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A survey-based cross-sectional study of doctors’ expectations and experiences of non-technical skills for Out of Hours work
  1. Michael Brown1,
  2. Dominick Shaw2,3,
  3. Sarah Sharples1,
  4. Ivan Le Jeune2,
  5. John Blakey4
  1. 1Human Factors Research Group/Horizon Digital Economy Research, University of Nottingham, Nottingham, Nottinghamshire, UK
  2. 2Department of Respiratory Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
  3. 3East Midlands Academic Health Science Network, Nottingham, Nottinghamshire, UK
  4. 4Department of Clinical Sciences, Liverpool School of Tropical Medicine, Nottingham, Nottinghamshire, UK
  1. Correspondence to Dr Michael Brown; Michael.brown{at}


Objectives The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH.

Design Survey-based cross-sectional study informed by focus groups.

Setting Online survey with participants from five large teaching hospitals across the UK.

Participants 300 Medical Students and Doctors

Outcome measure Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care.

Results The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey ‘Task Prioritisation’ (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for ‘Communication with Senior Doctors’, ‘Dealing with Clinical Isolation’, ‘Task Prioritisation’ and ‘Communication with Patients’. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work.

Conclusions Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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