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",isbn:"978-1-83968-760-0",printIsbn:"978-1-83968-759-4",pdfIsbn:"978-1-83968-761-7",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"cc49d6034d85f8f2e2890c6acc3cc629",bookSignature:"Dr. Abhijit Biswas",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10285.jpg",keywords:"Mott Insulators, Semi Metals, Polycrystals, Single Crystals, Electronic Properties, Magnetic Properties, PLD, MBE, Topological Insulators, Topological Hall Effect, Devices Applications, Catalysis",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 9th 2020",dateEndSecondStepPublish:"October 7th 2020",dateEndThirdStepPublish:"December 6th 2020",dateEndFourthStepPublish:"February 24th 2021",dateEndFifthStepPublish:"April 25th 2021",remainingDaysToSecondStep:"4 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"A pioneering researcher in the field of tailoring metal oxide crystal surfaces and growth as well as engineering of thin films for various emergent phenomena and energy applications. Dr. Biswas received his Ph.D. from POSTECH, South Korea.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"194151",title:"Dr.",name:"Abhijit",middleName:null,surname:"Biswas",slug:"abhijit-biswas",fullName:"Abhijit Biswas",profilePictureURL:"https://mts.intechopen.com/storage/users/194151/images/system/194151.png",biography:"Dr. Abhijit Biswas is a research associate at the Indian Institute of Science Education and Research (IISER) Pune, in India. His research goal is to design and synthesize highest quality epitaxial heterostructures and superlattices, to play with their internal degrees of freedom to exploit the structure–property relationships, in order to find the next-generation multi-functional materials, in view of applications and of fundamental interest. His current research interest ranges from growth of novel perovskite oxides to non-oxides epitaxial films, down to its ultra-thin limit, to observe unforeseeable phenomena. He is also engaged in the growth of high quality epitaxial layered carbides and two-dimensional non-oxide thin films, to exploit the strain, dimension, and quantum confinement effect. His recent work also includes the metal-insulator transitions and magneto-transport phenomena in strong spin-orbit coupled epitaxial perovskite oxide thin films by reducing dimensionality as well as strain engineering. He is also extremely interested in the various energy related environment friendly future technological applications of thin films. In his early research career, he had also extensively worked on the tailoring of metal oxide crystal surfaces to obtain the atomic flatness with single terminating layer. Currently, he is also serving as a reviewer of several reputed peer-review journals.\nDr. Biswas received his B.Sc. in Physics from Kalyani University, followed by M.Sc in Physics (specialization in experimental condensed matter physics) from Indian Institute of Technology (IIT), Bombay. His Ph.D., also in experimental condensed matter physics, was awarded by POSTECH, South Korea for his work on the transport phenomena in perovskite oxide thin films. Before moving back to India as a national post-doctoral fellow, he was a post-doc at POSTECH working in the field of growth and characterizations of strong spin-orbit coupled metal oxide thin films.",institutionString:"Indian Institute of Science Education and Research Pune",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Indian Institute of Science Education and Research Pune",institutionURL:null,country:{name:"India"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"20",title:"Physics",slug:"physics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"205697",firstName:"Kristina",lastName:"Kardum Cvitan",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/205697/images/5186_n.jpg",email:"kristina.k@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"8356",title:"Metastable, Spintronics Materials and Mechanics of Deformable Bodies",subtitle:"Recent Progress",isOpenForSubmission:!1,hash:"1550f1986ce9bcc0db87d407a8b47078",slug:"solid-state-physics-metastable-spintronics-materials-and-mechanics-of-deformable-bodies-recent-progress",bookSignature:"Subbarayan Sivasankaran, Pramoda Kumar Nayak and Ezgi Günay",coverURL:"https://cdn.intechopen.com/books/images_new/8356.jpg",editedByType:"Edited by",editors:[{id:"190989",title:"Dr.",name:"Subbarayan",surname:"Sivasankaran",slug:"subbarayan-sivasankaran",fullName:"Subbarayan Sivasankaran"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"54634",title:"Use of Psychological Examinations of Employees and Job Applicants in Personnel Management",doi:"10.5772/67868",slug:"use-of-psychological-examinations-of-employees-and-job-applicants-in-personnel-management",body:'Conceptual management skills and human resource (HR) planning are key elements of personnel management within the legal context of labour law relations, in particular, recruitment activities that result in acquiring certain types of employees who are capable of managing manufacturing, organisational and technical processes [1]. The importance of an effective selection procedure followed by selection of appropriate candidates for job vacancies has been increasing because of the gradually changing nature of manufacturing processes in the context of the fourth industrial revolution [2–18]. Industry 4.0 envisages that even tasks regularly performed in workers’ professions require the use of state‐of‐art manufacturing technologies that cost several thousand to tens of thousands of euros. The new nature of these work positions, therefore, requires that employers fill the vacancies with employees who are more psychologically resilient to work stress, have certain cognitive, psychomotor and behavioural skills and personality features that help them fulfil their work tasks and at the same time prevent possible damage to the manufacturing means and/or reduce complaints from customers, which represent direct employer costs.
The changing nature of work has also had a significant impact on the content of the selection procedure which is no longer purely focused on gathering information on a potential employee, their work background, qualifications, and/or language and other skills [3–21]. In addition to the traditional assessment of physical fitness of an employee, the issue of the psychological capability of a future employee has been more and more part of the medical fitness examination of a candidate, probing their personal characteristics, personality and the presence of possible indicators of psychopathological behaviour.
With insufficient national and international regulation in this area, a conceptual dispute between employers and employee representatives in the Slovak Republic deals with identification of the borderlines at which it is possible to accept such interference in an employee\'s personal integrity when assessing his/her physical and psychological fitness: when does this have direct relevance in the performance of work and when it must be concluded that an employer did not conform with Slovak laws and possibly infringed on an employee\'s right to privacy and/or legal provisions related to the collection of employee\'s personal data that have no relevance to work performance [4, 5]. In practice, the above‐described situation also includes, for example, if an employee must undergo a psychological examination when an employer wishes to terminate the employee\'s contract. These practices can be a certain form of bullying with the aim to exert pressure on an employee so that the employee would terminate employment on his/her own will and the employer might avoid paying compensation in the form of severance pay.
The situations and issues described above have drawn the interest of experts in the area of labour law and HR management, seeking to analyse the current legal status and to identify negative phenomena related to the application of current laws, with the ultimate goal to prepare amendments to the legal framework, including the drafting of new guidelines for its application in practice. These situations constituted the basis for the current research projects focusing on the collection of data to provide the basis for conclusions required for the preparation of de lege ferenda proposals as documented in this article.
The key objective of the paper is to analyse and compare the current national and international legal frameworks in the field of psychological examination of employees or job candidates and compare these with practical application. Other objectives of the research were to determine whether the examined industry sectors are engaging in psychological examinations and which forms and methods are being used to gather information about individuals, and/or the approach of an employer to the selection of employees or job candidates who are to be subjects of such examinations. We have applied multiple criteria regarding the subject matter of this paper and the acquired knowledge and its empirical context are the foundation for conclusions and the legal basis for drafting proposals to change the current legal framework as well as company procedures to become ‘best practices’.
In drafting the concept of the paper, it was necessary to collect facts and other information from primary and secondary sources. Primary data were acquired from a survey carried out as part of the scientific project sponsored by the Slovak Research and Development Agency (APVV - 15 - 0066): “New technologies in the context of labour law and employee protection”. Secondary data were drawn from scientific literature. Because of the nature of the studied issue, the authors opted for a combined methodology (qualitative research methods and the application of selected quantitative approaches). Of the qualitative methods, we used the following: critical in‐depth analysis of the current legal framework and scientific cognitive methods.
For the quantitative methods, we used inductive statistics to generalise the primary research results. The selected statistical set was composed of 150 employers of various organisational and legal forms with 110,000 employees, primarily from the manufacturing industry (automotive, electrotechnical and engineering). Most the companies had foreign equity involved. Given these facts as well as the content of the interviews with the representatives of these companies, it is reasonable to assume that a similar approach to psychological examination of employees is taken in the other countries where these companies operate.
