ABSTRACT
This chapter discusses the development of a tool for rating operating teams, and sub-teams of surgeons, anaesthetists and nurses, on their non-technical performance in the operating theatre. Non-Technical Skills (NOTECHS) was designed through pan-European collaboration between airlines and academics to provide a generic structure for NOTECHS in aviation training and to allow consistent assessment across different national and organisational cultures. For paediatric cardiac surgery, the Surgical NOTECHS evaluation was conducted entirely from the videotaped operation. The Oxford NOTECHS tool has been found to be reliable and to relate in different ways, depending upon operative type, to other intra-operative performance measures. One finding was that greater surgical situation awareness may result in fewer technical errors for laparoscopic cholecystectomy and carotid endarterectomy operations. One criticism is that the Oxford NOTECHS and failure assessments were scored by the same observer and thus may be contaminating one another.
