pathways of board-certified surgeons in Japan. Surg Today. 2015.

  13. Tsuburaya A. Desired behavior and competency for surgeons. J Jpn Surg Soc. 2012;113(Suppl 3):5–6.

    Google Scholar 

  14. Youngson GG. Teaching and assessing non-technical skills. Surgeon. 2011;9(Suppl 1):S35–7.

    Article  PubMed  Google Scholar 

  15. de Vries EN, Prins HA, Crolla RM, den Outer AJ, van Andel G, van Helden SH, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med. 2010;363(20):1928–37.

    Article  PubMed  Google Scholar 

  16. Pena G, Altree M, Field J, Sainsbury D, Babidge W, Hewett P, et al. Non-technical skills training for the operating room: a prospective study using simulation and didactic workshop. Surgery. 2015;158(1):300–9.

    Article  PubMed  Google Scholar 

  17. Sharma B, Mishra A, Aggarwal R, Grantcharov TP. Non-technical skills assessment in surgery. Surg Oncol. 2011;20(3):169–77.

    Article  PubMed  Google Scholar 

  18. Brewin J, Ahmed K, Challacombe B. An update and review of simulation in urological training. Int J Surg. 2014;12(2):103–8.

    Article  PubMed  Google Scholar 

  19. Lorello GR, Cook DA, Johnson RL, Brydges R. Simulation-based training in anaesthesiology: a systematic review and meta-analysis. Br J Anaesth. 2014;112(2):231–45.

    Article  CAS  PubMed  Google Scholar 

  20. Meurling L, Hedman L, Sandahl C, Fellander-Tsai L, Wallin CJ. Systematic simulation-based team training in a Swedish intensive care unit: a diverse response among critical care professions. BMJ Qual Saf. 2013;22(6):485–94.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yule S, Parker SH, Wilkinson J, McKinley A, MacDonald J, Neill A, et al. Coaching non-technical skills improves surgical residents’ performance in a simulated operating room. J Surg Educ. 2015;72(6):1124–30.

    Article  PubMed  Google Scholar 

  22. Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2015.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akira Tsuburaya.

Ethics declarations

Conflict of interest

We have no financial interests related to the material in this manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsuburaya, A., Soma, T., Yoshikawa, T. et al. Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center. Surg Today 46, 1451–1455 (2016). https://doi.org/10.1007/s00595-016-1322-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-016-1322-8

Keywords

Navigation