When identifying the legal framework in the selection procedure, Article 2 of the Fundamental Principles of the Labour Code (Act No. 311/2001, the Labour Code, as amended, hereinafter referred to as the ‘Labour Code’) may be used as the point of departure. Under the Labour Code, an employer has the right to freedom in selection of employees in the number and structure necessary as well as the right to define conditions and how this right is applied [6]. According to Section 41 of the Labour Code, even relations that are formed before the concluding of an employment contract are defined as contractual relations; based on this the employee has the right to fundamental human rights and freedoms, in particular the right to human dignity and protection of privacy and personality. It is required that the principle of equal treatment, and also all provisions of the Labour Code and the Constitution of the Slovak Republic relevant for the protection of the rights of employees, must be complied with.
Also, when organising and managing the selection procedure according to Section 62, paragraph 3 of Act No. 5/2004 on Employment Services, as amended (hereinafter referred to as Act No. 5/2004), an employer cannot require information from an employee during the selection process on his/her nationality, race or ethnicity, political attitudes, membership in trade unions, religion, sexual orientation or any information that is contrary to accepted principles of morality and personal information that is not needed to fulfil the tasks and duties set by the employer and defined by a special provision. Upon request by an employee, an employer is obliged to document the need for requesting personal information from an employee.
As part of pre‐contractual relations pursuant to Section 41 of the Labour Code, both the employer and the individual seeking employment have a certain obligation of information. In their effort to get to know their potential employees as thoroughly as possible, employers do not have the possibility to obtain, for example, referrals from former employers, and/or information concerning the use of narcotic substances, and so on, which could help employers select their employees.
Prior to concluding an employment contract, pursuant to Section 41 paragraph 1 of the Labour Code, an employer is obliged to inform an individual seeking a job about his/her rights and obligations that are subject to the future employment contract and about working and wage conditions under which he/she is to perform the work. An employer may, pursuant to Section 41 paragraph 5 of the Labour Code, require from an individual seeking a job for the first time only such information that is related to the work to be performed by the candidate if he/she is employed by the employer. From an individual previously employed, the employer may demand to submit an employment evaluation and an employment record. However, pursuant to Section 41 paragraph 6 of the Labour Code, an employer may not require information related to pregnancy, family situation, personal integrity, political affiliation, trade union membership or religious beliefs.
In general, based on the review of laws and regulations and practical experience from other European Union (EU) member states, the set of information could be outlined [7] of the types of information that an employer may be entitled to require from a job candidate, such as the ability to perform the offered job, work and professional background, courses attended, certificates obtained, logical skills, and the ability to manage stressful situations.
In Czech Republic, a new Specific Medical Services Act (Act No. 373/2011 Coll.) became effective. This act contains a new regulation on medical examinations of employees and stipulates the rights and obligations of employers and employees. The most significant changes in this field are a new legal fiction that a person who did not undergo an initial medical examination is deemed unfit for employment and a new legal fiction that a person without a valid medical examination is deemed unfit for employment. Each employee had to undergo an initial medical examination. The amendment introduces an exception that an initial medical examination is necessary in case of agreement on the performance of work or agreement on working activity only if the future employee shall perform hazardous jobs (as defined in legal regulations governing public health protection) or if the future employer expresses concern over the employee\'s state of health. The initial medical examination is performed prior to entering into an employment contract and takes at least 40 min (60 min in case of hazardous jobs). Upon this medical examination, the medical doctor issues a medical assessment by which the parties are bound, but may file an appeal.
The Act on Facilitating Business Activity in Poland is designed to simplify business operations and extends to such areas as employment law, modifying the rules for medical screening examinations of staff. Art. 229 of the Labour Code currently requires a preliminary medical examination, before beginning work, of persons newly hired, youth employees transferred to another position, and other employees transferred to a new position that involves health risks or difficult conditions. The amending act provides for a new exception of convenience to both employers and employees. There will be an exemption from the requirement for a medical screening examination also for persons hired by a new employer within 30 days after termination or expiration of a prior employment relationship, if they present to the new employer an up‐to‐date medical certificate confirming that there are no contraindications to working under the conditions described in the referral for a medical examination, and the new employer confirms that the conditions correspond to the working conditions at the new position.
In Hungary, based on 33/1998 on medical examination concerning suitability for sphere of activity, profession, and in regard to personal hygiene, the medical examination required for the position can be preliminary: periodical and extraordinary. Preliminary medical examination concerning suitability for sphere of activity shall be performed prior to the beginning of the working process: before the change of the position, the work place or the work environment. Periodical medical examination is required on an annual basis, for example, for the employee who is employed in a position, where risks of accidents are highly increased, the frequency of periodical medical examination is regulated by the decree. Extraordinary medical examination concerning suitability for sphere of activity shall be provided in the cases, for example, for the employee\'s health condition highly changed, which may make him/her unable to hold the position complying with occupational safety and occupational health requirements [8].
The use of psychological examination methods in HR management, especially in the context of the selection procedure, has become part and parcel of the modern concept of human resources. Professional use of psychological examination methods makes it possible for an employer to acquire information about personality features of candidates and/or employees, their personal characteristics, prerequisites and certain capabilities. These methods enable employers to assess the position and function that a candidate is most fit for, it helps them discover the candidate\'s growth potential and his/her strengths and weaknesses.
The first records about the selection of workers go back to the times of Ancient Rome when the Roman army selected their recruits—not only soldiers but also medics, explorers, carpenters, veterinarians and others. The ancient Roman army was highly demanding of its soldiers—despite the high pay it was a problem to recruit people fit for the job since the work of a soldier was also very risky. Therefore, recruiting agents travelled around the whole Roman Empire seeking suitable candidates.
An increased need to find fit, specialised workers emerged after the industrial revolution. The recruitment procedure started with a simple notification that, for example, a manufacturing plant had vacant posts and people could then simply apply for a job with that plant. The beginning of the use of psychological examination in the selection procedure dates back to 1901. The expansion of industry and the related demand for a great number of workers resulted in the need to look for quality employees to fill leading positions. For this purpose, psychological tests started to be used in practice. World War I had the most significant influence in the boom of intelligence testing (Army Alpha and Army Beta tests); an enormous number of military recruits had to undergo these tests. After successful use of psychological examinations during the war, this kind of testing started to expand in other areas. A more general interest in the tests occurred again before the beginning of World War II. Army psychologists were developing tests for various specialists. After the war, job agencies were established, offering work to job seekers.
Nowadays, the selection procedure focuses more on the selection of a candidate for a specific position in a company. An important change in the process of seeking and selecting employees was brought about by the Internet. The first round of job seeking and employee selection is currently done via the Internet.
The breaking point for the necessity to use psychological knowledge may be regarded as the period of the organisation of work initiated by the efforts of F.W. Taylor and F.B. Gilbreth to maximise the organisation, performance and rationalisation of work. Despite the fact that F.W. Taylor was vehemently refusing to accept social aspects of work and insisted on an individualistic approach, many of his processes and methods (e.g. timing of individual work operations, exact definition of workplace movements, breaks, etc.) meant a turning point in the development of work psychology [9]. Work psychology as an independent applied discipline dates back to the period after World War I. This discipline emerged under the direct influence of the specific needs of society. The publication of ‘Psychology and economic life’ by Műnsterberg (1912) [23] was a pre‐text to it. In this publication, the term ‘psychological technique’ was used for the first time ever and became a synonym for the first stage of the development of work psychology. The beginnings of psychological techniques are related to the development of psychological examination and diagnostics and, in particular, IQ tests. The term ‘psychological technique’ was defined by W. Stern, who originally meant the psychology of treating a person in search of an optimum between the means and intention, which differs from ‘psychological examination’ as a discipline of psychology in understanding a human being. Methods of psychological examination emerged to assess the characteristics of an individual and assist with the selection of a specific profession. It was based on a premise that problematic issues at work are caused by the fact that job positions are filled with individuals lacking the corresponding prerequisites. Recruiters focused their interest on finding differences between individuals and assessing how competent these individuals were to fill a specific job position. It was almost exclusively focused on the psychological selection of employees and professional counselling (a subjective psychological technique) and also, to a lesser extent, on the adaptation of working conditions (an objective psychological technique) [10].
Nowadays, the selection of suitable employees is important for companies primarily because of the financial aspect—an employee who is very productive may receive double the salary of an average or less efficient colleague; however, his/her performance is usually much more beneficial for the company than it might appear when looking at the salary difference between these two employees. It means that a smaller number of high‐quality employees are of greater value for a company than a larger number of average or very mediocre workers. Today, various psychological methods are used by psychologists in an attempt to find out if a candidate is capable of meeting relevant requirements of a job position; it means that the prerequisites and potential of a candidate are measured. In this respect, we consider the application of work psychology and occupational psychology as key, as these are specialised and particularly practice‐oriented disciplines that explore the principles of psychological regulation of work‐related activities and how these principles could be used for the benefit of society [11].
