The editors spent the last twelve years as part of the team developing and testing the NOTSS system and delivering presentations and workshops across the world. Readers will benefit by having, in one accessible handbook, a description of the NOTSS system and how it can be used for training, assessment, self-reflection and event analysis. The book also examines human error, performance limitations, and global safety initiatives in surgery. Because it encourages surgeons to reflect on their own performance and behaviour, it is suitable for surgeons in all specialties and at all levels.