Non-technical Skills Training Research Articles

Rethinking accounting education for a sustainable future: charting a course for sustainable development goals 2030

Purpose This paper aims to seek accounting graduates' perspectives on the demand for accounting in their workplaces, on the gaps in accounting education (AE), and on the future of the accounting profession, inspired by the new definition of accounting proposed by Carnegie et al. (2021, 2022, 2023a), to adopt a strong focus on sustainable development goals (SDGs) in AE to inculcate tertiary students with the skills that lead them to approach and apply accounting as a multidimensional technical, social and moral (TSM) practice. Design/methodology/approach The online qualitative survey was distributed to 100 randomly selected New Zealand accounting graduates in order to gather insights from their workplaces. All responses from the 30 graduates who completed the questionnaire underwent qualitative analysis using Leximancer software, which automatically identifies high-level concepts and insights and offers interactive visualizations without bias. Findings The graduates’ experiences underscore the ongoing significance of technical skills in the New Zealand workplace. They emphasized the lack of non-technical skills training, stressed the necessity of diverse business knowledge and highlighted the importance of automation and digital skills. Practical implications The implications for transforming AE involve adopting an activist approach to integrate a TSM perspective into teaching and learning and being open to an interdisciplinary approach to expose tertiary students to the impact of accounting on sustainable development, including collaboration with professional bodies for real-world experiences. Originality/value The importance of engaging with SDG-related narratives is stressed to stimulate further discussion, debate and research aimed at identifying practical solutions for AE as a facilitator for SDGs in realizing accounting as a TSM practice.

Development and applications of the Anaesthetists’ Non-Technical Skills behavioural marker system: a systematic review

ObjectivesTo comprehensively synthesise evidence regarding the validity and reliability of the Anaesthetists’ Non-Technical Skills (ANTS) behavioural marker system and its application as a tool for the training and assessment of...

Teaching nontechnical skills in the undergraduate education of health care professionals: a nationwide cross-sectional study in Hungary

BackgroundThe aim of our cross-sectional study was to evaluate the current situation and curriculum of nontechnical skills (NTS) training in the undergraduate education of health care professionals in Hungary.MethodsAll institutes with relevant NTS training in Hungarian faculties of medicine and faculties of health sciences were asked to fill out a 19-item questionnaire. Descriptive statistics were performed, and the characteristics of NTS teaching and non-NTS teaching institutes were compared. The independent predictors of teaching NTS in a particular institute were identified with multiple logistic regression.ResultsSeventy-seven institutes responded (52% response rate), of which 66% trained NTS. The most frequent method of NTS training is talking about them during a practice or lecture, and less than half of NTS respondents use simulation. The most frequent cause of not teaching NTS is a lack of human or technical resources. The type of faculty (p = 0.025), academic year (p = 0.001), field of medicine (p = 0.025), and importance of teamwork (p = 0.021) differed between NTS and noNTS institutes. Teaching students in academic year two represented the only independent predictor of NTS education (p = 0.012).ConclusionsOur findings show that the undergraduate curriculum of Hungarian universities includes some type of NTS education; however, this education requires further development.

A report from Lybia of a young Italian emergency physician. What I learned and what I was forgetting

Dear Editor, Every emergency medicine resident enjoys facing new clinical cases, learning new invasive procedures, and acting like a detective when it comes to mysterious illnesses. Simulations are essential to train non-technical skills during university education, even though someone could believe that they are a waste of time.1,2 Although all these technical skills are essential to our training, our work goes beyond that. Sometimes we believe that we are superheroes, as we were called during the COVID-19 pandemic. The truth is that we learn every day from the patients and their stories because we treat sick people and not their diseases.3,4 The ability to communicate correctly with patients, relatives, and caregivers is mandatory for all emergency physicians, both resident and senior, and needs to be taught and learned.5,6 If we add the cultural background and the chance to work outside Western countries, then we can learn to work for the patient and not on the patient. [...]

Non-technical skills and teamwork in trauma: from the emergency department to the operating room.

Management of a trauma patient is a challenging process. Swift and accurate clinical assessment is required and time-sensitive decisions and life-saving procedures must be performed in an unstable patient. This requires a coordinated response by both the emergency room (ER) and operating room (OR) teams. However, a team of experts does not necessarily make an expert team. Root cause analysis of adverse events in surgery has shown that failures in coordination, planning, task management and particularly communication are the main causes for medical errors. While most research is focused on the ER trauma team, the trauma OR team also deserves attention. In fact, OR team dynamics may resemble more the ER team than the elective OR team. ER and OR trauma teams assemble on short notice, and their members, who are from different specialties and backgrounds, may not train regularly together or even know each other beforehand. And yet, they have to perform high-risk procedures and make high stake decisions, in a time-sensitive manner. The airline industry has long recognized the role of team training and non-technical skills (NTS) in reducing hazards. The implementation of the so called crew resource management or crisis resource management (CRM) has significantly made airline travel safer and the transposition to the medical context, with specific training in non-technical skills, has also brought great benefits. In fact, it is clear that adoption of non-technical skills (NTS) in healthcare has led to an increase in patient safety. In this narrative review we recapitulate some of the key non-technical skills and their relevance in trauma, with a focus on both the emergency department (ER) and the operating room (OR) teams, as well as on the transition of care from one to the other. Also, we explore the use of debriefing the team, as well as the roles of NTS training in both undergraduate and postgraduate settings. We review some of the existing trauma training courses and their roles in developing NTS. Finally, we briefly address the challenges posed by the development of trauma hybrid operating rooms.

