Andersen Kristian Janus, Østergaard Helle Thy
Amtssygehuset i Herlev, Dansk Institut for Medicinsk Simulation.
Ugeskr Laeger. 2006 Dec 11;168(50):4412-7.
In aviation, it has been realised that technical training ensures competence in specific procedures, but does not counter errors due to communication or decision making in a dynamic environment. As a consequence, Crew Resource Management, consisting of training in co-operation, management, and communication skills, was introduced in order to serve as a countermeasure towards human errors. In the same way, medical school ensures academic and technical insight, but rarely offers systematic training in such non-technical skills. The aim of this study is to identify the standard of competence in skills of co-operation, management, and communication at the end of the Pre-Registration House Officership.
30 skills of management, co-operation, and communication divided into five main areas were identified. Using the Delphi method through two rounds of questionnaires, an expert panel of 50 doctors evaluated six different standards of competence for each skill.
The Panel reached consensus at a 75% level for five skills, all within the main area "Team communication in the acute situation". Consensus was not reached within any of the other four main areas. None of the 30 skills was evaluated as being irrelevant for the Pre-Registration House Officer by more than one panel member.
There was broad agreement on the need for high standards of competence within the area of team communication. There was considerable disagreement within the panel with regard to the other main areas, but all of the skills listed in this study were found relevant to the Pre-Registration House Officer in the acute situation.
