Finstad Anne Strand, Bjørshol Conrad Arnfinn, Aase Ingunn, Røislien Jo, Ballangrud Randi
Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Anesthesiol Res Pract. 2024 Jul 5;2024:2021671. doi: 10.1155/2024/2021671. eCollection 2024.
In situ simulation-based team training of non-technical skills is considered an important initiative for preventing adverse events caused by poor teamwork among healthcare personnel. This study aimed to assess the non-technical skills of anaesthesia personnel before and after in situ simulation-based team training in a clinical setting.
The study was conducted from October 2020 to June 2021 using a quasiexperimental before and after design based on video-recorded observations and ratings of anaesthesia teams' non-technical skills during anaesthesia induction in the operating room before and shortly after in situ simulation-based team training. Anaesthesia personnel were divided into 20 teams and video recorded during anaesthesia induction. The Anaesthetists' Non-technical Skills (ANTS) system was used to score the teams' non-technical skills. A paired-sample -test was used to assess the impact of the intervention on the anaesthesia teams' scores on the various ANTS categories. Interrater agreement between the two ANTS raters was assessed using weighted kappa.
At the category level, the overall scores had a statistically significant increase in performance after simulation-based team training (3.48 vs. 3.71; < 0.001). Furthermore, scores of five of the 15 elements were significantly different. Interrater agreement revealed moderate agreement between the two raters (weighted kappa = 0.51, value <0.001).
The anaesthesia teams' increased non-technical skills after simulation-based team training may indicate the transfer of knowledge from training to clinical practice. The moderate agreement between the raters could be attributed to the subjective nature of the evaluation procedure. The ANTS was originally used as an individual assessment tool; however, this study has demonstrated its potential as a team assessment tool.
基于现场模拟的非技术技能团队培训被认为是预防医护人员团队协作不佳导致不良事件的一项重要举措。本研究旨在评估临床环境中基于现场模拟的团队培训前后麻醉人员的非技术技能。
本研究于2020年10月至2021年6月进行，采用基于视频记录观察和评分的准实验前后设计，观察手术室麻醉诱导期间基于现场模拟的团队培训前后麻醉团队的非技术技能。将麻醉人员分为20个团队，并在麻醉诱导期间进行视频记录。使用麻醉医生非技术技能（ANTS）系统对团队的非技术技能进行评分。采用配对样本t检验评估干预对麻醉团队在各个ANTS类别上得分的影响。使用加权kappa评估两位ANTS评分者之间的评分者间一致性。
在类别层面，基于模拟的团队培训后，整体表现得分有统计学意义的提高（3.48对3.71；P<0.001）。此外，15个要素中的5个要素得分有显著差异。评分者间一致性显示两位评分者之间有中度一致性（加权kappa = 0.51，P值<0.001）。
基于模拟的团队培训后麻醉团队非技术技能的提高可能表明知识从培训转移到了临床实践。评分者之间的中度一致性可能归因于评估程序的主观性。ANTS最初用作个体评估工具；然而，本研究证明了其作为团队评估工具的潜力。