To be able to select employees, it is necessary to determine their personal characteristics, competencies and skills that are most suitable for a specific job position and what it requires. As for their purpose, work psychology methods may be divided into research methods and intervention methods. Even though it is possible to determine the individual types of methods which fall under these categories, their exact division is not as straightforward as science would ideally assume. For example, an interview as a method may be both a research and an intervention method. Psychological methods are therefore divided per various criteria. The following types are most frequent [12]:
Clinical methods: observation, interview, personal history and analysis of spontaneous responses;
Testing methods:
performance methods: IQ tests, tests of special skills and individual psychological functions (memory, creativity, technical, verbal, mathematics and art skills) and knowledge tests;
personality tests: projective tests, objective personality tests, questionnaires, evaluation scales;
Machine‐assisted methods.
Despite this division of psychological evaluation methods, it is necessary to emphasise that, ‘In principle, any method of psychological evaluation offers certain information that goes beyond the frame of its defined validity, for example, in addition to qualitative analysis of an observed behaviour of a respondent, IQ tests provide us with a fundamental outline of his/her personality’ [13]. Interview is the most frequently used method all over the world. IQ tests and personality tests are also widely used.
Intellect means an ability that has an impact on and is a prerequisite for whether a person is capable of dealing with various situations: ‘…it is the ability of an individual to learn and be able to find direction in a new situation regardless of previous experience’ [14]. When using an IQ test, it is therefore possible to predict work performance of a person. The more demanding the work is, the more it requires a certain degree of independent decision‐making and responsibility, and the more important it is to know the IQ score of a candidate for such a job position. It is also important to know that these types of tests may be applied successfully only if the individual is collaborating. If a person who is subject to the test does not collaborate, the test results do not reflect an objective level of the person\'s skills. In addition to this, the test results may be biased due to the current health condition and/or emotional state of a respondent, or due to other test situations (sex and age of the testing and the tested person, their mutual sympathies, the first impression, etc.). These test results are usually presented as the well‐known intelligence quotient—IQ. The average IQ score in the population is 100, with a standard deviation of 15 points (the intellectual capacity of the majority of the population is between 85 and 115 points). IQ tests are further divided into verbal tests (knowledge acquired through learning), performance tests (inborn potential not influenced by learning) and comprehensive tests. The following tests are currently used the most: Wechsler Adults Intelligence Scales (WAIS‐III), Raven Progressive Matrices and IQ Structure Test (IST).
It is only natural that the work performance of a person is also influenced by his/her personal characteristics. Personality tests are used in order to learn about the personal characteristics of a person and/or changes in their personality when subjected to various factors (e.g. extreme load, disease, injury, etc.). These tests are based on different concepts than performance tests. It is not performance that is measured; therefore, there are no ‘correct’ or ‘incorrect’ answers. The goal of these tests and examinations is to differentiate between individuals with different personality characteristics (e.g. introvert vs. extrovert, dynamic vs. passive, ability to lead a group or adapt to a group, and other characteristics), interests, attitudes and/or different clinical symptomatology (symptoms of mental disorders). When assessing psychological competencies of a person for the purposes of HR management, personality questionnaires and projective techniques are most relevant.
Personality questionnaires are based on a subjective deposition of a respondent about his/her personality characteristics, how he/she responds to various situations, what his/her opinions are, and so on. They rely on introspection (conceptions about oneself) because the answers of an individual depend on their inner observations (to what extent is a respondent able to make appropriate assessments of oneself). This is the reason why one of the most frequent criticisms of personality questionnaires is a reservation that they do not assess what a respondent is like but rather how they see themselves and what they wish to be like. Another disadvantage of these questionnaires is that the results may be intentionally biased. Many questionnaires attempt to control such possible intentions by engaging the so‐called ‘lie scales’. Individual items in these lie scales focus on minor human ‘sins’ that are considered negative, but on the other hand, they are committed by most people (e.g. the statement: ‘At home, I always eat with the same good manners as eating at a social event’.). As part of the modern selection procedure, mainly when selecting candidates for managing positions or mentally demanding conditions, the so‐called stress‐test of cognitive processes regulation is used. Its purpose is to assess mental stress resistance levels. The most frequently used questionnaires are NEO—Five Factor Personality Inventory; MMPI—Minnesota Multiphasic Personality Inventory; the Stroop Test; BIP—Business‐Focused Inventory of Personality; and others.
Projective methods employ indefinite and relatively unstructured stimuli. One may respond to such ambiguous stimuli in multiple ways, which creates room for projections. It is assumed that while processing and responding to multivalent stimuli, respondents project some parts of themselves into them, such as their perceptions, expectations, longings, despairs, complexes, moods and so forth. Such response may, therefore, provide information on personal characteristics of an individual. An advantage of the projective method is that it allows for a minimum (typically none at all) intentional influence over the results since the scrutinised person has no clue as to the purpose of the method. Moreover, the application (test procedure) of projective methods does not mimic an examination in its nature, thus it appeals to most respondents. However, the application of projective methods by non‐psychologists or psychologists without adequate training (for this purpose, a single university study programme of psychology is considered adequate training), possibly their application by psychologists who failed to undergo training courses on particular projective methods or those who lack experience in applying a particular projective method under satisfactory supervision, may pose a risk. Projective tests include the Rorschach test ROR, Hand test, Draw‐A‐Person test, Thematic Apperception test (TAT), Tree‐drawing test and Lüscher Color test.
There are a great number of theories about personality and personality characteristics. Based on extensive research, five basic characteristics have been determined as a result of an independent factor analysis by which every human being can be described. Currently, the most widely used is the five‐factor model of personality called the ‘Big Five’. Based on this model, there are five dimensions of personality:
Openness to experience—intellect;
Conscientiousness;
Extraversion;
Agreeableness;
Neuroticism—emotional stability.
Intelligence and some dimensions of personality are interconnected, but some are not. Based on this model, we propose the following:
Neuroticism—the higher it is, the lower the person\'s results in IQ testing is—his/her anxiety jeopardises his/her performance under stress;
Extraversion—a person with high level of extraversion can better cope with intrusions from the surrounding environment; he/she has a better short‐term memory; on the other hand, introversion is intertwined with good long‐term memory and long attention span;
Openness to experience—best correlates with intelligence; curious people seek more answers, do more research and these activities are backed up by abundance of knowledge, which is directly linked with the degree of intelligence;
Agreeability—fails to correlate with intelligence;
Conscientiousness—negatively correlates with congenital intellect, which means that people with lower level of intellect tend to be more systematic and persistent in order to leverage their insufficiencies; on the other hand, more intelligent people regard their intellect as sufficient and therefore feel no need for advancing their systematic qualities.
Psychological examination is a very complex process; therefore, the application of testing methods without mastering the theoretical background, and/or the mechanical interpretation of these methods without verification of hypotheses implied by the tests, and without the back‐up of clinical methods (observation, interview, information from the applicant and his/her surrounding) may not be objective and may not give a clear answer whether a candidate for work is or is not suitable for the job [15].
An employer may, pursuant to Section 41 paragraph 2 of the Labour Code, demand information concerning a future employee\'s health or psychological fitness and/or another condition necessary for determining the future employee\'s ability to perform work, but only if such capability for work performance is required by a special regulation. The intention of health evaluation of an employee as well as his/her psychological capability is that an employer has proof that the employee is competent to perform the agreed work and to ascertain that during the performance of agreed work the employee\'s life and health will not be threatened. The evaluation of an employee\'s health condition is important in labour law relations, although it is a very sensitive area and affects an employee\'s personal integrity. It is also part of the personal data of an employee or a candidate. Information on the health condition of an employee may be processed only by a person authorised to doing so according to special regulations (e.g. the Act on Health Care). For the purposes of selecting a suitable candidate, an employer may process only information whether the candidate is competent or incompetent to perform the work required by the specific work position.
