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Surgeon Non-Technical Skills Track with OR Efficiency

Selection prepared by Christopher DuCoin, MD, FACS

November 11, 2025

acs-store-journalperiodical.jpg

Abahuje E, Cong L, Nguyen M, et al. Relationship Between Surgeon Non-Technical Skills and Operating Team Efficiency: A Mixed-Methods Study. J Am Coll Surg. October 22, 2025.

At a single academic hospital, 45 surgeons across general surgery subspecialties were observed over 351 hours (167 procedures). Higher Non-Technical Skills for Surgeons (NOTSS) scores were associated with better OR efficiency, including a greater proportion of first-case on-time starts, more cases finishing within the expected duration, and turnovers achieved within target time. 

Qualitative observations highlighted behaviors linked to these gains: deliberate preoperative planning and briefs, explicit verbal and nonverbal cues that signal case end, and structured debriefs that also set up the next case.

For surgical leaders, the implications are direct. Surgeons should train and measure NOTSS including making brief–time-out–sign-out meaningful and coaching end-of-case communication so anesthesia, nursing, and technologist teams can anticipate and execute. 

Limitations include the single-center setting, volunteer bias, and possible Hawthorne effects, but the aligned quantitative and qualitative findings support targeted NOTSS interventions to improve throughput without compromising safety.

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