Non-technical skills training for Nigerian interprofessional surgical teams: a cross-sectional survey.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
16 May 2024
Historique:
received: 02 02 2023
accepted: 10 05 2024
medline: 17 5 2024
pubmed: 17 5 2024
entrez: 16 5 2024
Statut: epublish

Résumé

Non-technical skills (NTS) including communication, teamwork, leadership, situational awareness, and decision making, are essential for enhancing surgical safety. Often perceived as tangential soft skills, NTS are many times not included in formal medical education curricula or continuing medical professional development. We aimed to explore exposure of interprofessional teams in North-Central Nigeria to NTS and ascertain perceived facilitators and barriers to interprofessional training in these skills to enhance surgical safety and inform design of a relevant contextualized curriculum. Six health facilities characterised by high surgical volumes in Nigeria's North-Central geopolitical zone were purposively identified. Federal, state, and private university teaching hospitals, non-teaching public and private hospitals, and a not-for-profit health facility were included. A nineteen-item, web-based, cross-sectional survey was distributed to 71 surgical providers, operating room nurses, and anaesthesia providers by snowball sampling through interprofessional surgical team leads from August to November 2021. Data were analysed using Fisher's exact test, proportions, and constant comparative methods for free text responses. Respondents included 17 anaesthesia providers, 21 perioperative nurses, and 29 surgeons and surgical trainees, with a 95.7% survey completion rate. Over 96% had never heard of any NTS for surgery framework useful for variable resource contexts and only 8% had ever received any form of NTS training. Interprofessional teams identified communication and teamwork as the most deficient personal skills (38, 57%), and as the most needed for surgical team improvement (45, 67%). There was a very high demand for NTS training by all surgical team members (64, 96%). The main motivations for training were expectations of resultant improved patient safety and improved interprofessional team dynamics. Week-long, hybrid training courses (with combined in-person and online components) were the preferred format for delivery of NTS education. Factors that would facilitate attendance included a desire for patient safety and self-improvement, while barriers to attendance were conflicts of time, and training costs. Interprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, and believe it can improve team dynamics, personal performance, and ultimately patient safety. Implementation of NTS training programs should emphasize interprofessional communication and teamworking.

Identifiants

pubmed: 38755653
doi: 10.1186/s12909-024-05550-8
pii: 10.1186/s12909-024-05550-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

547

Investigateurs

Tosin Abah (T)
Akims Shattah (A)
Linus Hapiyati Homoweto (LH)
John Onyeji (J)
Joseph Okoko (J)
Joshua Sule (J)

Informations de copyright

© 2024. The Author(s).