As for health‐care assessment, according to the Act on Public Health (special Act No. 355/2007 on Support, Protection and Development of Public Health) and further to the duties of an employer defined in Section 30 item 1b and c of the Act (the duty of an employer to provide for medical supervision and evaluation of medical fitness for work), the nature and content of medical examination of a candidate for work and/or an employee are stipulated by the Journal of the Ministry of Health of the Slovak Republic (MH SR Journal), items 1 through 10 of 29 January 2014. The Journal determines mainly the type and timing of preventive medical check‐ups in connection to work factors and the work environment or more specifically to work positions for which a medical fitness examination is required according to special regulations. Preventive medical check‐ups aimed at the evaluation of medical fitness prior to the conclusion of a labour law relation or similar labour relation of a job seeker focus on the discovery of the already developed pathological conditions, and also clinically asymptomatic but already detectable risk indicators for an occupational disease or illness related to work. Finally, the aim of these examinations is to trace a disease that could later contraindicate the candidate\'s work performance. Work‐related preventive medical check‐ups typically apply to persons whose work positions are ranked as third or fourth category; persons whose jobs are ranked as the first or second category need to undergo work‐related preventive medical check‐ups only if a specific regulation requires so, or if an employee requests a preventive medical examination. A periodic work‐related preventive medical check‐up takes place biannually for work positions ranked as the third category and annually for work positions ranked as fourth category. Periodic preventive medical check‐ups of persons performing work belonging to the first or second category are conducted only if a special regulation so requires at intervals stipulated in the regulation. A preventive medical check‐up prior to a change in work position must, always, take place before the actual change occurs.
Examinations that are part of work‐related preventive medical check‐ups can be divided into basic examinations forming an inseparable part of each work‐related preventive medical check‐up in the extent stipulated for individual factors, groups of factors or performed activity (see MH SR Journal, Volumes 2–6) and complementary examinations performed in justified cases (see MH SR Journal Volumes 2–6). These are indicated by the physician performing work‐related preventive check‐up on an individual basis; they are warranted by identified and assessed health risks, labour factors or the occupational environment, work performed, potential occupational health hazards, or if it is necessary to conduct them in order to exclude contraindications. Work‐related preventive medical check‐ups, which are part of health supervision in the area of occupational health, are performed by qualified occupational physicians and physicians qualified as general practitioners working outside occupational health services [16].
Subsequently, it is important to pay special attention to psychological examination while differentiating whether it is part of health fitness assessment and a prerequisite for work performance (e.g. soldiers, police officers, judges and certain railway employees) or whether it is a psychological examination which goes beyond legal requirements and is, in fact, a requirement set (unilaterally) by an employer, unsupported by applicable laws and regulations (e.g. examining various skills of managing employees). In this respect, even the person performing these examinations may differ, that is, it may be a physician performing clinical psychology as a medical field or an occupational psychologist.
With regard to personal data protection in the context of psychological evaluation of a candidate\'s psychological capability, specific cases must be explored and whether in specific cases an obligation imposed by an employer is part of the basic or complementary examination within a preventive medical check‐up conducted in relation to work and with regard to the work and environment factors or the type of work performed by the employee. This means whether an employee should undergo such examination at all (e.g. assessment of his/her psychological capability for the performance of work). If the MH SR Journal stipulates that medical examinations include, for example, a psychological examination for a specific type of work, which is part of the basic or complementary examination for the assessment of medical fitness, it is then an employee\'s or a candidate\'s obligation to undergo such examination as there is legal base for the processing of personal data due to a special regulation (Act on Public Health, Journal of the Ministry of Health). If a psychological examination is only part of a complementary examination, it is necessary to explore the reasons for request of such examination on the part of the physician who performed the preventive medical check‐up in relation to the person\'s work, and with regard to issues related to material grounds for performing a complementary examination. Psychological examinations that are part of health condition assessment of employees or candidates for work are demanded within a basic examination for work that includes, for example, driving motor vehicles, and within a complementary examination with, for example, work that includes maintenance of boilers of I. through to V. categories, or maintenance of small motor vehicles.
If any part of the procedure described above for the implementation of a psychological examination of an employee as part of assessment of his/her health condition in relation to work performance is not observed, it is not possible to justify the requirement for a psychological examination based on the application of a special regulation, and such action on the part of an employer would be in direct contradiction of labour law provisions. Similarly, such procedure would be in contradiction of the Act on Personal Data Protection, since in this case the employer may only acquire personal data to an extent and in the manner prescribed in a special regulation.
When the psychological examination is part of a medical examination pursuant to relevant provisions of a special regulation, the manner of execution of the psychological assessment is at the discretion of the physician who performs the psychological examination (as a rule, it would be a clinical psychologist requested by the employee\'s general practitioner (GP); an occupational psychologist is rather an exception). The issue of the form and type of the examination (e.g. which psychological test is best in order to gather all the necessary information for an employer even beyond the facts that are to be acquired pursuant to a special legal provision) is exclusively subject to the decision of the GP and shall not be influenced by the demands of the employer or the employee. The primary responsibility is therefore borne by the GP while his/her decisions are subject to scrutiny according to a special regulation as part of lege artis scrutiny of provision of the health care.
More frequently scrutinised cases of medical fitness examination of job candidates are those in which no specific requirements about a candidate are laid down in a special legal provision, or there are no special legal provisions regulating the work performance of the candidate\'s job position. In practice, there are disputable situations related to medical fitness examinations when the concerned employees that are subject to medical fitness examination are not covered by the above‐described special regulation, and it is this fact that is similar to the issue of the physical fitness of an employee. An employer shall not assign work performance to an employee who is not medically fit to perform the work [17].
At present, some employers demand various psychological tests or examinations as part of their selection procedure. The question arises whether an employer may demand that a candidate take a psychological test or examination unless it is prescribed in a special regulation and, at the same time, whether an employer may define the form of such psychological examination of a candidate or an employee when the employer wishes to gain information about the reactions, behaviour and mental state of candidates or employees to be able to make a better decision with regard to the filling of a work position. Given that imposing duties on employees must be within the limitations of and based on the law, and that the Labour Code provisions may be considered cogent standards that cannot be departed from, it can be concluded that an employer does not have such authorisation. When imposing duties, an employer is also bound by the type and location of work performance of an employee, and/or agreed work conditions.
In this regard, it is necessary to differentiate whether the aim of a psychological assessment carried out by means of psychological examination methods is to understand characteristic features of an employee or to examine the core of his/her personality—which can be done only if required by special legal provisions. It is therefore questionable whether an employer may examine the above‐mentioned personality traits and/or whether such examination would not already constitute interference with the personal integrity of an employee executed without his/her consent. With the lack of special regulation in this area, the fundamental principle of private law in which ‘everything that is not forbidden is permitted’ cannot be taken as the baseline for permitting psychological examinations without any limitations exclusively at the discretion of an employer. It is our belief that a benevolent attitude to psychological examination of candidates for work and employees causes unacceptable interference with the balance of rights and obligations for both parties and leads to the occurrence of negative phenomena which have been confirmed also by the conclusions of the conducted research. To the contrary, the authors believe that it is essential to apply the principle that the assignment of duties to employees shall be done only on the grounds of law, within its boundaries and while observing fundamental rights and freedoms.
When attempting to determine the right of an employer to demand a certain psychological capability of employees and therefore demand that they undergo a psychological examination, it can be argued that the Labour Code stipulates that employers, in line with specific conditions of their work, can define their employees’ requirements for proper performance of work. An employer must proceed in line with the proportionality principle and define requirements in such a manner that they are justifiable and legitimate for a specific type of work. However, we believe that for certain types of work it should be possible to request special capabilities, including the requirements for a certain psychological capability provided this special capability is necessary for and directly linked to the kind of work and activities performed as part of this specific type of work. Thus, an employer\'s across‐the‐board instruction for employees to undergo psychological examination, regardless of the type of work or specific tasks to be performed, can be considered inappropriate and non‐justifiable.
Given the lack of specific regulation on the examination of psychological capabilities of employees, one must be aware that the exercise of establishing the legal basis for conducting a psychological examination must be carried out in the context of two, independent legal modes, and that these modes partially contradict themselves within the legal order of the Slovak Republic. The Labour Code, on one hand, stipulates that an employer may establish a psychological capability examination as a prerequisite for the performance of work and in order to secure legal certainty ask for consent of all employees with such assessment conducted by means of a psychological capability examination. If an employer does not have the consent of an employee to a psychological examination, the employer\'s authorisation to unilaterally demand that an employee take a psychological examination would be associated with a serious risk that such action would be evaluated as not being compliant with the law.
