The need for non-technical skills education in Iranian operating room practitioners: A letter to the editor

Document Type : Letter to Editor

Authors

1 Department of Operating Room, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Occupational Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran

10.22038/fmej.2025.87610.1643

Abstract

The operating room is a high-risk environment where non-technical skills—such as teamwork, communication, leadership, and situational awareness—play a critical role in ensuring patient safety. Research highlights that the most of adverse events in surgeries are linked to non-technical skills deficits. In recent years, the study of non-technical skills among Iranian operating room practitioners has gained attention. Research has been conducted on both operating room teams and individual practitioners. In Iran, studies on operating room practitioners have identified strengths and weaknesses in non-technical skills, with moderate teamwork levels, communication failures, and varying performance across roles. While some domains like task management score well, others, such as decision-making and leadership, require improvement. Despite the lack of standardized non-technical skills training in Iran, educational interventions have shown positive effects. Developing structured curricula and regular training programs for operating room staff is essential to enhance non-technical skills, reduce errors, and improve surgical safety. Universities and hospitals should implement educational programs to improve non-technical skills among operating room personnel and ensure surgical safety.

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  1. Ahmed I. Staff well-being in high-risk operating room environment: Definition, facilitators, stressors, leadership, and team-working—A case-study from a large teaching hospital. Int J Healthc Manag. 2019;12(1):1-17.
  2. De Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. BMJ Qual Saf. 2008;17(3):216-23.
  3. Gordon M, Fell CW, Box H, Farrell M, Stewart A. Learning health ‘safety’within non-technical skills interprofessional simulation education: a qualitative study. Med Educ Online. 2017;22(1):1272838.
  4. WHO. WHO guidelines for safe surgery: safe surgery saves lives. Geneva: World Health Organization; 2009.
  5. Somasundram K, Spence H, Colquhoun AJ, Mcilhenny C, Biyani CS, Jain S. Simulation in urology to train non‐technical skills in ward rounds. BJU international. 2018;122(4):705-12.
  6. Collins JW, Dell'Oglio P, Hung AJ, Brook NR. The Importance of Technical and Non-technical Skills in Robotic Surgery Training. Eur Urol Focus. 2018;4(5):674-6.
  7. Gillespie BM, Harbeck E, Kang E, Steel C, Fairweather N, Chaboyer W. Correlates of non-technical skills in surgery: a prospective study. BMJ Open. 2017;7(1):e014480.
  8. Kalantari R, Zakerian SA, Mahmodi Majdabadi M, Zanjirani Farahani A, Meshkati M, Garosi E. Assessing the teamwork among surgical teams of hospitals affiliated to social security organizations in Tehran City. Journal of Hospital. 2016;15(3):21-9.
  9. Gholami M, Zamanian Z, Kalantari R, Hasanshahi M, Hosseinzadeh Roknabadi E, Gheysari S. Assessment of anesthetist’s non-technical skills in Iranian hospitals. J Health Sci Surveill Syst. 2018;6(4):207-11.
  10. Hasanshahi M, Kalantari R, Zamanian Z, Gheysari S, Bakhshi E. Assessment of Non-Technical Skills in Iranian Orthopedic Surgeons: An Observational Study. Journal of Advances in Medical and Biomedical Research. 2020;28(129):191-7.
  11. Kalantari R, Farahani AZ, Garosi E, Badeli H, Jamali J. Translation and psychometric properties of the Persian version of oxford non-technical skills 2 system: Assessment of surgical teams’ non-technical skills in orthopedic surgery wards. Arch Bone Jt Surg. 2019;7(2):173-81.
  12. Kalantari R, Zamanian Z, Hasanshahi M, Jamali J, Faghihi AA, Niakan H, et al. Development and psychometric evaluation of a behavioral marker system for circulating nurse's non-technical skills. Perioper Care Oper Room Manag. 2021;23:100167.
  13. Garosi E, Kalantari R, Zanjirani Farahani A, Zuaktafi M, Hosseinzadeh Roknabadi E, Bakhshi E. Concerns About Verbal Communication in the Operating Room: A Field Study. Hum factors. 2019;62(6):640-53.
  14. Parnikh H, Kalantari R, Alaei E, Khajoogh ZA, Nourani SF, Movahednia Z. Assessment of Surgical Teams’ Teamwork Skills in Pediatric Surgery: A Cross-sectional Study. Med Surg Nurs J. 2022;11(2):e134001.
  15. Kalantari R, Zamanian Z, Hasanshahi M, Faghihi SA, Jamali J, Niakan H. The Effect of Educational Intervention on the Improvement of Nontechnical Skills in Circulating Nurses. Biomed Res Int. 2021;2021: 5856730.
  16. Kalantari R, Zamanian Z, Hasanshahi M, Jamali J, Faghihi A, Niakan MH, et al. An observational study to assess circulating nurses’ non-technical skills. J Perioper Pract 2022:17504589221117673.
  17. Khalafi A, Arman P, Manouchehrian N. Scenario-based simulation and debriefing sessions can potentially improve non-technical skills in nurse anesthetist students of Iran; a quasi-experimental study. Int J Afr Nurs Sci. 2022;17:100495.
  18. Khalafi A, Kordnejad M, Saidkhani V. Enhancement of the technical and non-technical skills of nurse anesthesia students using the Anesthetic List Management Assessment Tool in Iran: a quasi-experimental study. J Educ Eval Health Prof. 2023;20.