EXPERIMENTAL EVALUATION OF A BEHAVIOURAL MARKER SYSTEM FOR SURGEONS ’ NON-TECHNICAL SKILLS (NOTSS)

Non-technical skills provide a critical underpinning for good surgical practice, but they must be trained and assessed according to properly developed skills frameworks and validated measurement tools. The NOTSS (Non-Technical Skills for Surgeons) skills taxonomy was developed from cognitive task analysis with subject matter experts and has been reported previously. It comprises five categories (situation awareness, decision making, task management, communication and teamwork, and leadership) divided into fourteen elements. The aim of the present study was to evaluate this as a behavioural rating system. An evaluation was conducted with 44 consultant (attending) surgeons who were trained to use the prototype NOTSS system and then rated surgeons ’ behaviours in six videos of simulated surgical scenarios. Evaluation results indicate that the system is complete, the skills are observable, and can be rated with approaching acceptable levels of agreement. Responses regarding initial usability were positive