On the other hand, when looking at the issue in the light of the Act on the Protection of Personal Data, an employer may process personal data only at a scale pursuant to special legal provisions, and in only exceptional situations may the employer link such collection of information to an employee\'s consent. However, in such a case, the assessment of psychological capability would mean such a serious violation of the fundamental human rights and freedoms of an employee (in particular, the right to privacy and family life) that it should not be bound to the employee\'s consent to undergo a psychological examination. From the viewpoint of the Act on Protection of Personal Data, if the execution of a psychological examination of an employee cannot be legally based on any special regulation, an employer cannot carry out such psychological examination.
Our scientific survey points to several problematic issues in practice related to the execution of psychological examination during the selection procedure and within labour law relations. Therefore, we need to apply several criteria to the explored matter. The main goal of the survey was to identify the current state of play regarding the use of psychological examination methods primarily in selection procedures conducted by employers; our interest area was later extended to current employees of the employers in the selected sample. The survey also focused on the types of psychological examination methods used. The aim was to confirm the set hypotheses that were formulated based on prior experience of the authors. Various viewpoints were applied to the evaluation of the gathered survey material. Procedures taken by employers in relation to the collection of personal data of employees by means of psychological examination of their capabilities were explored as well as compliance of these procedures with the laws of the Slovak Republic. The application of psychological tests itself was evaluated by an independent psychologist, employing as a criterion the premise that the BIP personality test led to lesser interference with privacy (mainly in terms of personal data acquisition about the personality traits of candidates and employees that are not work‐performance related) than the more popular and widely used 16 PF test.
The examined selected sample confirmed that psychological and diagnostic examination of employees’ personality is carried out by approximately 60% of employers (90 employers), and a great majority of them (70%) use the 16PF personality test. When attempting to confirm our hypotheses, the primary emphasis was not to perform quantitative research but rather to identify the current status quo and determine the trends in practice so that we would be able to formulate conclusions in terms of de lege ferenda.
Hypothesis 1: There is a trend among employers to demand psychological examination across‐the‐board from candidates and employees when filling work positions regardless of the fact that the job descriptions and work assignments for these work positions do, in fact, differ.
When exploring and verifying this hypothesis, we concluded that this was confirmed and the reasons for this confirmation can be found in the organisational structure of employers. The organisational structure defined basic categories of employees regardless of the nature of the performed work (there was differentiation of employees to production and non‐production categories) and certain subcategories depending on the duration of employment with the employer. However, formally we were seeing the same level (type) of employees within the same line of the organisational structure. For example, some work posts with different work performed were marked as ‘desk officer‐operator’ but only one of the employees who was marked as ‘operator’ performed the actual work that required the operation of state‐of‐the‐art technology for which the requirement for a higher (certain) level of psychological capability could be objectively justified.
With all other operators, psychological examination was carried out ‘as if’ just to make sure, for example, if there was a need for replacement of the operator, the employer would be able to secure continuity of the manufacturing process. In the real world, though, such a replacement was used very rarely since in case of a need to replace such an operator employers used operators from other work shifts, which means that there was no use of other employees as replacement operators and there was no objective reason to use them because of the sufficient number of shift employees. However, employers had at their disposal a whole pack of information resulting from psychological examination of employees. These data were of a personal nature, concerning medical fitness, but the nature of these data was in no way related to the performed work of employees or the work to be performed by candidates (this kind of psychological examination was applied also to the assessment of job candidates). At the same time, employers did not have the consent of employees to such psychological examination since they had set as a prerequisite a certain level of psychological capability which, however, was not specifically defined by in‐house company regulations.
Hypothesis 2: As part of psychological examination, most employers tend to use tests that are intended to result in a greater scale of information about respondents’ personal characteristics (16 PF test instead of the BIP test) than would be required by the nature of work.
Based on prior empirical experience, a hypothesis was formulated, which was to verify whether employers tend to use contractual physicians to help them pick such forms of psychological examination of employees, the aim of which is not only to ascertain an employee\'s capability to perform certain work but also to acquire other types of information on a person that could help the employer better decide on a candidate for a specific work position. Verification of the hypothesis was based on a qualified assessment of tests that were used as part of psychological examination, pen and paper interviews with employees, and on the information that was provided to physicians during psychological examination. Similarly, pen and paper interviews were conducted with the psychologists in order to find out what the reasons were for having conducted the same type of interviews with employees.
The most frequent indications concerned IQ and personality tests of candidates for work or employees. Often, physicians (clinical psychologists) specified the purpose of an examination (e.g. a personality test with the focus on emotional disorders, tendencies to simulation or aggravation, etc.). As part of psychological examination, special methods were used with the aim to acquire information on a respondent that is valuable from the diagnostic point of view; both types of psychological examination methods were used (clinical methods and tests).
The majority of psychological examinations applied personality testing as the method for job candidates (these were also used with employees). These had general orientation without a direct relation to the nature of the work performed or to be performed and their aim was solely to determine a personality profile. Personality questionnaires, completed by respondents, and projective methods that were used with selected categories of employees (these were used most of the time when filling positions for higher management) were used to get a broad scope of information for an employer about the person\'s personality. Quite a high number of these tests were not related to the performed work; they just provided employers with information on personal characteristics of candidates. The studied sample confirmed quite extensive use of the standard personality test 16 PF, which from the viewpoint of labour law and with regard to the authorisation of an employer to collect such a broad spectrum of information means serious interference with an employee\'s privacy despite the fact that it is a very popular test in HR management (the test should be conducted by a clinical psychologist with appropriate certification, which is not the case with the majority of those sampled, and it is questionable whether the 16 PF test employing the current standardised norms is being used in order to produce reliable results). We consider the acquiring of information about emotional stability, firmness of attitudes, introvertedness or communicativeness as verifiable interference with the personality of job candidates that an employer does not have the right to exercise unless the job applicant had given prior consent pursuant to the Labour Code. Pursuant to the Act on the Protection of Personal Data and in terms of what was presented above, these actions were clearly on the contrary to the laws of the Slovak Republic. The use of the BIP test was less frequent, even though in the context of privacy protection of employees it is easier to determine the relevance of the test to the nature of the work to be performed by the job candidate or the employee, and/or the performed work in general. In terms of the nature of the acquired information, such as the respondent\'s conscientiousness, flexibility or confidence, the use of the BIP test can be considered more legally conforming.
The use of stress‐management tests was documented to a smaller scale (only the SVF 78 test was identified) especially in light of the fact that these types of tests were used only with regard to filling higher management positions where stressful situations are more likely to occur in greater numbers.
The above‐described state in the relevant national and international labour law provisions as well as the results of the conducted scientific research has led us to the conclusion that there is a need to adopt legislative amendments to laws regulating employee selection and hiring procedures, especially covering the area of medical fitness examination of job candidates and employees conducted by employers [19, 20]. Against these deliberations and efforts of, mainly, employee representatives stand the large, above all, multinational employers whose interest is to adapt formal selection procedure conditions to their internal, specific rules which often differ significantly from the general ones, and their intention is to acquire from potential employees as much information as possible that might help them decide about employment of a candidate. Regardless of the above‐described two parties of interest, and with an attempt to review the issue in an objective manner, we do believe that this review has demonstrated the necessity to define minimum legal criteria (procedural and material) for the process of psychological examination of job candidates and/or employees (also during employment) so that there are clear limitations set to an employer\'s interference with the employee\'s personality and his/her fundamental human right to privacy and family life [22].
What may be considered as recommendations are to define: who would be authorised to assess psychological capabilities, the types of admissible personality tests and projective methods with regard to the nature of work performance, and the obligation of an employer to always obtain consent from an employee for a psychological examination (with a prior obligation to provide information about the content and course of the examination, specifying the information that the employer is to learn about the employee\'s personality traits). In this respect and given the growing number of multinational companies and the universal nature of fundamental human rights and freedoms, we see room for professional international discussion of experts examining the possibility of adopting a common European (multinational) regulation.
This paper (legal status as of 31 January 2017) was written as part of the project sponsored by the Slovak Research and Development Agency (APVV‐15‐0066): ‘New technologies in the context of labour law and employee protection’ (author: Prof. JUDr. Helena Barancová, DrSc.).
