Non-technical skills in healthcare: why training in human factors has become essential
Introduction: Technical skills are no longer enough
In France, thousands of adverse events associated with care (AEACs) occur in healthcare facilities every year. Analysis of these incidents reveals a reality that is often overlooked: the vast majority of these events are not caused by technical failures, but by communication breakdowns, errors in judgment, poor situational awareness, or even stress and fatigue among healthcare professionals.
This observation led the French National Authority for Health (HAS), in partnership with the Human Factors in Healthcare (FHS) association, to publish a framework for non-technical skills (NTS) in April 2026—a guiding document that redefines the foundations of healthcare training.
What are non-technical skills (NTS)?
Non-technical skills refer to all the cognitive, social, and personal resources that complement technical skills and directly contribute to safety and performance in healthcare. They are organized into three main categories:
1. Cognitive Skills
- Situational Awareness: perceiving, understanding, and anticipating clinical and environmental changes
- Decision Making: Analyzing Available Options to Act Appropriately in the Face of Uncertainty
- Workload Management: Prioritizing, Planning, and Adapting to Unforeseen Events
2. Interpersonal Skills
- Effective Communication: ensuring that all team members and the patient clearly understand what is being said
- Teamwork and Coordination: cooperation, mutual trust, and support
- Leadership: guidance, empowerment, and conflict management
3. Personal Skills
- Stress Management: Staying Effective Under Pressure
- Fatigue Management: Recognizing one's own signs of fatigue and implementing appropriate strategies
These skills are not simply added to existing professional standards—they are essential cross-cutting dimensions, often implicit yet crucial.
Why Training in Human Factors Is a Public Health Priority
The American report *To Err is Human* (1999) revealed that more than 70% of serious medical errors are attributable to non-technical human errors. Decades of research in aviation, the nuclear industry, and maritime transport have shown that investing in soft skills sustainably transforms an organization’s safety culture. The HAS/FHS standard clearly confirms this: A technically competent but poorly coordinated team is at greater risk than a technically competent team trained in non-technical skills. The documented benefits of human factors training are numerous: Reduction of avoidable adverse events through better early detection of risky situations; Improved coordination of multidisciplinary teams; Enhanced well-being at work and prevention of burnout; Development of a sustainable safety culture based on reporting, feedback, and collective learning. The Origins of Non-Technical Skills: From Aviation to Healthcare
The history of soft skills began in aircraft cockpits. The 1977 Tenerife air disaster—the deadliest in civil aviation history—was not caused by a technical failure, but by communication and coordination problems between the crews. This realization led to the development of Crew Resource Management (CRM) training in the 1980s.
This model was then adapted to the medical field, first in anesthesia and intensive care through Anaesthesia Crisis Resource Management (ACRM), and then gradually to all healthcare professions. Today, it is organizational and human factors (OHF) that provide the systemic framework within which CNTs operate: people are no longer the weak link, but key players in safety and performance.
Frédéric Martin, founder of the SafeTeam Academy and founding member of the Human Factors in Healthcare group
The Human Factors in Healthcare group was founded by a group of healthcare professionals, ergonomists, and sociologists following their first meeting on September 21, 2017!
This group was initially called the Interest Group on Human Functioning in Medicine. It was composed of Thomas Lopes, Frédéric Martin, Christian Morel, Claude Valot, Pierre Raynal, Daphné Michelet, Laurence Piquard, Véronique Normier, Ludovic Mieusset, Sébastien Follet, Julien Picard, Olivier Bory, Rodolphe Lelaidier, François Jaulin, Tobias Gauss, and Thomas Baugnon. The Human Factors in Health (HFH) group co-led, with the HAS (French National Authority for Health), the drafting of this national framework, bringing together physicians, nurses, ergonomists, healthcare managers, patient representatives, and trainers around a shared conviction: non-technical skills are learned, maintained, and assessed. How to train in non-technical skills? The SafeTeam Academy Approach
In response to this training challenge, SafeTeam Academy offers programs specifically designed for healthcare professionals, based on best practices validated by international literature and aligned with the HAS (French National Authority for Health) framework.
Training that follows the recommended instructional design model
The HAS framework recommends a specific model: active and experiential teaching methods focused on real-world practice. SafeTeam Academy addresses this with programs based on:
- Healthcare simulation (on-site or at a simulation center) to place teams in realistic and safe situations
- Structured briefings and debriefings to reinforce learning and encourage reflection
- Health CRM sessions (Crew Resource Management adapted to the medical setting)
- Case studies and lessons learned (RETEX) from situations experienced by teams
- Multidisciplinary team modules, promoting mutual understanding of professional cultures
The 13 key skills covered by the framework
In accordance with the HAS framework, SafeTeam Academy training courses cover all 13 identified topics:
- Organizational and human factors
- Leadership & Teamwork
- Safety culture
- Self-awareness
- Neuroscience and Performance
- Effective communication
- Fatigue and fatigue management
- Workload management
- Stress and stress management
- Situational awareness
- Characteristics of an effective team
- Decision-making
- The patient's role in the team
Initial and continuing training: a pedagogical continuum
The framework emphasizes a spiral approach to learning: the same skills are practiced repeatedly in increasingly complex situations. SafeTeam Academy offers training programs tailored to each stage:
- Awareness training for teams beginning the process
- Comprehensive CRM healthcare programs for teams looking to take their work to the next level
- Train-the-trainer programs to amplify the internal impact
- Customized support for institutions seeking to integrate Human Factors Training (HFT) into their quality improvement process
The concrete impact of human factors training
Training with SafeTeam Academy means investing in measurable results:
For healthcare teams
- Better management of critical situations and emergencies
- Clearer communication, fewer dangerous ambiguities
- Greater awareness of early warning signs and emerging risks
- Reduced feelings of isolation and strengthened team solidarity
For healthcare facilities
- Reduction in preventable adverse events
- Improvements in quality indicators and HAS certification results
- Strengthening of a measurable safety culture (SAPS surveys, etc.)
- Better staff retention through improved working conditions
For patients
- Safer, better-coordinated care
- Greater patient involvement in the care team
- Reduction in complications related to communication errors
SafeTeam Academy supports you in this transformation with practical, scientifically sound training that can be directly applied to your practice.
