Eye movements in surgery: A literature review

With recent advances in eye tracking technology, it is now possible to track surgeons’ eye movements while engaged in a surgical task or when surgical residents practice their surgical skills. Several studies have compared eye movements of surgical experts and novices, developed techniques to assess surgical skill on the basis of eye movements, and examined the role of eye movements in surgical training. We here provide an overview of these studies with a focus on the methodological aspects. We conclude that the different studies of eye movements in surgery suggest that the recording of eye movements may be beneficial both for skill assessment and training purposes, although more research will be needed in this field

Senior charge nurses’ leadership behaviours in relation to hospital ward safety: a mixed method study.

Background: High standards of quality and patient safety in hospital wards cannot be achieved without the active role of the nursing leaders that manage these units. Previous studies tended to focus on the leadership behaviours of nurses in relation to staff job satisfaction and other organizational outcomes. Less is known about the leadership skills of senior charge nurses that are effective for ensuring safety for patients and staff in their wards. Objectives: The aim of the two studies was to identify the leadership behaviours of senior charge nurses that are (a) typically used and, (b) that relate to safety outcomes. Methods: In study one, semi-structured interviews were conducted with 15 senior charge nurses at an acute NHS hospital. Transcribed interviews were coded using Yukl's Managerial Practices Survey (MPS) framework. In study two, self ratings of leadership (using the MPS) from 15 senior charge nurses (SCN) and upward ratings from 82 staff nurses reporting to them were used to investigate associations between SCNs’ leadership behaviours and worker and patient-related safety outcomes. Results: The interviews in study one demonstrated the relevance of the MPS leadership framework for nurses at hospital ward level. The SCNs mainly engaged in relations-oriented (n = 370, 49%), and task-oriented (n = 342, 45%) behaviours, with fewer change-oriented (n = 25, 3%), and lead by example behaviours (n = 26, 3%). In demanding situations, more task-oriented behaviours were reported. In study two, staff nurses’ ratings of their SCNs’ behaviours (Monitoring and Recognizing) were related to staff compliance with rules and patient injuries (medium severity), while the self ratings of SCNs indicated that Supporting behaviours were linked to lower infection rates and Envisioning change behaviours were linked to lower infection and other safety indicators for both patients and staff. Conclusion: This study provides preliminary data on the usability of a standard leadership taxonomy (Yukl et al., 2002), and the related MPS questionnaire, on a nursing sample. The findings indicate the relevance of several leadership behaviours of SCNs for ensuring a safer ward environment and contribute to the evidence base for their leadership skills training

Ground-breaking research supports technology adoption. [News article]

The Oil and Gas Technology Centre and Aberdeen's Robert Gordon University (RGU) have launched a new research programme to identify the behavioural barriers to successful technology adoption and deployment on the UK Continental Shelf (UKCS), creating a toolkit to support both developers and operating companies

Enhancing safety performance: non-technical skills and a modicum of chronic unease.

Current debates on professionalism and safety cover a range of interpretative challenges and theoretical perspectives, as the workshop organized by FonCSI in 2015 revealed. One avenue for consideration was to address the question of the role of professionalism in the job with regard to safety. For example, should safety training just be part of normal job training or should it have a separate and distinctive position in the training curriculum? In this paper, I consider two ways in which safety training and safety thinking are being integrated into routine managerial and technical work. The first of these is behavioural, namely to focus on the non-technical skills (NTS) for a given job, as evidenced by the airlines' Crew Resource Management training and assessment programmes. This approach is now being adopted in other safety-critical sectors, such as acute medicine and offshore oil and gas operations. The second direction is more attitudinal in nature: it examines the relatively novel concept of chronic unease, derived from the High Reliability Organisation literature. These two approaches show that addressing both workplace behaviours (non-technical skills) and underlying attitudes to operational risks (chronic unease), can help to build protective skills for safety into the professional job repertoire

Assessing risk in dynamic situations:lessons from fire service operations

Fire Service personnel face risk on a daily basis, frequently working in extremely hazardous conditions—and the severity of the danger faced can fluctuate rapidly. The Fire Service has therefore become extremely experienced at managing dynamic risks. The aim of this article is to review techniques used in the UK fire service to attenuate the effects of risk and to discuss these with respect to organisations which experience dynamic risk in other fields—even if in less dramatic conditions

Car driver attitudes, perceptions of social norms and aggressive driving behaviour towards cyclists.

