Application of Non-Technical Skills (Human Factor) Principles
in the Operating Theatre


By Loh Huey Peng, Assistant Director, Nursing, Operating Theatre, Singapore National Eye Centre (SNEC)
My interest in Non-Technical Skills (NTS), or human factors, began when I visited The Rotterdam Eye Hospital in Netherlands for the inaugural World Association of Eye Hospital (WAEH) meeting back in 2007. I was intrigued and fascinated by studies which applied aviation NTS training principles into the operating theatre, for example surgeons experiencing the role of a pilot. NTS is a combination of cognitive, social, and personal resource skills that complement technical skills and they are a crucial component in many high risk industries such as aviation, nuclear plants, and in my professional field, the operating theatre.

I realised NTS could potentially bridge a gap in adverse patient safety occurrences, a concern still prevalent today, more than 15 years after the Institute of Medicine first published the report “To Err is Human” in 1999. The report highlighted that many of such adverse patient safety events were attributed to failures in NTS rather than a lack of technical expertise. However, progress to assess, train, and improve NTS for similar high risk areas such as the operating theatre remains restricted. Identifying important non-technical skills and their associated behaviours underpin the development of future training programs in enhancing patient safety efforts.

That’s where my research comes in. I was determined to explore this area for my PhD despite its many challenges. Firstly, convincing fellow clinicians that this was a research area of significant impact and value was essential. I was fortunate to have support from my organisation as well as guidance from both my site supervisors, Dr Yin ShanQin, a human factor specialist and Dr Dirk De Korne, who came to Singapore from The Rotterdam Eye Hospital. Both are equally passionate in research about human factors in healthcare.

Loh Huey Peng

Loh Huey Peng, Assistant Director, Nursing, Operating Theatre, Singapore National Eye Centre (SNEC)

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