NOTSS
Development of the NOTSS (Non-Technical Skills for Surgeons) behavior rating system.
Non-technical skills are defined as "Behavioral Aspects of performance in the operating theater
Which underpin medical expertise, use of equipment and drugs." They are the
cognitive and interpersonal skills which underpin clinical and technical skills and are
requirements for a competent surgeon1. 
The NOTSS system was developed and tested under funding from the Royal College of Surgeons of Edinburgh and NHS Education for Scotland, from 2003-2007. The project was run by the University of Aberdeen, with a steering group of surgeons, psychologists and an anaesthetist. ............................................................................... The aim of the NOTSS project was to develop and test an educational system for assessment and training based on observed skills in the intraoperative phase of surgery. The system was developed from the bottom up with subject matter experts (consultant surgeons), instead of adapting existing frameworks used in other industries. We thought it was important to understand the unique aspects of non-technical skills in surgery, and not to assume that the non-technical
skills identified for pilots, nuclear power controllers or anaesthetists would be exactly
mirrored in surgeons. The NOTSS system is in surgical language for suitably trained surgeons
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