Nontechnical Skills in Surgery

Nontechnical skills are the cognitive and social skills that underpin knowledge and expertise in high-demand workplaces. In the operating room (OR), surgeons with good nontechnical skills can effectively share information about their perceptions of ongoing situations with other team members, elicit critical information from others regarding the task and patient safety, and allow the formation of better shared mental representations about the operation in real time. In rare OR crises, surgeons use their nontechnical skills to delegate tasks and effectively manage challenging operations under time pressure. This review covers approaches in high-risk industry; the development, testing, and usage of the non-technical skills for surgeons (NOTSS) system; and the underpinning theory of nontechnical skills. Tables outline the NOTSS skills taxonomy, behavioral rating tools in surgery, and the skills taxonomy used in the aviation industry. This review contains 3 tables, and 95 references. Key Words: Non-technical skills, leadership, Situation Awareness, Decision Making, Communication, Teamwork, Coaching, Error, Simulation