Surgical resection for early stage non-small cell lung cancer (NSCLC) (Stage I and II) is associated with the lowest risk for local and distant recurrence and the best 5-year survival compared to other available treatment options [1]. The preferred approach for the surgical management of resectable, early-stage NSCLC has shifted in recent years from open thoracotomy to minimally-invasive surgery (MIS). Although thoracotomy has evolved over several decades to utilize muscle sparing incisions and improved postoperative pain control using epidural and paravertebral catheter systems, this technique is associated with more significant muscle dissection, rib spreading, and increased risk for morbidity and mortality after surgery. This includes a protracted period of recovery following hospital discharge, a slower return to baseline quality of life, and the potential for chronic pain associated with a larger thoracotomy incision.
With fewer perioperative complications and quicker recovery, minimally invasive surgery offers expanded opportunities for surgical resection in patients who otherwise would not tolerate the morbidity of thoracotomy. There are additional benefits to minimally invasive resection, including significantly improved postoperative pain control, shorter hospital length of stay, quicker return to baseline quality of life, and earlier return to work that enhance and support the utilization of this platform for NSCLC [2, 3, 4]. These advantages have resulted in a significant shift in the surgical management of NSCLC patients, where formerly open resection and up to a week-long hospitalization were standard even without significant postoperative complications, current expectations for VATS lung resection include discharge to home in the majority of cases within 4–5 days or less [5]. Additionally, in cases where there may be a recommendation for adjuvant therapy, MIS patients are more likely to have recovered and be ready to receive such therapy earlier in their treatment course. Therefore, minimally invasive resection has significant advantages, especially when considering some percentage of thoracotomy patients might not receive adjuvant therapy given a challenging recovery from their index lung resection.
Video-assisted thoracoscopic surgery (VATS) for lung resection has been a part of the thoracic surgeon’s toolbox for the past three decades. Lewis et al. first described the use of VATS in 1992 [6]. The technique was quickly adapted to lobectomy in elderly patients with early-stage NSCLC, where some of the first cases were completed with similar or better results to historical controls [7]. Since these initial reports, VATS surgery has become increasingly common, with expanded use in complex lung resections, pneumonectomy, bronchovascular sleeve resections, and tumors that include the chest wall [8, 9, 10]. While only 8% of lobectomies in the United States were performed thoracoscopically in 2003, this figure has increased significantly over time, up to 54% as reported in 2014, especially among high-volume surgeons [11, 12, 13]. Trends that favor VATS adoption include being a dedicated thoracic surgeon in a high-volume center, performance of lung resection in a larger hospital, and lung resections performed in the Northeast. In one multi-variate analysis, there was a significant association between VATS adoption and surgeon volume (>15 lobectomies performed per year), which is not unexpected given the technical challenges associated with becoming proficient with this technique [11]. Although VATS adoption has significantly improved, there remains a large number of both general, dedicated thoracic, and cardiothoracic surgeons who continue to perform a thoracotomy for NSCLC, limited by both volume challenges and the learning curve associated with VATS lobectomy. Although the percentage of open lung resection has declined over time, this technique still represents a large proportion of early stage NSCLC surgery performed in the United States. As a result, there is an opportunity to expand on the availability of minimally invasive lung resection to patients, and to do so using technology that favors a natural transition for otherwise traditional open surgeons.
This need has led to another major technical innovation in thoracic surgery over the last two decades with the adoption of the Da Vinci robotic system (Intuitive Surgical Inc., Sunnyvale, CA, USA), a platform that is at the forefront of minimally-invasive lung, esophageal, and mediastinal tumor resection. In robotic-assisted thorascopic surgery (RATS), the surgeon is seated at a console adjacent to the sterile field which operates a bedside patient cart with several robotic arms (Figure 1). Attached to these arms are robotic instruments that enter the pleural space via keyhole incisions and robotic ports. At the console, the surgeon manipulates the robotic arms with three-dimensional controls which translate the surgeon’s hand movements to the wristed instruments on each of the robotic arms. A RATS platform aids the surgeon by enhancing visualization with a three-dimensional high-definition view, minimizing hand tremors, and improving dexterity of the instruments by functioning with multiple degrees of freedom. Wristed instruments mimic the surgeon’s actual hand movements, simulating open surgery, allowing for the precise dissection of vascular structures and a thorough lymphadenectomy, key steps to success when performing minimally invasive lung resection. While this technique is a dramatic change from either open or VATS procedures as the surgeon is not at the patient’s bedside, repetition and the frequency of performing robotic cases helps one’s personal comfort as they transition to RATS.
Da Vinci XI patient cart with four robotic arms. Image courtesy of © [2020] Intuitive Surgical, Inc.
Although the technical advantages of RATS make the platform desirable, the adoption of minimally-invasive robotic surgery is associated with some challenges. While benefits such as reduced postoperative pain, decreased peri-operative morbidity, reduce risk for postoperative air leak, and shorter hospital length of stay have been described, concern over upfront investment and increased cost per operation may be considered a barrier to access. Additional training for operating room staff is required, capital investment into larger operating rooms and to modernize traditional open surgery rooms that might like technological infrastructure, as well as increased operating times impact the opportunity cost of performing other operations and can contribute to some level of adoption apprehension for hospitals that have no robotic experience. Despite any misgivings, there is clear evidence that the adoption of robotic surgery for lung resection is on the rise. In just two years, from 2010 to 2012, robotic surgery increased in popularity by 3-fold, accounting for 9.1% of lung resections annually in 2012 [14]. More recently, an estimated 17.5% of lobectomies were performed robotically in 2017 [15]. Trends in robotic adoption seem to suggest that the technical advantages associated with robotic lung resection outweigh the capital and educational investment needed to make such a program successful. What specific metrics drive robotic adoption and improve outcomes in thoracic surgery are defined in the literature. This chapter will address the advantages and disadvantages of MIS for NSCLC, including the role of robotic surgery, and discuss its future directions in this field.
Minimally-invasive thorascopic surgery, and in turn RATS, have several advantages over traditional open surgery. Compared to thoracotomy, VATS and RATS utilize small incisions to access the chest cavity, reducing peri-operative morbidity and enhancing recovery. This allows the surgeon to select a larger range of patients who may otherwise be unable to tolerate open resection. Avoiding the muscle dissection/division and rib spreading associated with thoracotomy, while not compromising on the oncologic efficacy of the procedure, are the key advantages to both VATS and RATS procedures. For the facile VATS surgeon, lung resection and complete lymphadenectomy can be accomplished with a high rate of success, low risk of complication, and an expedited pathway to recovery. There are specific subsets of patients at higher risk for conversion during VATS procedures, particularly in cases where dissection is difficult due to fibrocalcified nodes, large tumor >3 cm, or prior induction therapy [16, 17]. In these cases, the advantages of robotics can be significant. The fundamental benefit of the robotic platform is that it simulates open techniques but with the advantages of smaller incision surgery. RATS procedures utilize insufflation to help maximize exposure, 3-dimensional optics to help define important structures and their relationship to adjacent structures, 10× magnification rather to improve visualization, and the ability to reach farther into the chest with longer instruments while still performing fine dissection work, all without losing out on the ergonomics associated with open surgery. This includes the ability to use robotic stapling devices which are similar to open and VATS variants, bipolar energy devices that articulate, vessel sealing devices that articulate, and fluorescence imaging in cases where tumor localization or performance of segmental resection is preferred. Not only does this provide open-only surgeons with an easier opportunity to incorporate MIS into their technical portfolio but affords a larger number of patients with the opportunity to undergo minimally invasive lung resection when appropriate.
An additional advantage is the ease in which segmental resection can be performed. RATS visualization and the precision in which segmental anatomy can be dissected has helped improve the adoption of segmentectomy in the United States [18]. As new data becomes available regarding the advantage of segmental resection over wedge, and potentially the equivalence of segmentectomy to lobectomy for subsets of early stage NSCLC either <2 cm or in patients with non-solid nodules, the utilization of techniques to improve rates of segmentectomy will become more important. While VATS segmentectomy is both well described and widely performed, it remains a technical challenge for many surgeons to adopt with proficiency required that can be significantly more complex than superior segmentectomy. RATS segmentectomy may be an opportunity for lobectomy only surgeons to increase their success with segmentectomy given these advantages. Previously data has demonstrates that surgical outcomes are comparable between RATS and VATS segmentectomy, both in terms of oncologic outcome and the adequacy of lymph node evaluation [19]. This principle is important to keep in mind as there is no scenario in which the size of an incision is more important than achieving an appropriate and adequate lung cancer resection.
