Abstract
BackgroundSimulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room).MethodsThe MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected.ResultsThe mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories.ConclusionThe MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.
Highlights
Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations
The results suggest that the MINTS-DR behavioural markers are a coherent support for the debriefing among peers, since they help them to observe and discuss non-technical skills (NTS) by grounding their feedback in objective behaviours
It is important to capitalize on this method by means of a proper debriefing session, where the experience could be integrated with the reflection on theories, models, guidelines, and expected behaviours
Summary
Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. Patient safety during clinical emergencies strongly depends on the effective coordination of multi-professional teams. Such a complex situation cannot be safely managed solely with the implementation of procedures, the adoption of technical skills, and the reliance on high-tech equipment. The Joint Commission on Accreditation of Healthcare Organizations reports that human factors, communication, situation assessment, and leadership were considered to be the main root causes of the maternal sentinel events that were analysed between 2004 and 2014. Communication breakdown among practitioners or between them and the families has been shown to be associated with perinatal adverse events, patient dissatisfaction, and litigations [8]. Literature in perinatology reveals that the communication problems mainly concern the unavailability of prenatal information, the difficulty practitioners have in discussing their cases and in sharing doubts with their colleagues, and the inadequate counselling of patients and families [9,10,11]
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