Références

Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons’ non-technical skills. Med Educ. 2006;40(11):1098–104.
doi: 10.1111/j.1365-2929.2006.02610.x
Flin R, O’Connor P, Crichton M. Safety at the sharp end: a guide to non-technical skills. 1st ed. London: CRC; 2017.
doi: 10.1201/9781315607467
Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6):614–21.
doi: 10.1067/msy.2003.169
Scott JW, Lin Y, Ntakiyiruta G, Mutabazi Z, Davis WA, Morris MA, et al. Identification of the critical nontechnical skills for surgeons needed for high performance in a variable-resource context (NOTSS-VRC). Ann Surg. 2019;270(6):1070–8.
doi: 10.1097/SLA.0000000000002828
Uramatsu M, Fujisawa Y, Mizuno S, Souma T, Komatsubara A, Miki T. Do failures in non-technical skills contribute to fatal medical accidents in Japan? A review of the 2010–2013 national accident reports. BMJ Open. 2017;7(2):e013678.
doi: 10.1136/bmjopen-2016-013678
Hull L, Arora S, Aggarwal R, Darzi A, Vincent C, Sevdalis N. The impact of nontechnical skills on technical performance in surgery: a systematic review. J Am Coll Surg. 2012;214(2):214–30.
doi: 10.1016/j.jamcollsurg.2011.10.016
Yule S, Flin R, Maran N, Rowley D, Youngson G, Paterson-Brown S. Surgeons’ non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system. World J Surg. 2008;32(4):548–56.
doi: 10.1007/s00268-007-9320-z
Wood TC, Raison N, Haldar S, Brunckhorst O, McIlhenny C, Dasgupta P, et al. Training tools for nontechnical skills for surgeons—a systematic review. J Surg Educ. 2017;74(4):548–78.
doi: 10.1016/j.jsurg.2016.11.017
Higham H, Greig PR, Rutherford J, Vincent L, Young D, Vincent C. Observer-based tools for non-technical skills assessment in simulated and real clinical environments in healthcare: a systematic review. BMJ Qual Saf. 2019;28(8):672–86.
doi: 10.1136/bmjqs-2018-008565
Lin Y, Scott JW, Yi S, Taylor KK, Ntakiyiruta G, Ntirenganya F, et al. Improving surgical safety and nontechnical skills in variable-resource contexts: a novel educational curriculum. J Surg Educ. 2018;75(4):1014–21.
doi: 10.1016/j.jsurg.2017.09.014
Rwanda - non-technical skills for surgeons. https://www.notss.org/notssrwanda . Accessed 29 Mar 2024.
Mossenson AI, Mukwesi C, Elaibaid M, Doverty J, May A, Murray M, et al. Vital Anaesthesia Simulation Training (VAST); immersive simulation designed for diverse settings. Int J Surg Glob Health. 2021. https://doi.org/10.1097/GH9.0000000000000064 .
doi: 10.1097/GH9.0000000000000064
Mossenson AI, Tuyishime E, Rawson D, Mukwesi C, Whynot S, Mackinnon SP, et al. Promoting anaesthesia providers’ non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting. Br J Anaesth. 2020;124(2):206–13.
doi: 10.1016/j.bja.2019.10.022
Guckian Fisher M. The SAFE operating room course. J Perioper Pract. 2018;28(7–8):175–6.
Abahuje E, Bartuska A, Koch R, Youngson G, Ntakiyiruta G, Williams W, et al. Understanding barriers and facilitators to behavior change after implementation of an interdisciplinary surgical non-technical skills training program in Rwanda. J Surg Educ. 2021;78(5):1618–28.
doi: 10.1016/j.jsurg.2021.01.011
Eysenbach G. Improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004. https://doi.org/10.2196/jmir.6.3.e34 . Erratum in: doi: https://doi.org/10.2196/jmir.2042 .
R Core Team. The R project for statistical computing. 2020. http://www.r-project.org/index.html . Accessed 29 Mar 2024.
Glaser BG. The constant comparative method of qualitative analysis. Soc Probl. 1965;12(4):436–45.
doi: 10.2307/798843
Chun Tie Y, Birks M, Francis K. Grounded theory research: a design framework for novice researchers. SAGE Open Med. 2019;7:2050312118822927.
doi: 10.1177/2050312118822927
Non-Technical Skills for Surgeons (NOTSS). 2024. https://www.notss.org/ . Accessed 29 Mar 2024.
Federal Ministry of Health. National Surgical, Obstetrics, Anaesthesia & Nursing Plan (NSOANP) for Nigeria. Strategic Priorities for Surgical Care (StraPS). Planning for a future of surgical equity, safety & progress. 2019–2023. 2019. https://www.pgssc.org/_files/ugd/d9a674_1f7aa8161c954e2dbf23751213bc6f52.pdf . Accessed 29 Mar 2024.
West African College of Surgeons. West African College of Surgeons faculty of surgery training programmes and curricula. 2013. https://www.wacscoac.org/downloads/SURGERY%20CURRICULUM.pdf . Accessed 29 Mar 2024 .
National Postgraduate Medical College of Nigeria. National Postgraduate Medical College of Nigeria Faculty of Surgery Residency Training Program for the Medical College in Surgery and Surgical Specialties (FMCS). 2014. https://npmcn.edu.ng/downloads/curriculumsurgery.pdf . Accessed 29 Mar 2024.
Nursing and Midwifery Council of Nigeria. Perioperative nursing: curriculum. Abuja: Nursing and Midwifery Council of Nigeria; 2004.
Ogbuanya AU, Anyanwu SNC, Ajah A, Otuu O, Ugwu NB, Boladuro EA, et al. Surgical capacity in rural southeast Nigeria: barriers and new opportunities. Ann Glob Health. 2021;87(1):118.
doi: 10.5334/aogh.3367
Mayaki S, Stewart M. Teamwork, professional identities, conflict, and industrial action in Nigerian healthcare. J Multidiscip Healthc. 2020;13:1223–34.
doi: 10.2147/JMDH.S267116
Omisore AG, Adesoji RO, Abioye-Kuteyi EA. Interprofessional rivalry in Nigeria’s health sector: a comparison of doctors and other health workers’ views at a secondary care center. Int Q Community Health Educ. 2017;38(1):9–16.
doi: 10.1177/0272684X17748892
Mohammed ENA. Knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria. BMC Health Serv Res. 2022;22(1):320.
doi: 10.1186/s12913-022-07664-5
Badejo O, Sagay H, Abimbola S, Van Belle S. Confronting power in low places: historical analysis of medical dominance and role-boundary negotiation between health professions in Nigeria. BMJ Glob Health. 2020;5:e003349. https://doi.org/10.1136/bmjgh-2020-003349 .
doi: 10.1136/bmjgh-2020-003349
Uchejeso OM, Etukudoh NS, Chongs ME, Ime DM. Challenges of inter-professional teamwork in Nigerian healthcare. In: Levine MP, editor. Interpersonal relationships. IntechOpen; 2022. https://doi.org/10.5772/intechopen.95414 .
Trout B. The effect of class session length on student performance, homework, and instructor evaluations in an introductory accounting course. J Educ Bus. 2018;93(1):16–22.
doi: 10.1080/08832323.2017.1415196
Torda A. How COVID. -19 has pushed us into a medical education revolution. Intern Med J. 2020;50(9):1150–3.
doi: 10.1111/imj.14882
Oke AE, Arowoiya VA. Critical barriers to augmented reality technology adoption in developing countries: a case study of Nigeria. J Eng Des Technol. 2021;20(5):1320–33.
McAuliffe MJ, Gledhill SE. Enablers and barriers for mandatory training including basic life support in an interprofessional environment: an integrative literature review. Nurse Educ Today. 2022;119:105539.
doi: 10.1016/j.nedt.2022.105539
Seyi-Olajide J, Anderson J, Williams O, Faboya O, Amedu J, Anyanwu S, et al. National surgical, obstetric, anaesthesia and nursing plan, Nigeria. Bull World Health Organ. 2021;99(12):883–91.
doi: 10.2471/BLT.20.280297
Adeloye D, David RA, Olaogun AA, Auta A, Adesokan A, Gadanya M, et al. Health workforce and governance: the crisis in Nigeria. Hum Resour Health. 2017;15(1):32.
doi: 10.1186/s12960-017-0205-4
Reis T, Faria I, Serra H, Xavier M. Barriers and facilitators to implementing a continuing medical education intervention in a primary health care setting. BMC Health Serv Res. 2022;22(1):638.
doi: 10.1186/s12913-022-08019-w
Alayande BT, Isichei M, Adejumo AA, Wina FM, Forbes CW, KingPriest PT, Agbo CA, Bekele A, Riviello R. Non-technical skills training for Nigerian surgical teams: which way forward? J Am Coll Surg. 2022;235(5):S226–7. https://doi.org/10.1097/01.XCS.0000894776.72384.9a .
doi: 10.1097/01.XCS.0000894776.72384.9a

