Intraoperative non-technical skills: a critical target for improving surgical outcomes

Surgical performance is a function of technical and non-technical skills, the latter of which encompasses both cognitive and interpersonal skills.1 The important role of intraoperative non-technical skills in determining surgical safety and outcomes has been increasingly recognised in recent years. To that end, in this issue, Sexton et al2 evaluate the non-technical skills of teamwork and situation awareness. Specifically, they examine the effect of team anticipation on operative time and cognitive load in the environment of robotic surgery. Through analysis of video and audio from 12 robot-assisted radical prostatectomies, they were able to calculate anticipation ratios (per cent of requests that were non-verbal) and investigate the impact on surgical performance. While increased anticipation led to decreased operating room time, it also increased the assistant surgeon's cognitive workload.2 Prior work has shown that increased cognitive load is associated with errors and poorer performance, which demonstrates the...

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