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“Managing Surgical Crisis: non-technical skills for new surgeons” A Human Factors course for core surgical trainees. Geraghty A, Tang B, Tait I, Maran N, Monepenny M. Threat Error Management. Highly effective safety training - train to overcome threats identified in error literature.
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“Managing Surgical Crisis: non-technical skills for new surgeons”A Human Factors course for core surgical trainees Geraghty A, Tang B, Tait I, Maran N, Monepenny M
Threat Error Management • Highly effective safety training - train to overcome threats identified in error literature • Cognitively more effective way to avoid error is to train to overcome it
Threats • Physical problems • Bleeding • Leaks – bowel/bile/urine/CSF • Unusual anatomy • Human factors problems • Communication • Teamwork • Leadership • Situation awareness • Decision making
Effective Management • Physical problems • Technical training • Human factors problems • Non technical skills for surgeons • Graded assertiveness • Shared mental models • SBAR • Closed loop communication
Core Surgical Trainees • Developing independent operative skills • Naïve situation awareness/judgement pathways • High technical demand can compromise non-technical skills • Same threats are present in ALL surgical contexts
Crisis Management Algorithm Team Environment Assess/Analyse/Anticipate Manage Resources Shared mental models Graded assertiveness Sterile cockpit Situation Awareness Analytical decision making SBAR Closed loop communication
Attitudes Empowered me in my role as a surgical trainee to take responsibility in theatre “I am more aware and ready to take action before a crisis hits.” “It has made me think about what I can do to prepare before situations so more information is in the automatic portion of my brain so that I have maximum space for active thought processes in emergency and elective situations” “It has given me a structured approach to managing crisis…. helpful in thinking about the big picture and definitive solution”
Managing Surgical Crisis: non-technical skills for new surgeons3rd JuneCuschieri Skills Centre, Dundee Places Available