When it comes to surgery, many assume that improving outcomes depends solely on improving technique. While this certainly plays a major role, surgery relies on a much larger set of skills, not all of which are technical.
Soft skills in the OR are just as important as mastering technical aspects. Nearly half of all errors in the OR have been attributed to surgeon behavior and decision-making. We can identify two types of soft skills: cognitive (planning, decision-making, awareness) and social (leadership, teamwork, communication).
Cognitive Skills in the OR
Developing a keen sense of how to identify the situation and decide the appropriate course of action takes time. Because each patient will have slightly different circumstances, being able to navigate the situation is part knowledge and part intuition.
Coming from medical school, learning how to translate knowledge into practice can sometimes be difficult. No longer a matter of memorized facts or mastering techniques, being aware of how to act and react to the situation is harder to teach. In a study of 252 laparoscopic bile duct injuries, 97% of procedural errors were the result of visual perception and not the actual technique. While better camera and increased visualization do help to improve this, it ultimately falls to the surgeon to interpolate the images into an actual course of action.
Taking the Lead
Surgical success relies on more than just the surgeon. There is an entire surgical team that all work in harmony with each other to ensure the best outcome for the patient. While in surgery there must be an open flow of communication between the surgeon and the rest of the staff to guarantee that all are able to perform their appropriate role.
Failure to communicate has serious impacts. In of study of closed claim malpractice suits, the American College of Surgeons found that 78% of claims stemmed from poor communication, whether while in the surgery or while in post-op.
Leadership ultimately falls to the surgeon. Coordinating their individual actions with the actions of nurses, OR managers, and potentially another surgeon requires a steady flow of communication, as well as establishing a shared understanding of protocol, especially during escalated events.
Honing Non-Technical Skills
Finding ways to integrate non-technical skills is crucial for training successful surgeons. Teaching intuition and leadership, however, are perhaps a bit less obvious than refining technique. One solution hospitals are turning to is surgical coaching. In a 2017 TED Talk, Atul Gawande highlighted the importance and impact having a coach and mentor can have, particularly for surgeons.
New technologies are also helping to further refine this coaching. Using audio and visual recording in the OR, coaches can review with surgeons where the breakdown in either cognitive or social skills occurred and offer insight on how to course correct going forward. This helps to improve non-technical skills and teach surgeons best practices. Striking a balance between technical and non-technical training offers surgeons (and their patients) the best chance at success.