Non-technical skills training to enhance performance of obstetrics and gynaecology residents in the operating room

Document Type



Medical College Pakistan; Educational Development


The importance of incorporating non-technical skills in surgical training cannot be understated, however, these remain non-core components of training. The aim of our study was to evaluate the effectiveness of a training course in improving residents' non-technical skills performance in the operating room. Twenty-eight eligible Obstetrics and Gynaecology residents were divided into conventional and experimental groups by using blocked randomisation. The experimental group received a training course comprising of 20 h over 5 weeks as an educational intervention. A blinded assessor assessed non-technical skill performance by using non-technical skill for surgeons rating system while performing two procedures evacuation and curettage and elective caesarean section in pretest and post-test phase. The post-test results of experimental training group improved significantly in all four categories: situational awareness, decision-making, communication and leadership than the conventional training group demonstrating the effectiveness of a training course. Participants found the course useful and relevant to their practices and strongly recommended the incorporation of similar courses in early years of training. Impact Statement What is already known on this subject? Operating room is the mainstay of surgeons and the majority of the studies done in the operating room relate to structured courses to teach residents about non-technical skills, with training and evaluation done on the same day. These either explores the perception of trainees, expansion of the cognitive component and/or feasibility of training for non-technical skills. To date, there is a lack of evidence in the literature to address questions regarding the appropriate time to incorporate non-technical skills in the curriculum, due to study designs. This highlights the need for more randomised control trials with different curricular designs to evaluate effectiveness. What do the results of this study add? The results of our study enable a comparative analysis between learning curves of conventional training, with the experimental group demonstrating the effectiveness of a training course. This strongly supports implementation of non-technical training in postgraduate competency-based curricula. What are the implications of these findings for clinical practice and/or further research? This study shall be used as an evidence-based source to design curricula for teaching non-technical skills to residents.


Journal of Obstetrics and Gynaecology