Effect of non-technical skills teaching on performance – An evaluation of additional non-technical skills teaching in Resuscitation Council ALS course

Abstract

Sudden cardiac arrest remains the most common cause of cardiovascular death in the world. The delivery of timely and high quality cardiopulmonary resuscitation (CPR) is the key to patient survival. Observational studies have consistently demonstrated that quality of CPR delivered in training and in the clinical setting is substandard. Tremendous effort has been put into training healthcare providers in performing high quality CPR. Advanced life support (ALS) is now a core competency in both undergraduate and postgraduate medical training. ALS encompasses simple technical skills such as chest compression and ventilation and more complex technical skills such as the safe delivery of an appropriate defibrillating shock. Non-technical skills describe situational awareness, decision making, task management, leadership and team working. The importance of non-technical skills in emergency situations is now widely accepted across many acute medical specialties including resuscitation. A survey of advanced life support trained doctors revealed many did not feel ready to lead a cardiac arrest and did not feel equipped with adequate leadership skills. Simulation studies have found that competent ALS providers often lacked leadership attributes such as task allocation, effective communication. Previous research has demonstrated that leadership behaviour is correlated with quality of CPR, with shorter hands off time, pre-shock pauses and time to first shock. Understanding and improving non-technical skills may help to reduce errors, create more effective teams and improve patient outcome. In 2014, the ALS course will be updated with additional non-technical skills teaching in both online and face to face teaching. The planned launch of the updated ALS course in 2014 presents a unique opportunity to evaluate the impact of additional non-technical skills training on non-technical and technical skill performance compared to standard ALS course.