Enhancing Surgical Performance: A Primer in Non-Technical Skills explains why non-technical skills are vital for safe and effective performance in the operating theatre. The book provides a full account, with supporting empirical evidence, of the Non-Technical Skills for Surgeons (NOTSS) system and behavioural rating framework, which helps identify the key elements involved in successful operative surgery. The editors spent the last twelve years as part of the team developing and testing the NOTSS system and delivering presentations and workshops across the world. Readers will benefit by having, in one accessible handbook, a description of the NOTSS system and how it can be used for training, assessment, self-reflection and event analysis. The book also examines human error, performance limitations, and global safety initiatives in surgery. Because it encourages surgeons to reflect on their own performance and behaviour, it is suitable for surgeons in all specialties and at all levels.
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SURGICAL PERFORMANCE: RECOGNITION OF THE CHALLENGE Intraoperative Performance, Non-Technical Skills and Surgical Safety Introduction Surgical Skills Non-Technical Skills What Non-Technical Skills Are Not Factors Influencing Surgical Performance Surgical Error About this Book Human Factors: The Science Behind Non-Technical Skills Introduction Human Factors Science Evolution of Non-Technical Skills Non-Technical Skills for Pilots NOTECHS: Non-Technical Skills for Pilots Non-Technical Skills in Other Industries Non-Technical Skills in Health Care Summary Non-Technical Skills for Surgeons: The NOTSS Behaviour Marker System Overview NOTSS System Using NOTSS Underpinning Theory of Non-Technical Skills Non-Technical Skills at Work in the Operating Room New Developments with NOTSS Since the Taxonomy Was Published Importance of NOTSS for Surgeons and Patients Conclusion UNDERPINNING CONCEPTS Situation Awareness Introduction Human Memory System Model of Situation Awareness Influencing Factors Training Situation Awareness Assessing Situation Awareness Summary Decision Making Introduction Model of Intra-Operative Decision Making Decision-Making Methods: What Shall I Do? Factors Influencing Intra-Operative Decision Making Training Surgeons' Intra-Operative Decision Making Assessing Surgeons' Intra-Operative Decision-Making Skills Summary Teamwork and Communication Introduction Exchanging Information Establishing a Shared Understanding Co-Ordinating Team Activities Interventions to Improve Teamworking and Communication Conclusion Leadership Introduction Leadership in NOTSS Setting and Maintaining Standards Supporting Others Coping with Pressure Surgeons' Leadership Inventory Conclusion Performance-Shaping Factors Introduction Stress in Surgery Fatigue Conclusion IMPLEMENTATION AND IMPROVEMENT Training Methods For Non-Technical Skills Introduction Training Design and Development for Non-Technical Skills Evaluation Integrating Non-Technical Skills Training into Surgical Training Training Modalities Practical Matters and Future Possibilities Assessing Non-Technical Skills in the Operating Room Introduction Emergence of Non-Technical Skills Assessment Principles of Assessment Behavioural Marker Systems Practical Issues and Problems with Behavioural Marker Systems Current Methods for Assessing Surgeons Summary What Next? Development of Non-Technical Skills Acquisition: Education in Patient Safety and Non-Technical Skills Using, Developing and Enhancing Non-Technical Skills Coaching and Debriefing Using Non-Technical Skills for Surgeons Non-Technical Skills and Quality Improvement Safety Management Systems Safety Culture and Non-Technical Skills Liability, Indemnity and Non-Technical Skills Adverse Event Analysis and Non-Technical Skills Demonstrating and Retaining Competence in Non-Technical Skills Limits and Boundaries Conclusions
