A cross-sectional survey of the safety attitudes questionnaire subscale stress recognition and the effect of non-technical skills training in operating theatre staff.

Objectives: Non-technical skills (NTS) training of surgical staff is a quality improvement measure to improve patient safety. One factor that can compromise patient safety is impaired staff performance due to stressors such as tiredness. Awareness of the impact of such stressors is measured by the stress recognition (SR) domain of the Safety Attitudes Questionnaire (SAQ). The aim of this study was to assess whether NTS training improves SR scores and whether there are any groups with divergent SR scores. Methods: A cross-sectional survey of all operating theatre staff in a German major trauma centre was undertaken using the stress recognition (SR) subscale of the SAQ. A multivariable linear regression was performed to assess which factors are associated with SR scores. Data are presented as median (interquartile range). Results: From 226 invited staff members, 89 responses (39 %) were received. Twenty-eight respondents (31 %) had attended NTS training. The overall SR score was 4.3 (3.5-4.5). There was no effect of NTS training, age, gender, profession, or specialty on SR scores. Physicians in leadership positions had lower SR scores (3.4 (3.06-4.0)) than physicians without leadership positions (4.5 (4.3-5.0), p<0.001). Conclusions: Attendance at NTS training courses did not improve SR scores in the clinical staff of operating theatres of a German major trauma centre. Interestingly, physicians in leadership positions had lower SR scores than other physicians. Further studies using the SAQ should discriminate between physicians in leadership positions and other physicians when reporting SR scores.