Table 2 Oxford Non-Technical Skills (NOTECHS) subteam modifiers
Surgical subteamAnaesthetic subteamNursing subteam
Leadership and management
Positive modifiers⇒Raises team morale⇒Takes control when required⇒Scrub provides clear instructions to circulating nurse(s)
⇒Intervenes if deviation⇒Demonstrates desire for high standard⇒Senior nurse makes sure protocols are followed
⇒Prioritises tasks⇒Appropriately distributes tasks b/w rest of team⇒Speaks up when unhappy
Negative modifiers⇒Deflates or fails to motivate team⇒Does not take control when required⇒Senior nurse does not support juniors
⇒Does not attempt to build cohesion⇒Does not set standards
⇒Inappropriate task distribution
Teamwork and cooperation
Positive modifiers⇒Open⇒Supportive of other subteams⇒Nurses cooperate and support each other well
⇒Appropriate use of abilities within team⇒Appreciates functions of other subteams⇒Senior nurse covers for junior scrub
⇒Supportive of other subteams when necessary
Negative modifiers⇒Aggressive in conflicts⇒Remains idle when problems arise⇒Poor coordination between equipment needs and those provided
⇒Does not appreciates others’ abilities⇒Functions separately from other subteams
Problem-solving and decision-making
Positive modifiers⇒Demonstrates generation of options⇒Participates in solving problems⇒Takes an active part in decision-making
⇒Open discussion and agreement over anatomy⇒Raises suggestions⇒Suggests solutions to problems—eg, alternative equipment
⇒Incorporates other subteam issues
Negative modifiers⇒Decisions made unsystematically⇒Does not consider anaesthetic options when met with problem⇒Blames the surgeons when faced with problems
⇒Does not utilise team where it may benefit
Situation awareness
Specific to subteams
    Positive modifiers⇒Periodically gathers awareness of surroundings⇒Anticipates surgical and process needs⇒Anticipates equipment needs
    Negative modifiers⇒Is fixated on operative field⇒Is not present at important stages of the operation or for long periods of time⇒Absent at stages when needed to provide service
For all subteams
    Positive modifiers⇒Patient: Has awareness of patient condition/comorbidity
⇒Procedure: Appreciates stage of operation
⇒People: Who is present in theatre, what skills they have and what they are doing