Reliability of a revised NOTECHS scale for use in surgical teams

Sevdalis, Nick; Davis, Rachel; Koutantji, Mary; Undre, Shabnam; Darzi, Ara; Vincent, Charles A.

doi:10.1016/j.amjsurg.2007.08.070

« Previous Next »The American Journal of Surgery
Volume 196, Issue 2 , Pages 184-190, August 2008

Reliability of a revised NOTECHS scale for use in surgical teams

Nick Sevdalis, B.Sc., M.Sc., Ph.D.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK
- National Patient Safety Agency, London, UK
- Corresponding author. Tel.: +011-44 (0) 207 886 7761; fax: +011-44 (0) 207 886 6309.
Rachel Davis, B.Sc., M.Sc.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK
Mary Koutantji, B.Sc., Ph.D.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK
Shabnam Undre, Ph.D., F.R.C.S.E.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK
Ara Darzi, K.B.E., M.D., F.R.C.S.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK
Charles A. Vincent, B.Sc., Ph.D.
- Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK

Received 28 May 2007; received in revised form 13 August 2007 published online 16 June 2008.

Abstract

Background

Recent developments in the surgical literature highlight the need for assessment of nontechnical skills in surgery. We report a revision of the NOn-TECHnical Skills (NOTECHS) scale of the aviation industry for use in surgery and detailed analysis on its reliability.

Methods

The original NOTECHS scale assesses (1) Cooperation, (2) Leadership and Managerial Skills, (3) Situation Awareness and Vigilance, and (4) Decision Making. We added a Communication and Interaction dimension and adapted all subscales for use in surgical context. Reliability was assessed in simulation-based training for trainee clinicians.

Results

Satisfactory reliability (Cronbach's α) was obtained (1) across professional groups and trainers and trainees, (2) in separate analyses for trainers and trainees, (3) in successive administrations of the scale, and (4) in surgical, anaesthetic and nursing groups analyzed separately. In the operating department practitioners group, Situation Awareness and Vigilance and Cooperation and Team Skills exhibited lower reliability.

Conclusions

Assessment of surgical nontechnical skills is becoming a training priority. The present evidence suggests that the revised NOTECHS scale exhibits good reliability. Further empirical research should assess the validity of the scale.

Keywords: Surgical education, surgical training, surgical simulation, NOTECHS, reliability analysis