MIS allows surgeons to select patients who would otherwise be unable to tolerate open pulmonary resection. The morbidity of a thoracotomy precludes many patients from benefitting from surgery with otherwise resectable cancers, leading to suboptimal treatments and decreased survival. In these cases, some institutions may turn to a more liberal use of radiation therapy as a means of local control. However, many studies have demonstrated the increased risk of local recurrence and inferior 5-year survival that makes radiation a less desirable choice for subsets of NSCLC patients, even in early stage cancers [1, 20, 21]. The decision to pursue surgery and in what format requires clinical judgment and cannot be determined by looking a one particular clinical parameter (ex. FEV1/DLCO, performance status, specific comorbidities alone). For example, a patient with less than perfect but acceptable pulmonary reserve, a history of cardiac disease who is medically optimized with a negative stress test, and in a motivated patient with reasonable performance status, surgical resection is likely to be well tolerated and preferable to other local therapy options (ex. SBRT or ablation). In this subset, MIS has obvious benefits compared to open resection. For example, in patients who underwent minimally-invasive thorascopic surgery, preoperative FEV1 < 60% was noted to be significantly associated with a lower risk for postoperative compilations compared to thoracotomy patients [12]. Although this concept may have seemed novel at the time, there is clearly an association between postoperative pain control, patient ambulation and participation with pulmonary toilet, and risk for postoperative complications following lung resection. Therefore, in patients who might be viewed as medically more marginal, MIS provides these patients with an opportunity for a curative resection and the benefits of lung cancer survival identified in the lung cancer study group with a lower complication profile [22].
Elderly patients are also at risk of receiving suboptimal treatment due to a perception of high-risk associated with surgery. When evaluating the surgical candidacy of this group, it is critical to determine both: 1) preoperative cardiac fitness and performance status as well as 2) competing causes of death. In the current era, it is reasonable to consider MIS as a curative procedure for early stage NSCLC in patients in their 80’s or even in their 90’s. Without a competing cause of death, it is reasonable to consider surgical resection for early-stage NSCLC in this age group. However, thoracotomy is a physiologically demanding procedure, and in elderly patients, MIS should be strongly considered when possible. Previous reports have demonstrated that post-operative outcomes remain superior in RATS and VATS compared to open thoracotomy for elderly patients. One propensity score-adjusted analysis examining 2,766 patients over the age of 65 with stage I to IIIa NSCLC in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database found lower overall surgical complication rates in RATS versus thoracotomy, as well as lower rates of blood transfusion, shorter ICU stay, and a significant decrease in overall length of stay [23]. In the same study, both VATS and RATS were found to have lower complication rates, adequate lymph node evaluation, and equivalent lung cancer specific survival [23].
Obese patients pose unique challenges for thoracic surgery. While studies show obese patients may have similar risk for complications and long-term outcomes compared to patients with normal body mass index (BMI), severely overweight patients (BMI greater than or equal to 40 kg/m2) face an increased risk of any major postoperative complication, including atelectasis requiring bronchoscopy, pneumonia, ARDS, extended ventilatory support, reintubation, and tracheostomy [24]. In addition to consideration for postoperative pain control, adequate pulmonary toilet, the ability to transfer patients from bed to chair, and the need for postoperative patients to ambulate aggressively, a question that arises is an obese patient’s tolerability of a longer surgical case. This may be even more important when for RATS lung resection, especially for surgeons early in their learning curve where operative times may be longer than VATS procedures When we look to literature and evaluate best available data to help develop a recommendation, the use of RATS in obese patients has not been shown to be associated with a significantly higher risk of postoperative complications, longer hospital length-of-stay (LOS), and is associated with similar 5-year survival compared to open lobectomy, suggesting that a robotic approach remains safe in this patient population [25]. While the outcomes of RATS lung resection in the obese population may be similar to VATS, the technical advantages of performing an anatomic lung resection in this population remain significant. To date, no large database or single institution data has defined an association between BMI and inferior outcomes in obese patients that require conversion due to vascular injury or technical challenges associated with lung resection.
Patients undergoing RATS experience a similar or lower rate of perioperative complications compared to those who undergo open thoracotomy or VATS. Post-operative complications after robotic lung resection were seen in 10–39% of patients in a review which included five case series and four comparative studies [26]. The most common postoperative complications included prolonged air leaks and atrial fibrillation [26, 27]. Pooled analysis of several studies did not show a prolonged air leak risk that was significantly higher following robotic surgery compared to thoracotomy [28].
Major complications including acute respiratory distress, reoperation for air leak, pulmonary embolism, or arrhythmia requiring pacemaker placement were rare, seen in approximately 2.4% of patients [27]. The rate of major complication in robotic surgery appears lower than thoracotomy, with fewer instances of respiratory failure, hemorrhage, or reoperation [29, 30]. Currently, perioperative mortality at high volume centers where most robotic surgeries are performed is lower in RATS compared to open resection [31]. Although this outcome metric is difficult to interpret as mortality is low for all lung resection regardless of surgical technique, it should be expected than as more centers adopt robotics for minimally invasive resection, the morbidity and mortality of RATS should remain at a comparable level to open and VATS resection.
Conversion from RATS to an open procedure is also low. Recent studies demonstrated a conversion rate of 6.5–9.2% [27, 29, 32]. The most common indications for conversion were technical limitations, inability to achieve an adequate oncologic resection, and bleeding [27]. The learning curve for RATS proficiency appears to be in the range of 20–25 cases, after which the risk for conversion can be expected to go down significantly. Unlike VATS conversions, where the surgeon is present at the bedside and can more easily perform a thoracotomy expeditiously, RATS conversions require a coordinated and well planned ‘fire drill’ to ensure patient safety. This includes a bedside assist that can hold pressure on a bleeding structure via a non-robot port, that the robot arms can be moved away to allow for better access to the chest, and that the staff in the room are prepared to open instruments that are needed to complete the case. Although these processes may be unfamiliar to the novice robotic surgeon, adequate preparation for case should include discussion of these scenarios with the operating and anesthesia staff. When compared to VATS, there were no differences in conversion rates in recent independent studies or meta-analyses. [28, 29]
Robotic surgery holds several key advantages with regards to post-operative outcomes when directly comparing VATS and RATS techniques. In one retrospective propensity score-matched study of 774 patients undergoing anatomical segmentectomy at a single academic institution, there were no significant differences in operative time, blood loss, risk for postoperative complication, or length of stay between RATS and VATS [33]. In another study examining 50 RATS and 80 VATS segmentectomies for patients with stage IA lung cancer at the Shanghai Chest Hospital, there was a shorter mean operative time and lower blood loss with RATS during anatomic resection and mediastinal lymphadenectomy [34]. For centrally located tumors which may be more difficult to access through VATS, robotic surgery was found to be associated with less bleeding, shorter operative times, and reduced volume of chest tube drainage and days with a chest tube, while having comparable oncologic outcomes including disease-free survival [35]. In a meta-analysis of ten studies by Emmert examining perioperative outcomes of minimally invasive thoracic surgery, tube drainage duration, length of hospitalization, and mortality were lower in patients undergoing RATS compared to VATS [36]. Therefore, it is reasonable to consider that the technical advantages associated with the robotic platform, including enhanced visualization and use of articulating instructions, are responsible for the low complication rates seen in RATS lung resection, and that with proficiency the outcomes of this technique can be equivalent to VATS.
One important area of scrutiny associated with the adoption of robotic surgery has been that VATS outcomes are already significantly better than open surgery, and that an expensive minimally invasive alternative with surgeon only advantages is a challenge to justify. As with any new technology, are the important outcomes the same or better? This is a fundamental necessity in cancer surgery. These concerns have been expressed since the introduction of the first robot in 2001, particularly with respect to adoption of both VATS and RATS approaches. When studied well, it is clear that both VATS and RATS are associated with excellent oncologic outcomes, equivalent to open surgery particularly with respect to lymph node evaluation and adequacy of resection, and that depending on the platform chosen, a proficient surgeon can be expected to have outcomes that meet or exceed their open surgery experience.
