This last week has found Margaret busy with teaching, travel, and even attending a course. Last Monday, the first ever Non-Technical Skills for Surgeons (NOTSS) in a Variable Resource Context (VRC) was conducted here in Kigali.  NOTSS is a well known course on the “softer” but equally important skills for surgeons. It is the surgeon focused version of the Anesthesia Not Technical Skills (ANTS) Course that many of us in my specialty are familiar with.

NOTSS (and ANTS) try to tackle the very important concepts of leadership, situational awareness, decision making, communication, and teamwork. In our specialties, the importance of technical ability has always been known, but it is often not what creates error or challenges. It is the other, “softer” and much more difficult to teach and assess skills that get us into trouble and can ultimately compromise patient safety. The NOTSS course addresses these skills and issues in a formalized way.

For the course here in Kigali, a team of Human Resources for Health Care surgeons had worked to develop the course specifically with the variable resource context in mind. In Canada/USA/UK we don’t have to worry (very often) about not having a piece of equipment we need or a medication or even a flow of oxygen! But in Rwanda, these challenges are a part of daily life and make non technical skills arguable more important. For, example, 3 languages are routinely spoken in the OR here: Kinyarwandan, English, and French. You can imagine the communication challenge of knowing who to speak to in what language at any given time!

Last Monday’s inaugural NOTSS – VRC course brought together surgical residents and staff from different disciplines, anesthesiology residents and staff, and operating room nurses. We all took the course together. The highlight of the course, I think, was watching the video vignettes which were filmed here in Rwanda by Rwandan film students and starring local staff and residents. They were highly entertaining and definitely delivered their key messages about non technical skills!

I was honoured to be present for this course and even more honoured when I had the opportunity to facilitate one of the small groups.  I was very proud to see the anesthesia residents (who now feel like “my residents”) participate actively, thoughtfully, and with confidence.

It was an excellent day that I think we all enjoyed. Huge kudos to all the effort made by the great group of people to adapt this course to the VRC and deliver it so successfully.