Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale

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Abstract

Objective

In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale.

Methods

This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed.

Results

62 participants comprising trainees ( n = 43) and specialists ( n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total ( p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters ( n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session ( p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability.

Conclusions

The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.

Electronic supplementary material

The online version of this article (10.1007/s00345-020-03406-6) contains supplementary material, which is available to authorized users.

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Most cited references 27

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More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods.

Taylor Sawyer, Walter Eppich, Marisa Brett-Fleegler … (2016)

Debriefing is a critical component in the process of learning through healthcare simulation. This critical review examines the timing, facilitation, conversational structures, and process elements used in healthcare simulation debriefing. Debriefing occurs either after (postevent) or during (within-event) the simulation. The debriefing conversation can be guided by either a facilitator (facilitator-guided) or the simulation participants themselves (self-guided). Postevent facilitator-guided debriefing may incorporate several conversational structures. These conversational structures break the debriefing discussion into a series of 3 or more phases to help organize the debriefing and ensure the conversation proceeds in an orderly manner. Debriefing process elements are an array of techniques to optimize reflective experience and maximize the impact of debriefing. These are divided here into the following 3 categories: essential elements, conversational techniques/educational strategies, and debriefing adjuncts. This review provides both novice and advanced simulation educators with an overview of various methods of conducting healthcare simulation debriefing. Future research will investigate which debriefing methods are best for which contexts and for whom, and also explore how lessons from simulation debriefing translate to debriefing in clinical practice.

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‘The Diamond’: a structure for simulation debrief

Peter Jaye, Libby Thomas, Gabriel Reedy (2015)

Background Despite debriefing being found to be the most important element in providing effective learning in simulation-based medical education reviews, there are only a few examples in the literature to help guide a debriefer. The diamond debriefing method is based on the technique of description, analysis and application, along with aspects of the advocacy-inquiry approach and of debriefing with good judgement. It is specifically designed to allow an exploration of the non-technical aspects of a simulated scenario. Context The debrief diamond, a structured visual reminder of the debrief process, was developed through teaching simulation debriefing to hundreds of faculty members over several years. The diamond shape visually represents the idealised process of a debrief: opening out a facilitated discussion about the scenario, before bringing the learning back into sharp focus with specific learning points. Debriefing is the most important element in providing effective learning in simulation-based medical education reviews Innovation The Diamond is a two-sided prompt sheet: the first contains the scaffolding, with a series of specifically constructed questions for each phase of the debrief; the second lays out the theory behind the questions and the process. Implication The Diamond encourages a standardised approach to high-quality debriefing on non-technical skills. Feedback from learners and from debriefing faculty members has indicated that the Diamond is useful and valuable as a debriefing tool, benefiting both participants and faculty members. It can be used by junior and senior faculty members debriefing in pairs, allowing the junior faculty member to conduct the description phase, while the more experienced faculty member leads the later and more challenging phases. The Diamond gives an easy but pedagogically sound structure to follow and specific prompts to use in the moment.

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A systematic review of the effectiveness of simulation debriefing in health professional education.

Tracy Levett-Jones, Samuel Lapkin (2014)

The objective of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals.

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Author and article information

Contributors

Abdullatif Aydın:

ORCID: http://orcid.org/0000-0002-5440-7741

abdullatif.aydin@kcl.ac.uk

Journal

Journal ID (nlm-ta): World J Urol

Journal ID (iso-abbrev): World J Urol

Title: World Journal of Urology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0724-4983

ISSN (Electronic): 1433-8726

Publication date (Electronic): 18 August 2020

Publication date PMC-release: 18 August 2020

Publication date (Print): 2021

Volume: 39

Issue: 6

Pages: 2231-2237

Affiliations

[1 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, MRC Centre for Transplantation, Guy’s Hospital, , King’s College London, ; 5th Floor Southwark Wing, London, SE1 9RT UK

[2 ]GRID grid.494150.d, ISNI 0000 0000 8686 7019, Department of Urology, , NHS Forth Valley, ; Glasgow, UK

[3 ]GRID grid.419439.2, ISNI 0000 0004 0460 7002, Department of Urology, , Salisbury NHS Foundation Trust, ; Salisbury, UK

[4 ]GRID grid.420545.2, Department of Urology, , Guy’s and St, Thomas’ NHS Foundation Trust, ; London, UK

[5 ]GRID grid.466642.4, ISNI 0000 0004 0646 1238, European School of Urology, , European Association of Urology, ; Amsterdam, The Netherlands

[6 ]GRID grid.7080.f, Dept. of Urology, Fundació Puigvert, , Universitat Autònoma de Barcelona, ; Barcelona, Spain

[7 ]GRID grid.429705.d, ISNI 0000 0004 0489 4320, Department of Urology, , King’s College Hospital NHS Foundation Trust, ; London, UK

Author information

Abdullatif Aydın http://orcid.org/0000-0002-5440-7741

Article

Publisher ID: 3406

DOI: 10.1007/s00345-020-03406-6

PMC ID: 8217036

PubMed ID: 32809178

SO-VID: f0d50b47-2475-4d29-9172-263a41536967

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 24 April 2020

Date accepted : 7 August 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100007568, Urology Foundation;

Funded by: King's College London

Custom metadata

ScienceOpen disciplines: Urology

Keywords: non-technical skills,simulation,urology,notss,notsus

Data availability:

ScienceOpen disciplines: Urology

Keywords: non-technical skills, simulation, urology, notss, notsus

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Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale

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Abstract

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Electronic supplementary material

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Most cited references 27

More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods.

‘The Diamond’: a structure for simulation debrief

A systematic review of the effectiveness of simulation debriefing in health professional education.

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