Jirativanont T, Raksamani K, Aroonpruksakul N, Apidechakul P, Suraseranivongse S
Assistant Professor, Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Associate Professor, Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Anaesth Intensive Care. 2017 Jul;45(4):469-475. doi: 10.1177/0310057X1704500410.
We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants, composed of 24 PGY-1, 24 PGY-2 and 22 PGY-3 residents. Both instruments differentiated the non-technical skills of PGY-1 from PGY-3 residents ( <0.05). Inter-rater agreement was measured using the intraclass correlation coefficient (ICC). For the ANTS instrument, the intraclass correlation coefficients for task management, team-working, situation awareness and decision-making were 0.79, 0.34, 0.81 and 0.70, respectively. For the Ottawa GRS, the intraclass correlation coefficients for overall performance, leadership, problem-solving, situation awareness, resource utilisation and communication skills were 0.86, 0.83, 0.84, 0.87, 0.80 and 0.86, respectively. The Cronbach's alpha for internal consistency of the ANTS instrument was 0.93, and was 0.96 for the Ottawa GRS. There was a high correlation between the ANTS and Ottawa GRS. The raters reported the ease of use of the Ottawa GRS compared to the ANTS. We found sufficient evidence of validity in the ANTS instrument and the Ottawa GRS for the evaluation of non-technical skills in a simulated anaesthesia setting, but the Ottawa GRS was more practical and had higher reliability.
我们试图评估两种非技术技能评估工具——麻醉医师非技术技能（ANTS）行为标记系统和渥太华全球评级量表（GRS）——应用于麻醉培训的有效性。描述了内容效度、反应过程、内部结构、与其他变量的关系及结果以作为效度证据。启动了模拟危机管理课程，期间两名经过培训的评估者对研究生一年级、二年级和三年级（PGY - 1、PGY - 2和PGY - 3）麻醉住院医师的表现进行评估。该研究包括70名参与者，由24名PGY - 1、24名PGY - 2和22名PGY - 3住院医师组成。两种工具均能区分PGY - 1和PGY - 3住院医师的非技术技能（<0.05）。使用组内相关系数（ICC）测量评估者间的一致性。对于ANTS工具，任务管理、团队协作、态势感知和决策的组内相关系数分别为0.79、0.34、0.81和0.70。对于渥太华GRS，整体表现、领导力、问题解决、态势感知、资源利用和沟通技能的组内相关系数分别为0.86、0.83、0.84、0.87、0.80和0.86。ANTS工具内部一致性的Cronbach's α系数为0.93，渥太华GRS为0.96。ANTS和渥太华GRS之间存在高度相关性。评估者报告称，与ANTS相比，渥太华GRS使用起来更简便。我们发现有充分证据表明，在模拟麻醉环境中，ANTS工具和渥太华GRS在评估非技术技能方面具有效度，但渥太华GRS更实用且可靠性更高。
