Department of Anaesthesiology, Kantonsspital Liestal, University of Basel, Rheinstrasse 26, Liestal, Switzerland.
Br J Anaesth. 2012 Nov;109(5):723-8. doi: 10.1093/bja/aes256. Epub 2012 Jul 31.
Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario.
This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score.
TS and NTS were significantly correlated to each other (r=0.45, P<0.05).
During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.
技术技能(TS)和非技术技能(NTS)对于确保急性护理实践中的患者安全和有效的危机管理至关重要。这些技能通常是分开教授和评估的。我们假设 TS 和 NTS 不是相互独立的,我们旨在评估在模拟术中危机情景下 TS 和 NTS 之间的关系。
本研究是对先前发表的一项工作的回顾性分析。在获得机构伦理批准后,50 名麻醉学住院医师管理了一个模拟的术中心脏骤停的危机情景,原因是恶性心律失常。我们使用改良 Delphi 方法设计了一个专门用于管理需要除颤的恶性心律失常的 TS 检查表。所有场景均被记录。每个表现均由四位独立专家进行分析。对于每个表现,两位专家使用 TS 检查表独立评估技术表现,另外两位专家使用麻醉师非技术技能评分独立评估 NTS。
TS 和 NTS 彼此显著相关(r=0.45,P<0.05)。
在需要危机资源管理的 5 分钟模拟复苏中,我们的结果表明 TS 和 NTS 相互关联。这项研究为未来评估这种关系的性质、NTS 培训对 TS 表现的影响以及确定 NTS 是否在需要不同 TS 的危机之间通用和可转移的研究提供了基础。