Auteurs

Barnabas Tobi Alayande (BT)

Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda. dr.alayande@gmail.com.
Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria. dr.alayande@gmail.com.
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America. dr.alayande@gmail.com.
Surgical Equity Research Hub, Jos, Nigeria. dr.alayande@gmail.com.

Callum Forbes (C)

Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America.

Paul Kingpriest (P)

Surgical Equity Research Hub, Jos, Nigeria.

Adeyinka Adejumo (A)

Federal Medical Centre, Keffi, Nasarawa State, Nigeria.

Wendy Williams (W)

Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America.

Felix Wina (F)

Department of Surgery, Bingham University Teaching Hospital, Jos, Nigeria.

Christian Agbo Agbo (CA)

Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria.

Bamidele Omolabake (B)

Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria.

Abebe Bekele (A)

Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.

Bashiru O Ismaila (BO)

Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

Fiona Kerray (F)

Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK.

Augustine Sule (A)

Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

Egide Abahuje (E)

University of Rwanda, Kigali, Rwanda.
Department of Surgery, Northwestern University, Evanston, Ilinois, United States of America.

Jamie M Robertson (JM)

Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America.

Steven Yule (S)

Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK.

Robert Riviello (R)

Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America.
Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America.
Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America.

Mercy Isichei (M)

Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.
The Faith Alive Foundation, Jos, Nigeria.

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