Non-technical Skills in Surgery: A Pending Subject

To the Editor,

We have read with great interest the publication by Berner and Ewertz¹ on the importance of non-technical skills (NTS) in today's surgical setting.

We have recently reported the results of a survey at our hospital about the perception of medical students, residents and specialists in General and Digestive Surgery about their knowledge of human factors and NTS.² These results demonstrate that 60% of the respondents were unaware of the definition of ‘human factors’; however, 77% considered them the cause of adverse events (AE) in the workplace, either occasionally or frequently. ‘Errors in communication’ was defined by 37% as the most frequent contributing factor in witnessed AE, and 71% believed that NTS were as important as technical skills. Finally, 85% of those surveyed showed interest in receiving feedback on their NTS.

Although the study of human factors, NTS and the role they play in the operating room have been known for decades,³ their relevance has gained importance in recent years, a fact that is reflected in the growing number of publications.^4–7

In this context, the Cirugía Segura (“Safe Surgery”) program,⁸ headed by the AEC and promoted by the Spanish Ministry of Health, Consumption and Social Welfare, has included NTS guidelines and their contribution to patient safety within its educational curriculum for surgical professionals. This content can also be consulted in their published manual.⁹

Like the authors,¹ we believe that education in NTS, knowledge and surgical skills, as well as the understanding of human factors, enable surgeons to provide patients comprehensive care and contributes to the development of a safe surgical environment.

However, we understand that this type of teaching should be included in standard training, not only of specialists being trained in surgery, but also of medical students as part of their education, and it is already being offered at certain teaching hospitals.^5,6 This will undoubtedly be useful for medical professionals in performing their duties in multi- and interdisciplinary environments, which is typical of different healthcare scenarios in our country.