Nontechnical skills and decision making in operative vaginal delivery.

Nontechnical skills are defined as social, cognitive and personal resource skills that are necessary to conduct any technical skill safely. Whilst the skills are categorised into three domains: social, cognitive and personal resources, these are dependent on each other and the development and effectiveness of one relies on the other two. Effective nontechnical skills are essential in the safe care of patients in any setting, and their importance can be clearly demonstrated in the safe development of skills in many areas of medicine and surgery. Increasingly the importance of these skills is being recognised in outcomes for patients and staff, and training courses and assessment tools are being developed and used in obstetrics. Understanding of the role of nontechnical skills in labour and especially in operative vaginal births should be embedded across the specialty. Further research is needed in validation of assessment tools for these skills when used in obstetrics.