Several studies have examined and compared margin status, recurrence, disease-specific survival, and overall survival in open thoracotomy, VATS, and RATS. A study of the National Cancer Database found similar positive margin status (2%) after robotic surgery as compared to open resection, which is considerable given the lack of haptic feedback associated with RATS [37]. Other series also describe similar R0 resection rates of 97% [38]. Five-year disease recurrence has reported to be from 3% to 24.9% depending on cancer stage, which is also comparable to open surgery for appropriately matched patients [32, 39]. In this series and others, overall and disease-free survival at three and five years did not differ between RATS and either open surgery or VATS [32, 37, 38, 40, 41, 42, 43]. These results all suggest that robotic lung resection is a non-inferior alternative to prior surgical options.
The data on nodal evaluation during lung resection is heterogenous for robotic surgery. Some studies report no advantage in nodal stations examined or nodal harvest when compared to open surgery or VATS [28, 29, 44, 45]. One study found that fewer lymph nodes were examined with RATS compared to VATS [14]. Others report improved lymph node examination and retrieval [30, 33, 37, 46, 47]. In particular, one study found N1 (hilar) lymph nodes were better evaluated by robotic surgery as compared to VATS, both in terms of the number (4 vs. 3) and stations (3 vs. 2) examined [33].The experience of these authors and others are that the technical advantages of robotic surgery allow for an equivalent lymph node dissection to VATS, with some significant advantages including improved hemostasis and thoroughness of lymph node resection performed during mediastinal lymphadenectomy. The use of articulating bipolar instruments allows for complete lymph node packet resection, while improved visualization helps to define lymph node associations to adjacent structures. This is clearly an advantage over VATS, were ring clamps or non-articulating instruments can be used to grasp lymph nodes and non-articulating energy devices are used to free lymph nodes from surrounding structures. Whether these technical advantages translate into differences in short or long-term outcomes is unknown. However, no study to date has demonstrated that taking fewer lymph nodes or an incomplete lymph node evaluation is better than comprehensive lymphadenectomy. Additionally, as surgical outcomes become more heavily scrutinized, particularly with respect to the adequately of lymph node dissection, the use of this platform is likely to help facilitate a comprehensive hilar and mediastinal lymphadenectomy to meet these expectations.
The true advantage of robotic surgery appears to be the technical advantages conferred to the surgeon, specifically the enhanced visualization and improved dexterity of the instruments. While comparisons between robotic and open thoracotomy appear to have similar rates of complications, outcomes of VATS versus RATS are less uniform. Robotic surgery, in some series, is associated with less bleeding, shorter operative time, and shorter tube drainage duration [35]. These studies are largely retrospective and do not offer a definitive answer as to the causation for these improvements. However, one factor that likely contributes to these perceived results are the ergonomics of the robotic system. Robotic instruments moved with seven degrees of freedom, and as a result the surgeon in control at the console can mimic natural motions of the hand and wrist in the handling of tissue. This allows a surgeon to perform more complex functions in a safer fashion, reducing the risk of inadvertent injury while maintaining the oncologic standards. Important moves during anatomic lung resection, including thorough performance of lymphadenectomy and circumferential mobilization of critical vascular structures, can be performed with improved hemostasis, improved visualization, and reduced risk of injury.
Overall, the literature supports RATS as an alternative to open surgery and VATS. Fewer perioperative complications, improved quality of life, and similar oncologic outcomes have been established following RATS lung resection, bringing minimally invasive surgical options to a wider range of patients. While the advantages of RATS over VATS are certainly up for debate and are more informed by surgeon preference, the ability to improve minimally invasive lung resection availability to patients across the United States helps to drive interest in outcomes related to RATS procedures. The literature clearly demonstrates that surgeons facile with VATS lung resection provide patients with an oncologically sound operation and survival/recurrence expectations that rival results demonstrated in the LCSG. However, this skillset is challenging to learn and the highest standards for technical excellence are not as reproducible as open surgical techniques. In this space, RATS lung resection continues to evolve as adoption of minimally invasive lung resection grows.
While robotic surgery has key advantages compared to open and VATS techniques, it has not been uniformly adopted. As compared to VATS, this technology requires a significant capital investment, is associated with its own learning curve, and requires robotically trained support staff for a surgeon to have a successful robotic lung resection practice. All of these characteristics can be overcome but require stakeholders from surgery and the operating room to commit to the success of this platform.
The cost of robotic surgery is one of its main points of contention. There are two aspects of robotic surgery which contributes to this cost. The first is the initial investment in the robotic system. The second includes intra-operative costs, consisting of the use of consumables and longer operative times associated with RATS [28, 33, 45]. As the second is modifiable, it has garnered more attention in the literature. One study using patients from the SEER-Medicare database found the total cost of lung resection was similar between RATS and thoracotomy ($54,702 vs. $57,104, p = 0.08) [23]. Much of the variability in cost associated with robotic surgery likely stems from the difference in post-operative complications when compared to open resection. In particular, overall length of stay after RATS is significantly shorter than open surgery [29, 31, 38, 47, 48], and may be similar or better than VATS (4 days vs. 5 days) [40]. Therefore, although the cost of the operation may be higher in RATS, the direct associated cost may not be significantly different compared to open or VATS [49]. In time, as familiarity with the robotic platform increases and operating room efficacy is improved to rival VATS procedures, further cost savings can offset the increased initial investment and operative costs.
Another concern for surgeons unfamiliar with robotic surgery is training and familiarization with a new surgical platform. In fact, one of the early difficulties with the transition from VATS to open surgery was the steep learning curve. Laparoscopic instruments are relatively inflexible compared to the dexterity a surgeon is accustomed to during open surgery. Circumferential mobilization of important blood vessels requires dissection facilitated by subtle changes in how one engages the tissue, and these techniques are both important and challenging to learn for a novice VATS surgeon. Additionally, the VATS camera is limited to 3.5x magnification, images are shown in only 2 dimensions, and the camera needs to be held and constantly adjusted by the surgeon assistant. At 10× magnification, with 3D imaging, and a fixed camera that is not subject to fatigue or the concept of ‘guess what I am thinking and look where I want you to look’, getting used to robotic optics is fairly quick. The learning curve for a robotic lobectomy is approximately twenty cases [26, 50]. In this regard, mastery of robotic surgery appears to easier than VATS, owing to the more natural movements afforded by the robot.
Efficiency of RATS does rely more heavily on the familiarity of supporting operating room staff and the surgeon’s bedside assistant than VATS procedures. As the surgeon is seated at a console away from the sterile field, a bedside assistant must assist in exchanging instruments and repositioning robotic arms as needed. Thus, in addition to surgeon training, it is imperative that adequate training be provided to dedicated staff supporting the surgeon in order to maintain a safe working environment and maximum efficiency.
In our experience, a surgeon who gains robotic proficiency prefers the robot for a majority of their cases unless the platform is unavailable. Technically, VATS offers little advantage over RATS for the operating surgeon. Few instances exist where cost and time to set up outweighs the benefit. We utilize VATS for short cases such as decortications and pleurodesis, but favor RATS for most pulmonary resections. For technically challenging cases such as pneumonectomies, open surgery may be preferred, however, some case series describe successful RATS applications in pneumonectomy [51, 52].
In conclusion, robotic surgery represents the latest innovation for lung cancer surgery and an important opportunity for general and thoracic surgeons who still perform open lung resection. RATS procedures are associated with comparable or better outcomes than open surgery or VATS, and over the past two decades has been shown to be a safe platform with which lung cancer procedures can be performed. RATS procedures have significant technical advantages for the surgeon, namely the 3D vision, 10× magnification, and articulating instruments that mimics open surgery and allows for the performance of critical components of an operation safely. Although the advantages of RATS for patients are similar to VATS procedures, the adoption of RATS by open surgeons allows for a larger number of lung cancer patients in the United States to undergo minimally invasive procedures than ever before, which further realizes the patient specific advantages of minimally invasive techniques in this often medically complex population. A lower complication rate and better tolerability increases access to a definitive resection for NSCLC, optimizing 5-year survival. In time, as the volume of robotic surgery increases, the capital investment associated with adoption is likely to decrease. Additionally, with increased surgeon experience, operative times, risks for air leak, and overall hospital length of stay are also expected to decrease, allowing for improved utilization of hospital resources and efficiency.
Justin D. Blasberg, MD MPH is a proctor for Intuitive Surgical.
None.
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\n\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\n\n5. TERMINATION
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\n\n6. INTECHOPEN’S DUTIES AND RIGHTS
\n\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\n\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\n\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\n7. MISCELLANEOUS
\n\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\n\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\n\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
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\n\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\n\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\n\nLast updated: 2020-11-27
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