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首页> 外文期刊>Annals of Surgery >Implementation of an Effective Strategy for Teaching Nontechnical Skills in the Operating Room: A Single-blinded Nonrandomized Trial
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Implementation of an Effective Strategy for Teaching Nontechnical Skills in the Operating Room: A Single-blinded Nonrandomized Trial

机译：在手术室中实施非技术技能教学有效策略的实施：单盲非随机试验

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Objective:To evaluate the effectiveness of debriefing and feedback on intraoperative nontechnical performance as an instructional strategy in surgical training.Background:Regulatory authorities for accreditation in North America have included nontechnical skills such as communication and teamwork in the competencies to be acquired by surgical residents before graduation. Concrete recommendations regarding the training and assessment of these competencies, however, are lacking.Methods:Nonrandomized, single-blinded study using an interrupted time-series design. Eleven senior surgical residents were observed during routine cases in the operating room (OR) at baseline and post-training. The Non-Technical Skills for Surgeons (NOTSS) rating system was used. Observers were trained in NOTSS and blinded to the study purpose. Independent of the blinded observations, a surgeon educator conducted intraoperative observations, which served as the basis for the structured debriefing and feedback intervention. The intervention was administered to participants after a set of (blinded) baseline observations had been completed. Primary outcome was nontechnical performance in the OR as measured by the NOTSS system. Secondary outcome was perceived utility as assessed by a post-training questionnaire.Results:Twelve senior trainees were recruited, 11 completed the study. Average NOTSS scores improved significantly from 3.2 (SD 0.37) at baseline to 3.5 (SD 0.43) post-training [t(10) = -2.55, P = 0.29]. All participants felt the intervention was useful, and the majority thought that debriefing and feedback on nontechnical skills should be integrated in surgical training.Conclusions:Debriefing and feedback in the OR may represent an effective strategy to ensure development of nontechnical skills in competency-based education.
机译：目的：评估对术中非技术性表现的汇报和反馈作为外科手术训练的指导策略的有效性。背景：北美的认证监管机构已将非技术性技能（例如沟通和团队合作）纳入了外科住院医师在获得技能之前的技能毕业。然而，缺乏有关训练和评估这些能力的具体建议。方法：采用间断时间序列设计的非随机，单盲研究。在基线和培训后的手术室（OR）的常规病例中，观察到11位高级外科住院医师。使用了外科医生非技术技能（NOTSS）评分系统。观察员接受了NOTSS培训，对研究目的视而不见。独立于盲目观察，外科医生由术者进行术中观察，这是结构化汇报和反馈干预的基础。在完成一组（盲目）基线观察后，对参与者进行了干预。主要结果是由NOTSS系统衡量的手术室的非技术性能。通过培训后问卷评估，次要结局被认为是效用。结果：招募了12名高级培训生，其中11人完成了研究。平均NOTSS得分从基线时的3.2（SD 0.37）显着提高到训练后的3.5（SD 0.43）[t（10）= -2.55，P = 0.29]。所有参与者都认为干预是有用的，并且大多数人认为对非技术技能的汇报和反馈应该纳入外科手术培训中。结论：手术室中的汇报和反馈可能是确保在基于能力的教育中发展非技术技能的有效策略。

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