A comparative study on the frequency of simulation-based training and assessment of non-technical skills in the Norwegian ground ambulance services and helicopter emergency medical services

Henrik Langdalen,Stephen J. M. Sollid,Håkon B. Abrahamsen,Eirik B. Abrahamsen,Leif Inge K. Sørskår

doi:10.1186/s12913-018-3325-1

Abstract

BackgroundInadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety. Simulation-based training and assessment is promising with respect to improving NTSs. The frequency of simulation-based training in and assessment of NTSs among crewmembers in the Norwegian helicopter emergency medical service (HEMS) has gained increased attention over recent years, whereas there has been much less focus on the Norwegian ground emergency medical service (GEMS). The aim of the study was to compare and document the frequencies of simulation-based training in and assessment of seven NTSs between the Norwegian HEMS and GEMS, conditional on workplace and occupation.MethodA comparative study of the results from cross-sectional questionnaires responded to by employees in the Norwegian prehospital EMSs in 2016 regarding training in and assessment of NTSs during 2015, with a focus on the Norwegian GEMS and HEMS. Professional groups of interest are: pilots, HEMS crew members (HCMs), physicians, paramedics, emergency medical technicians (EMTs), EMT apprentices, nurses and nurses with an EMT licence.ResultsThe frequency of simulation-based training in and assessment of seven generic NTSs was statistically significantly greater for HEMS than for GEMS during 2015. Compared with pilots and HCMs, other health care providers in GEMS and HEMS undergo statistically significantly less frequent simulation-based training in and assessment of NTSs. Physicians working in the HEMS appear to be undergoing training and assessment more frequently than the rest of the health trust employees. The study indicates a tendency for lesser focus on the assessment of NTSs compared to simulation-based training.ConclusionHEMS has become superior to GEMS, in terms of frequency of training in and assessment of NTSs. The low frequency of training in and assessment of NTSs in GEMS suggests that there is a great potential to learn from HEMS and to strengthen the focus on NTSs. Increased frequency of assessment of NTSs in both HEMS and GEMS is called for.

Highlights

Inadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety
Physicians working in the helicopter emergency medical service (HEMS) appear to be undergoing training and assessment more frequently than the rest of the health trust employees
HEMS has become superior to ground emergency medical service (GEMS), in terms of frequency of training in and assessment of NTSs

Summary

Introduction

Inadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety. Team composition, education, medical care and treatment processes (e.g. a greater number of advanced medical interventions in HEMS [4, 5]), as well as the physical environments, differ substantially. In both prehospital EMSs, educated, knowledgeable and skilled personnel are required to appraise the situation and adopt the appropriate approach in a vast diversity of encountered circumstances [6, 7]. The complexity of the prehospital EMS makes the operating environment prone to human error [6, 9, 10]

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