Measuring Intangibles: Defining Predictors of Non-Technical Skills in Critical Care Air Transport Team Trainees.

Abstract

Critical Care Air Transport Teams (CCATTs) are integral to the U.S. Air Force aeromedical evacuation paradigm. The current study was conducted to evaluate predictors of nontechnical skills (NOTECHS) in CCATT trainees. Sixteen CCATTs were studied over a 6-month period. Team members completed a biographical survey and teams were videotaped during a simulated CCATT mission. Teams and individuals were assigned a "red flag score" using a validated assessment tool for NOTECHS. Salivary cortisol levels were measured at baseline and pre- and postsimulation exercises. 63% of participants reported regular intensive care unit (ICU) experience and 67% had flown real-world CCATT missions. Sixteen simulated missions were reviewed, with 69 crisis events identified. Task saturation was observed in 42% of crisis events. Average team red flag score correlated with task saturation during the simulated missions (odds ratio = 0.5). Daily ICU experience (p < 0.03) and previous deployment (p < 0.04) correlated with NOTECHS performance. Cortisol levels increased from baseline as the result of the simulation (p < 0.01) but did not correlate with red flag scores or biographical data. Task saturation occurred frequently and correlated with performance of NOTECHS. Previous real-world CCATT experience and daily ICU care correlated with improved performance of NOTECHS.