Non-technical skills help reduce surgical errors

Issue: March 25, 2019

ORLANDO — The qualities of a surgeon consist of both technical and non-technical skills, but it is the non-technical skills “that determine how we react when things go wrong,” according to the Cataract Surgery: Telling It Like It Is International Guest of Honor.

In medicine, up to 45% of adverse events involve surgical patients, and 35% to 66% of the events occur in the operating theater, according to Brian Little, MA, DO, FRCS, FRCOphth, FEHA, of Moorfields Eye Hospital.

“It is a pretty intolerable situation,” Little said. “We need to get better at all we are doing in order to reduce the risk of complications.”

According to Little, qualities of a “perfect surgeon” include attitude, aptitude, ability, ambition, adaptability and humility. Humility is the ability to say, “Sorry, we got it wrong,” or “Sorry, I don’t know,” he said.

Robert H. Osher, MD, Cataract Surgery: Telling It Like It Is course director (left), presents the International Guest of Honor Award to Brian Little, MA, DO, FRCS, FRCOphth, FEHA, of Moorfields Eye Hospital.

Additionally important are cognitive and interpersonal technical and non-technical skills.

“The cognitive skills are the process that we use when we are basically evaluating what is going on around us — gathering information, assessing the situation,” he said. One identifies the options and chooses the best one.

Equally important is how one reacts under pressure.

“Success hinges on how we react to failure,” he said.

Little suggested that surgeons need to acquire cognitive skills, such as information gathering, situation assessment and decision making, similar to how pilots use flight simulators.

Eyesi Surgical by VRmagic is a cataract and vitrectomy simulator system in which a surgeon can “learn to do dry runs before we actually fly solo,” Little said, noting there are both dry and wet lab options available for surgeons to acquire skills before “going live.”

In a surgical crisis, a surgeon’s ability to “stay calm, look at what’s going on, work out what’s going to happen” and make a good decision is the difference between a crisis and a disaster. – by Joan-Marie Stiglich, ELS

Reference:

Little B. International guest of honor lecture. Presented at: Cataract Surgery: Telling It Like It Is; February 6-10, 2019; Orlando.

Disclosure: Little reports no financial disclosures related to this lecture.