A lack of communication and awareness in nontechnical skills training? a qualitative analysis of the perceptions of trainers and trainees in surgical training

Research output: Contribution to journalArticlepeer-review


External organisations

  • Nottingham University Hospitals NHS Trust


OBJECTIVE: To examine the perceptions of surgical trainees and trainers towards nontechnical skills (NTS) as a concept, its role in training, and the challenges of developing these skills. DESIGN: A case series of semistructured interviews using an interpretivist grounded theory approach for qualitative analysis.

SETTING: East Midlands (North) core surgical training programme in the United Kingdom.

PARTICIPANTS: Ten out of 81 volunteer core surgical trainees and academic educational supervisors (consultant surgeon trainers).

RESULTS: Understanding of NTS was consistent amongst trainers and trainees but the conceived definition of NTS was much broader than previous definitions. Most viewed NTS as important for surgeons. Trainees believed trainers did not appreciate or were unaware of NTS, likely because of a lack of discussion in practice. Trainers had several reasons for not discussing NTS including insufficient personal relationships with trainees and a lack of robust evidence on which to base discussions. A lack of insight into NTS and surgeon arrogance were suggested as barrier to effective learning.

CONCLUSIONS: Apparent discordant perceptions may be contributing to a lack of focused NTS feedback for surgeons in training. To implement NTS training changes, more will have to be done to develop a shared understanding.


Original languageEnglish
Pages (from-to)873-888
Number of pages16
JournalJournal of Surgical Education
Issue number4
Early online date6 Feb 2020
Publication statusPublished - Jul 2020


  • decision making, education medical, interdisciplinary communication, leadership, situational awareness, specialties surgical

ASJC Scopus subject areas