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Effects of a Brief Team Training Program on Surgical Teams' Nontechnical Skills: An Interrupted Time-Series Study

Gillespie, Brigid M. PhD, RN, FACORN; Harbeck, Emma BS (Hons); Kang, Evelyn MHP (Hons), RN; Steel, Catherine MN, RN; Fairweather, Nicole FANZCA, MBBS; Panuwatwanich, Kriengsak PhD; Chaboyer, Wendy PhD, RN
Journal of Patient Safety: Post Author Corrections: April 27, 2017
doi: 10.1097/PTS.0000000000000361
Original Article: PDF Only


Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS.


Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program.


We observed 179 surgical procedures with cardiac, vascular, upper gastrointestinal, and hepatobiliary teams. Mean posttest NOTECHS scores increased across teams, showing special cause variation. There were also significant before and after improvements in NOTECHS scores in respect to professional role and in the use of the Surgical Safety Checklist.


Our results suggest associated improvements in teams' NOTSS after implementation of the team training program.

Correspondence: Brigid Gillespie, PhD, RN, FACORN, 58 Parklands Dr, Southport QLD 4215, Australia (e-mail:

The authors disclose no conflict of interest.

B.M.G. acknowledges the financial support of the Australian Research Council, Early Career Discovery Fellowship Scheme, and the NHMRC Centre for Excellence in Nursing Research.

B.M.G. conceived of the study, assisted in data analysis, interpreted results, and drafted the article. E.H. performed data analysis and assisted in interpretation. W.C. and K.S. assisted in analysis and interpretation. E.K., C.S., and N.F. assisted in recruitment and interpretation. All authors participated in the coordination of the study and read and approved the final article.

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