Compétences non techniques en neurochirurgie

Abstract : The field of surgery with its sensitive environment, its quality and safety issues is naturally close to other work environments such as the nuclear industry, civil aviation and the armed forces. The technical expertise and even the declarative knowledge of each individual component of the set of individuals interacting together in these environments are not sufficient to achieve sufficient safety levels. More than 70% of serious adverse events are due to human coordination and communication issues. Non-technical skills (NTS) are thus essential to ensure efficient and safe performance. The first part of this work is a review of the literature on NTS in surgery. After giving general definitions and positioning these skills with respect to technical and procedural skills, we present a systematic review of the CNT literature in thespecific field of neurosurgery. The second part of this work focuses on interpersonal skills: on teamwork and communication. The concept of crew familiarity is explored. In order to achieve this, we present an observational study carried out in a real neurosurgical operating room environment dealing with workflow disruptions and involving teamwork. These workflow disruptions are iterative events leading to the mobilization of NTS within a group of professionals. The third part is dedicated to cognitive skills with a study based on interviews of neurosurgeons with different levels of expertise. The aim is to better understand the surgeon’s mental representation during preoperative surgical planning. Grounded theory approach, a qualitative methodology, is used in this part and we justify its use for this work.
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Submitted on : Thursday, September 12, 2019 - 4:41:06 PM
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Pierre-Louis Hénaux. Compétences non techniques en neurochirurgie. Médecine humaine et pathologie. Université Rennes 1, 2019. Français. ⟨NNT : 2019REN1B012⟩. ⟨tel-02285407⟩

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