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Non Technical Skills

Non Technical Skills. John Salisbury. What are non technical skills?. John Salisbury.

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Non Technical Skills

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  1. Non Technical Skills John Salisbury

  2. What are non technical skills? John Salisbury

  3. Non-technical skills are a combination of cognitive (for example, decision making) and social skills (for example, team working), which complement knowledge and technical skills and contribute to safe performance.

  4. Aims • Why NTS are so important • What they are • How you can improve them

  5. Origins of NTS • http://www.youtube.com/watch?v=mLFZTzR5u84

  6. 2 High profile air crashes with many casualties. • Looked at causes of these and other air disasters and near misses. • Realised 70 to 90 % due to crew error. • Since then extrapolated to many other high risk industries including medical teams. Similar results.

  7. Relevance to you! • In USA estimated that 44 to 98000 people die every year because of medical mishap. • 70-90 % of these incidents are due to a failure of NTS. • Its very important! • Recognised by WHO that training needs to start at beginning of medical school. • NTS will play an increasingly important part of undergrad and postgrad assessment

  8. “To err is human to forgive divine” Alexander Pope 1709

  9. Swiss cheese model (Reason J 1990)

  10. What are the NTS applicable to medicine?

  11. Some NTS applicable to medicine • Situational awareness • Decision making • Communication • Team working • Leadership • Managing stress • Coping with fatigue

  12. What is situational awareness? • “What you need to know not to be surprised” Kelly and Thompson 2005 • Knowing what the ***** is going on!

  13. Dr Mica Endsley

  14. Why is this car braking?

  15. Too late now!

  16. Decision making Medical decision making is hard because : 1)Ultimate complex system 2)Incomplete information 3)High stakes 4)Many pressures eg time

  17. Decision making • Stop and think • Use of all of the team • Use CLEAR

  18. CLEAR • Clarify the problem • Look for and share information • Evaluate options • Act ie decide communicate act • Review how’s it going, may need to start again!

  19. Communication • Oral and written. Clear notes. • Use of tools eg SBAR. Paraphrase check understanding • Giving info speak up if unhappy be assertive but polite • Include context and background • Rec information, encourage dissent • Min distractions

  20. Team working • Support • Conflict resolution • Exchange information • Coordinate actions

  21. Managing stress • Awareness of effects on self. Perception of control. • Performance arousal curve • Deliberate calm.Hudson river crash audio

  22. Performance arousal curve

  23. Coping with fatigue • Recognition of it in yourself • Recognise its effects • Coping mechs

  24. http://www.who.int/patientsafety/education/curriculum/EN_PSP_Education_Medical_Curriculum/en/index.htmlhttp://www.who.int/patientsafety/education/curriculum/EN_PSP_Education_Medical_Curriculum/en/index.html • http://www.chfg.org/ • http://www.abdn.ac.uk/iprc/uploads/files/Bromiley%20and%20Mitchell%20article.pdf

  25. Human Factors Investigation Tool Gordon et al 2005, Industrial Psychology Research Centre, Aberdeen

  26. Your brain at work Rational Brain Stimulus LTM Senses STM Outputs Emotional Brain

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