PDF(Pubmed)
Abstract：
BACKGROUND: Undeniably, robotic-assisted surgery (RAS) has become very popular in recent decades, but it has introduced challenges to the workflow of the surgical team. Non-technical skills (NTS) have received less emphasis than technical skills in training and assessment. The systematic review aimed to update the evidence on the role of NTS in robotic surgery, specifically focusing on evaluating assessment tools and their utilisation in training and surgical education in robotic surgery.
METHODS: A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick\'s validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles.
RESULTS: Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon\'s situational awareness.
CONCLUSIONS: This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery.
METHODS: A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick\'s validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles.
RESULTS: Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon\'s situational awareness.
CONCLUSIONS: This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery.
摘要：
背景：不可否认，近几十年来，机器人辅助手术(RAS)变得非常流行，但它给手术团队的工作流程带来了挑战。在培训和评估中，非技术技能（NTS）的重点不如技术技能。系统评价旨在更新NTS在机器人手术中的作用的证据，特别关注评估工具及其在机器人手术培训和手术教育中的应用。
方法：对PubMed，PsycINFO,MEDLINE,并进行EMBASE以鉴定RAS中NTS的主要文章。利用梅西克的有效性框架和改良的医学教育研究质量工具来评估摘要文章的有效性证据的质量。
结果：17项研究符合最终分析条件。Communication,环境因素,期望和团队合作是RAS的关键NTS。与团队相关的因素，如环境噪声和颤振，由于在手术过程中重复要求造成的不便以及由于手术室设计不良造成的限制可能会在RAS期间损害患者安全。确定了三种新颖的基于评分器的评分系统和一种基于传感器的方法来评估RAS中的NTS。在明确的口头命令之前，团队预测并执行下一步行动的预期提高了外科医生的态势感知能力。
结论：本系统综述强调了机器人手术中缺乏非技术技能的报告，仅确定了三种定制的客观评估工具。Communication,环境因素,期待,团队合作是机器人手术中的关键非技术技能，并且需要进一步的研究来调查它们的益处，以提高机器人手术期间患者的安全性。
方法：对PubMed，PsycINFO,MEDLINE,并进行EMBASE以鉴定RAS中NTS的主要文章。利用梅西克的有效性框架和改良的医学教育研究质量工具来评估摘要文章的有效性证据的质量。
结果：17项研究符合最终分析条件。Communication,环境因素,期望和团队合作是RAS的关键NTS。与团队相关的因素，如环境噪声和颤振，由于在手术过程中重复要求造成的不便以及由于手术室设计不良造成的限制可能会在RAS期间损害患者安全。确定了三种新颖的基于评分器的评分系统和一种基于传感器的方法来评估RAS中的NTS。在明确的口头命令之前，团队预测并执行下一步行动的预期提高了外科医生的态势感知能力。
结论：本系统综述强调了机器人手术中缺乏非技术技能的报告，仅确定了三种定制的客观评估工具。Communication,环境因素,期待,团队合作是机器人手术中的关键非技术技能，并且需要进一步的研究来调查它们的益处，以提高机器人手术期间患者的安全性。
