SynthesisThe British journal of surgery2025
Impact of surgical non-technical skills on clinical outcomes: systematic review.
Synthesis in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Heart Rate Variability and Body Motion as Digital Biomarkers of Task Workload During Military En Route Critical Care Simulations.Sensors (Basel, Switzerland) · 2026Article
- Identifying novel indicators of non-technical skills derived from operative video annotation.The British journal of surgery · 2026Article
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundDeficiencies in non-technical skills (NTS) such as leadership and communication can lead to intraoperative inefficiency and error. However, the relationship between these skills and patient-level outcomes has yet to be synthesized. The aim of this study was to systematically review the evidence examining the relationship between intraoperative NTS and clinical outcomes.
methodsThe PubMed, Embase, CENTRAL, CINAHL, and PsycINFO databases were searched for relevant studies published between inception and 1 November 2024. Eligible studies assessed NTS of operating room personnel, were conducted in non-simulated environments, and reported clinical outcomes. NTS were categorized into five core domains including leadership and communication. Patient-level outcomes comprised eight clinical measures including mortality and postoperative complications.
resultsOf 6313 screened studies, 21 met the inclusion criteria. Included studies represented 8536 participants performing 251 180 procedures across 13 specialties. Eleven observational studies assessed NTS of surgical personnel via study participants or observers. Ten interventional studies introduced NTS team training initiatives. Twelve of 21 studies (57%) incorporating 247 036 of all procedures (98.4%) reported significant improvements in clinical outcomes. Nine of 11 observational studies (82%) reported significant improvement in clinical outcomes compared with 3 of 10 interventional studies (30%). No studies demonstrated a significant deterioration in clinical outcomes associated with improved NTS.
conclusionPublished evidence shows a significant link between intraoperative NTS and patient-level outcomes. These findings reinforce the value of behavioural assessment in surgery, support evidence-based team training, and underscore the need to embed NTS into regulatory frameworks to improve surgical quality and safety worldwide.
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