Abstract
ABSTRACTThe introduction of non-technical skills during nursing education is crucial to prepare nurses for the clinical context and increase patient safety. We found no instrument developed for this purpose. Objectives:to construct, develop and validate a non-technical skills assessment scale in nursing. Method:methodological research. Based on the literature review and experience of researchers on non-technical skills in healthcare and the knowledge of the principles of crisis resource management, a list of 63 items with a five-point Likert scale was constructed. The scale was applied to 177 nursing undergraduate students. Descriptive statistics, correlations, internal consistency analysis and exploratory factor analysis were performed to evaluate the psychometric properties of the scale. Results:scale items presented similar values for mean and median. The maximum and the minimum values presented a good distribution amongst all response options. Most items presented a significant and positive relationship. Cronbach alpha presented a good value (0.94), and most correlations were significant and positive. Exploratory factor analysis using the Kaiser-Meyer-Olkin test showed a value of 0.849, and the Bartlett’s test showed adequate sphericity values (χ2=6483.998; p=0.000). One-factor model explained 26% of the total variance. Conclusion:non-technical skills training and its measurement could be included in undergraduate or postgraduate courses in healthcare professions, or even be used to ascertain needs and improvements in healthcare contexts.
Highlights
The term non-technical skills (NTS) was primarily used in the aviation industry in a simulation-based training program for safety, known as crew resource management, designed to educate pilots and their crews about human performance limitations, understanding of cognitive errors, behavior analysis, communication, conflict-resolution and decisionmaking
The effective training prototype from aviation was adapted to healthcare contexts and became the crisis resource management (CRM), providing a simulation-based model for teaching NTS to healthcare professionals based on 15 acting principles: to know the environment, anticipate and plan, call for help early, exercise leadership and followership, distribute the workload, mobilize all available resources, communicate effectively, use all available information, prevent and manage fixation errors, cross check, use cognitive aids, re-evaluate repeatedly, have a good teamwork, allocate attention wisely, and set priorities dynamically[1]
No theoretically based and easy-touse assessment instrument has been published or developed and validated for the assessment of NTS in the activities of nurses in general. Such an instrument is necessary to benchmark good NTS and to guide a formative feedback to the future practice of nursing students, and that is what we aim to discuss in this paper: to present the development and validation studies of a scale built based on theories and previous studies of NTS, adapted for nursing undergraduate students, as it can be used to assess NTS in order to enable a greater understanding of these skills and enhance the performance of nursing undergraduate students in their future practice and patient safety[22]
Summary
The term non-technical skills (NTS) was primarily used in the aviation industry in a simulation-based training program for safety, known as crew resource management, designed to educate pilots and their crews about human performance limitations, understanding of cognitive errors, behavior analysis, communication, conflict-resolution and decisionmaking. The effective training prototype from aviation was adapted to healthcare contexts and became the crisis resource management (CRM), providing a simulation-based model for teaching NTS to healthcare professionals based on 15 acting principles: to know the environment, anticipate and plan, call for help early, exercise leadership and followership, distribute the workload, mobilize all available resources, communicate effectively, use all available information, prevent and manage fixation errors, cross (double) check, use cognitive aids, re-evaluate repeatedly, have a good teamwork, allocate attention wisely, and set priorities dynamically[1]. Several instruments have been developed to be used in various domains (operating room, resuscitation teams, obstetrics teams, trauma teams, trauma resuscitation, healthcare teams in acute settings and emergency environment), in order to meet this need[4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21] in the context of specific multidisciplinary teams, working on a specific context, with specific procedures
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