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A ward-round non-technical skills for surgery (WANTSS) taxonomy.

Klaas, Schuur; Kara, Murray; Nikki, Maran; Rhona, Flin; Simon, Paterson-Brown


Schuur Klaas

Murray Kara

Maran Nikki

Paterson-Brown Simon


Background: Around half of surgical adverse events occur outside the operating room. However the majority of non-technical skills (NTS) training programs have been developed for the intra-operative environment. Ward rounds are a crucial part of extra-operative care and to date no specific NTS training manual has been developed targeting emergency general surgical ward rounds. Aim: To develop a NTS taxonomy for emergency general surgical ward rounds that can be used to improve surgical team members’ NTS and improve outcomes. Methods: A literature review of existing NTS taxonomies was conducted, followed by semi-structured interviews and observational data collection, to determine good and poor surgical ward round behaviours. These behaviours were reviewed by a panel of subject matter experts and categorised into a taxonomy, using the Non-Technical Skills for Surgeons (NOTSS) taxonomy framework as a guide. Results: The Ward-round Non-Technical Skills for Surgery (WANTSS) taxonomy includes examples of good and poor ward round specific behaviours, grouped into elements and categories. The taxonomy can be used as both a training and teaching manual for the surgical team. Conclusion: Ward rounds are a crucial part of extra-operative surgical care. The WANTSS taxonomy provides surgical teams with a manual to help them improve their ward round NTS.


SCHUUR, K., MURRAY, K., MARAN, N., FLIN, R. and PATERSON-BROWN, S. 2020. A ward-round non-technical skills for surgery (WANTSS) taxonomy. Journal of surgical education [online], 77(2), pages 369-379. Available from:

Journal Article Type Article
Acceptance Date Sep 16, 2019
Online Publication Date Oct 5, 2019
Publication Date Apr 30, 2020
Deposit Date Sep 19, 2019
Publicly Available Date Oct 6, 2020
Journal Journal of surgical education
Print ISSN 1931-7204
Electronic ISSN 1878-7452
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 77
Issue 2
Pages 369-379
Keywords Non-technical skills (NTS); Taxonomy; Surgery; Ward rounds; Surgical care
Public URL


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