Objective

The purpose of this study was to identify, synthesize, and discuss objective behavioral or physiological metrics of surgeons’ nontechnical skills (NTS) in the literature.

Background

NTS, or interpersonal or cognitive skills, have been identified to contribute to safe and efficient surgical performance; however, current assessments are subjective, checklist-based tools. Intraoperative skill evaluation, such as technical skills, has been previously utilized as an objective measure to address such limitations.

Methods

Five databases in engineering, behavioral science, and medicine were searched following PRISMA reporting guidelines. Eligibility criteria included studies with NTS objective measurements, surgeons, and took place within simulated or live operations.

Results

Twenty-three articles were included in this review. Objective metrics included communication metrics and measures from physiological responses such as changes in brain activation and motion of the eye. Frequencies of content-coded communication in surgery were utilized in 16 studies and were associated with not only the communication construct but also cognitive constructs of situation awareness and decision making. This indicates the underlying importance of communication in evaluating the NTS constructs. To synthesize the scoped literature, a framework based on the one-way communication model was used to map the objective measures to NTS constructs.

Conclusion

Objective NTS measurement of surgeons is still preliminary, and future work on leveraging objective metrics in parallel with current assessment tools is needed.

Application

Findings from this work identify objective NTS metrics for measurement applications in a surgical environment.

中文翻译：

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外科医生非技术技能的客观测量：范围审查

客观的

本研究的目的是识别、综合和讨论文献中外科医生非技术技能 (NTS) 的客观行为或生理指标。

背景

NTS 或人际交往或认知技能已被确定有助于安全和高效的手术表现；然而，目前的评估是主观的、基于清单的工具。术中技能评估，例如技术技能，以前已被用作解决此类限制的客观措施。

方法

按照 PRISMA 报告指南搜索了工程、行为科学和医学的五个数据库。资格标准包括具有 NTS 客观测量、外科医生的研究，并在模拟或现场手术中进行。

结果

本综述收录了 23 篇文章。客观指标包括沟通指标和生理反应的测量，例如大脑激活和眼睛运动的变化。16 项研究使用了手术中内容编码交流的频率，这些频率不仅与交流结构相关，而且与情境意识和决策的认知结构相关。这表明沟通在评估 NTS 结构中的潜在重要性。为了综合范围内的文献，使用基于单向通信模型的框架将客观测量映射到 NTS 结构。

结论

外科医生的客观 NTS 测量仍处于初步阶段，未来需要在利用客观指标与当前评估工具的同时开展工作。

应用

这项工作的结果确定了在手术环境中测量应用的客观 NTS 指标。