1. Director, Medical Education and Training
Training in Professional Skills (TIPS): Outcomes of a Non Technical Skills (NTS) course for Surgical Education and Training (SET) trainees
A/Prof Robert O’Brien
Director, Medical Education and Training

2. ACKNOWLEDGEMENTS Mr Adrian Anthony 2 Prof Debra Nestel3
Mr David Birks 2
Mr Phil Moreau 2
MrPhil Truskett 2
Julian van Dijk 1
Prof John Cartmill 2
1 St Vincent's Hospital, 2 Royal Australasian College of Surgeons
3 Monash University, 4 Southern Simulation Centre
Prof Debra Nestel3
A/Prof Brendan Flanagan 4
ADMINISTRATION Ellen Webber2
Jess Murphy2
Oana Cochrane2

3. AIM OF TIPS
Utilise a range of education methods, including simulation, to provide opportunities for SET trainees to increase their understanding of the importance of Non Technical Skills (NTS) in contributing to patient safety and good professional practice.

4. WHY?

6. What are professional / non technical skills
Cognitive functioning and observable behaviors that underpin safe ad effective clinical practice. They include without being limited to:
Communication
Leadership
Teamwork
Situational awareness and decision making
Resource management
Safe practice, adverse event minimization / mitigation
professionalism

7. One of the challenges of surgical training has been to ensure that trainees are cognisant of the core non-technical skills and are exposed to the opportunity to develop their expertise in these skills.
The TIPS course is designed to explore six of the nine core competencies:
Professionalism
Scholar / Teacher
Management and leadership
Collaboration
Communication
Judgement - Clinical decision making

8. A range of interactive lectures, facilitated discussions, small group activities, and simulation scenarios involving simulated patients are used to build on the knowledge and skills throughout the course.
Faculty are from a range of backgrounds including consultant surgeons, physicians and medical educators at a ratio of 2:1 participants to instructors.
TIPS was conducted as a pilot on four occasions before being launched and is currently conducted four times per year with 12 participants per course

10. Course Day 1 Day 2 Course Objectives
Understand the importance of professional skills in surgical practice
Recognise what constitutes professional skills
Develop competencies relating to professional skills
Day 1
Define patient centred communication
Discuss informed consent and open disclosure as examples of patient centred communication
Identify effective techniques in patient centred communication
Consider strategies for difficult communication settings
Day 2
Develop an understanding of what a team is and how it operates
Discuss how teams communicate
identify effective techniques for conflict resolution and negotiation
define and describe the key elements of situational awareness

11. How are these being taught?
Error Disclosure
Immersive Simulation
Simulated patients
Error disclosure
Family meeting – end of life
Informed consent
Communicating while operating
Situational awareness
Games / puzzles
Link to the Clinical Environment via debrief

12. Trainee Perceptions Learning Objectives Day 1
Recognise the importance of structure in consultations
Describe skills for effective explaining
Outline responsibilities in obtaining informed consent
Discuss benefits and challenges associated with obtaining informed consent including explaining risk
Outline responsibilities associated with communicating with conscious patients while operating
Discuss benefits and challenges associated with team communication while operating
Outline responsibilities during error disclosure
Identify skills for sensitive and difficult communications
Practice and reflect on skills used in the above contexts

13. Major Learning Points
110 comments listed
Strategies for dealing with emotions
ISBAR – communication framework
Graded assertiveness and use of CUSS
Communication styles
Open disclosure – saying sorry
Patient Centred Communication

14. Educational Methods Introduction Ice breaker – role play
Presentation: Patient-centred communication
Scenario on informed consent including feedback and discussion
Scenario on communicating while operating including feedback and discussion
Scenario on error disclosure including feedback and discussion
Scenario on end of life, family meeting including feedback and discussion
Large group discussion
Written materials (inc. pre-reading)

15. Error Disclosure - SP
Simulated patients
Simulation Debrief

16. Operating while communicating

17. Trainee Perceptions Learning Objectives Day 2
Recognise the importance of structure in consultations
Describe skills for effective explaining
Outline responsibilities in obtaining informed consent
Discuss benefits and challenges associated with obtaining informed consent including explaining risk
Outline responsibilities associated with communicating with conscious patients while operating
Discuss benefits and challenges associated with team communication while operating
Outline responsibilities during error disclosure
Identify skills for sensitive and difficult communications
Practice and reflect on skills used in the above contexts

18. Trainee Perceptions Learning Objectives Day 2
Discuss the importance of effective teamwork in surgical practice
Describe teamwork skills relevant to surgical practice including leadership and role delegation
Discuss the benefits of effective team oriented communication skills, including debriefing, graded assertiveness and task focused communication
Describe a standardised approach for communicating patient information via the telephone
Practice and reflect on skills used in the above contexts

19. Major Learning Points
109 comments made by participants Graded assertiveness CUSS ISBAR Importance of situational awareness Fixation error HALT

20. Educational Methods Introduction Teamwork activity and presentation
Communicating in teams presentation
Communication activity – block game
Conflict resolution presentation
Scenario on resuscitation including feedback and discussion
Scenario on conflict resolution including feedback and discussion
Scenario using lego including feedback and discussion
Situational awareness presentation
Introduction to simulation
Immersive clinical scenario and debrief
Just a routine operation summary/wrap-up

22. Learning Points
ISBAR
Strategies for difficult communications
Previewing / bow shots
Structured communication
Patient V disease
Graded Assertiveness
Working in teams and the impact of leadership

23. ? Activity: white board responses to the last point:
Lets map out what’s achievable

24. Training in Professional Skills (TIPS): Outcomes of a Non Technical Skills (NTS) course for Surgical Education and Training (SET) trainees
A/Prof Robert O’Brien
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