healthmedicinet

The programme should allow surgeons to show leadership and take charge in the
operating theatre but also create an atmosphere so more junior members of
the team feel able to speak up when they feel a mistake is being made. The
hierarchy and lack of confidence of the team have been shown to cost lives
during operations.

Ian Ritchie, president of the Royal College of Surgeons of Edinburgh and a
consultant trauma and orthopaedic surgeon, said: “Safety is an issue
which concerns all those who care for patients and lies at the heart of
medical practice.

“All surgeons have a primary responsibility to participate in established
procedures and help develop new measures to improve patient safety: at The
Royal College of Surgeons of Edinburgh we are committed to improving
standards through education and training and by supporting research into
human factors which may prevent or mitigate patient harm.

“We’re proud to have developed the world’s only behavioural marker tool
for surgeons and are excited to see it adopted into the curriculum of all
surgical specialties.”

Mr Simon Paterson-Brown, consultant general and upper GI surgeon at the Royal
Infirmary of Edinburgh and Fellow of the Royal College of Surgeons of
Edinburgh, said: “For many years now it’s been demonstrated that
avoidable complications and deaths still occur because of flawed learning
behaviours and surgeons’ poor understanding of the importance of
non-technical skills in operative performance; as a result training for
future surgeons must encompass more than just clinical and technical skills.

“Other high-hazard sectors have recognised that technical expertise is
not enough to ensure safety, for example airline pilots and anaesthetists
have their own behaviour ratings systems to assess performance. NOTSS is
both innovative and unique in that it was developed entirely by surgeons for
surgeons, underpinned by psychologists experienced in studying human
factors.

“There is increasing evidence that the contributory role of non-
technical skills failures in surgical adverse events is higher than was ever
recognised. Whilst most people are used to, and recognise the importance of,
the concepts of IQ v EQ or ‘emotional intelligence’, surgical training in
the UK has only in recent years moved away from knowledge-based set pieces
in favour of competency-based assessment in the workplace.

“This approach is encouraging greater emphasis on identifying the skills
necessary to maximise safe and effective management of patients and requires
an appreciation of the role of non-technical abilities, defined as the
cognitive and interpersonal skills that underpin technical proficiency.”