The interaction of car drivers and cyclists is one of the main causes of cycle incidents. The role of attitudes and social norms in shaping car drivers' aggressive behaviour towards cyclists, is not well understood and merits investigation. A sample of 276 drivers completed an online questionnaire concerning their attitudes towards cyclists, attitudes towards risky driving, perception of social norms concerning aggressive driving towards cyclists, and the frequency with which they engage in such aggressive driving behaviours. The results showed that attitudes towards cyclists, as well as social norm perceptions concerning aggressive driving towards cyclists, were associated with aggressive driving towards cyclists. Negative attitudes towards cyclists were more pronounced in non-cyclists than cyclists and their association with aggressive driving behaviour was stronger in cyclists than non-cyclists. The perception of social norms concerning aggressive driving towards cyclists had a stronger association with aggressive driving in non-cyclists than cyclists. Attitudes towards risk taking did not affect aggressive driving towards cyclists. These findings can inform campaigns that aim to improve cyclist and car driver interaction on the roads, making them safer to use for cyclists

Patient safety in surgery: non-technical aspects of safe surgical performance

The performance of operative surgery has an understandable focus placed on dexterity, technical precision, as well as the choice of procedure. There is less appreciation of the cognitive and social skills of the individual surgeon and the effect that these have on the surgical team and on patient outcome. This article highlights that impact and explores the contribution of non-technical skills to safe practice within the operating room

Non-technical skills of the scrub practitioner: the SPLINTS system.

This article describes the nontechnical skill set, and behavioural rating tool, for scrub practitioners/nurses (e.g. perioperative registered nurses; operating room technicians) known as the Scrub Practitioners' List of Intraoperative Non Technical Skills or the SPLINTS system. The SPLINTS system was developed at the Industrial Psychology Research Centre of the University of Aberdeen, Scotland, by a research team comprising psychologists, scrub nurses, and a surgeon. Details of the system were presented, by Rhona Flin, at the ORNAC National and International Conference with IFPN, in Ottawa, in April of 2013. This article outlines the background of the research project and the method used to develop the SPLINTS system and suggests why it might be a valuable training and assessment tool for scrub practitioners in Canada

Staying in the zone: offshore drillers' situation awareness.

Objective: The aim of this study was to identify the cognitive components required for offshore drillers to develop and maintain situation awareness (SA) while controlling subsea hydrocarbon wells. Background: SA issues are often identified as contributing factors to drilling incidents, most recently in the Deepwater Horizon blowout. Yet, there is a limited body of research investigating SA in the offshore drilling environment. Method: In the first study, critical incident interviews were conducted with 18 experienced drilling personnel. Transcripts were subjected to theory driven thematic analysis, producing a preliminary cognitive framework of how drillers develop and maintain SA during well control. In the second study, 24 hr of observations (in vivo and video) of drillers managing a high fidelity well-control simulator were analyzed to further develop the framework. Results: The cognitive components that enable drillers to build up an understanding of what is happening in the wellbore and surrounding environment, to predict how this understanding may develop, were identified. These components included cue recognition, interpretation of information in conjunction with the current mental model, and projection through mental simulation. Factors such as distracters, expectations, and information sharing between crew members can both positively and negatively influence the drillers SA. Conclusion: The findings give a preliminary understanding into the components of drillers SA, highlighting the importance of SA for safe and effective performance and indicating that Endsleys model of SA can be applied to drilling. Application: The results have consequences for training, task management, and work design recommendations

Product safety culture: a preliminary study in the UK manufacturing industry.

Do accidents where users are injured or killed by unsafe products reveal underlying weaknesses in the safety culture of the responsible organisations? While manufacturing firms have long been concerned with organizational culture factors that relate to product quality, there has been much less attention to the relationship with consumer safety. Product safety culture can be defined as the attitudes, norms, beliefs and behaviours of staff in manufacturing organisations that affect the integrity of a product in relation to the well-being of its users. There has been limited research into this type of safety culture, with the exception of several studies from the food industry. This exploratory study in one large company adopted a qualitative approach to identify the dimensions of product safety culture in the manufacture of engineered products. Study 1 consisted of phone interviews (8 managers, 2 workforce). Study 2 was on two UK manufacturing sites where interviews and focus groups were conducted (46 participants in total: 7 managers, 39 workforce). The transcriptions were coded using inductive thematic analysis to identify the main components of product safety culture. The findings indicated six principal dimensions: management commitment to product safety, communication, safety systems, trust, understanding of safety systems and product safety ethic. The first five dimensions are well-established components of culture relating to worker and process safety. The last dimension appears to be a distinctive component (compared to other types of safety culture) relating to an employee’s moral and ethical stance toward product safety, where user well-being is considered during product manufacture. This ethical component is a more novel feature which suggests that fostering concern for unknown product users may be an additional facet of product safety culture worth investigating in the effort to reduce the risks to consumers