THE IMPACT OF WORKING IN A STATISTICAL COLLABORATION LABORATORY ON THE STATISTICS STUDENT COLLABORATORS

Graduate level statistics education curricula often emphasize technical instruction in theory and methodology but can fail to provide adequate practical training in applications and collaboration skills. We argue that a statistical collaboration center (“stat lab”) structured in the style of the University of Colorado Boulder’s Laboratory for Interdisciplinary Statistical Analysis (LISA) is an effective mechanism for providing graduate students with necessary training in technical, non-technical, and job-related skills. We summarize the operating structure of LISA, and then provide evidence of its positive impact on students via analyses of a survey completed by 123 collaborators who worked in LISA between 2008–15 while it was housed at Virginia Tech. Students described their work in LISA as having had a positive impact on acquiring technical (94%) and non-technical (95%) statistics skills. Five-sixths (83%) of the students reported that these skills will or have helped them advance in their careers. We call for the integration of stat labs into statistics and data science programs as part of a comprehensive and modern statistics education, and for further research on students’ experience in these labs and the impact on student outcomes.

A Systematic Review of Immersive Virtual Reality for Nontechnical Skills Training in Surgery

Immersive virtual reality (IVR) can be utilized to provide low cost and easily accessible simulation on all aspects of surgical education. In addition to technical skills training in surgery, IVR simulation has been utilized for nontechnical skills training in domains such as clinical decision-making and pre-operative planning. This systematic review examines the current literature on the effectiveness of IVR for nontechnical skill acquisition in surgical education. A literature search was performed using MEDLINE, EMBASE, and Web of Science for primary studies published between January 1, 1995 and February 9, 2022. Four reviewers screened titles, abstracts, full texts, extracted data, and analyzed included studies to answer 5 key questions: How is IVR being utilized in nontechnical skills surgical education? What is the methodological quality of studies? What technologies are being utilized? What metrics are reported? What are the findings of these studies? The literature search yielded 2340 citations, with 12 articles included for qualitative synthesis. Of included articles, 33% focused on clinical decision-making and 67% on anatomy/pre-operative planning. Motion sickness was a recorded metric in 25% of studies, with an aggregate incidence of 13% (11/87). An application score was reported in 33% and time to completion in 16.7%. A commercially developed application was utilized in 25%, while 75% employed a noncommercial application. The Oculus Rift was used in 41.7% of studies, HTC Vive in 25%, Samsung Gear in 16.7% of studies, Google Daydream in 8%, and 1 study did not report. The mean Medical Education Research Quality Instrument (MERSQI) score was 10.3 ± 2.3 (out of 18). In all studies researching clinical decision-making, participants preferred IVR to conventional teaching methods and in a nonrandomized control study it was found to be more effective. Averaged across all studies, mean scores were 4.33 for enjoyment, 4.16 for utility, 4.11 for usability, and 3.73 for immersion on a 5-point Likert scale. The IVR nontechnical skills applications for surgical education are designed for clinical decision-making or anatomy/pre-operative planning. These applications are primarily noncommercially produced and rely upon a diverse array of HMDs for content delivery, suggesting that development is primarily coming from within academia and still without clarity on optimal utilization of the technology. Excitingly, users find these applications to be immersive, enjoyable, usable, and of utility in learning. Although a few studies suggest that IVR is additive or superior to conventional teaching or imaging methods, the data is mixed and derived from studies with weak design. Motion sickness with IVR remains a complication of IVR use needing further study to determine the cause and means of mitigation.

How the training level has influenced clinical year medical students’ approach towards learning and practising non‑technical skills

This study aimed to investigate the influence of non-technical skills (NTS) training on the clinical year students’ approach towards learning and practising these skills. The first objective of this study was to explore the understanding of NTS in clinical-year medical students. The second objective was to study the teachers’ perspectives on how possible insufficient NTS training has influenced students’ approach and attitudes towards learning and practising NTS. A qualitative study using the constructivist approach was conducted by interviewing 35 clinical-year medical students and 20 teachers. Data was analysed using thematic analysis and the Cochran’s-Q test. Only a few students (7 out of 35) showed NTS understanding, and a majority of the teachers (75%) also believed that most students do not have NTS knowledge. Homogeneity was found in responses indicating that NTS were not sufficiently taught as more focus was on teaching technical skills. Teachers perceived the undervaluing of NTS by students as a major impact of limited training. 88% of students showed a willingness to receive NTS training, of which 22% suggested training without assessment. Integration of NTS into the curriculum can be suggested as a possible solution to reduce the impact of training level.

Effects of non-technical skill-based surgical education for trainees on herniorrhaphy outcomes.

Non-technical skills are essential for surgical patient safety and are implemented in clinical practice. However, training for non-technical skills has not been thoroughly investigated. This study aimed to evaluate the learning curve for non-technical skill-based education in herniorrhaphy. Quality improvement initiatives, including non-technical skill-based intervention, were performed in the department of surgery. The intervention included declaring the patient safety policy, briefing and debriefing, and criterion for the switching of places of the trainee and instructor as defined by the department. Patients who underwent herniorrhaphy from April 2014 to September 2017 were included. A total of 14 trainees and nine instructors in the pre-intervention period and 14 trainees and seven instructors in the intervention period were included in this study. The median experience of each trainee was 28 and 15 cases in the pre-intervention and intervention groups, respectively. A total of 749 patients were included: 473 in the pre-intervention period and 328 in the intervention period. Demographics and hernia types were mostly similar between groups, and morbidity was not statistically different between the two groups (3.4 vs. 1.2%, p = 0.054). The nonlinear regression model showed an early decline and deep plateau phase of the learning curve in the intervention group. A significant difference was observed in the plateau operation time (61 min in the pre-intervention group and 52 min in the intervention group). This study demonstrated the effectiveness of non-technical skill-based intervention for surgical training. An early decline and deep plateau of the learning curve can be achieved with well-implemented quality improvement initiatives. Nonetheless, further studies are needed to establish a training program for non-technical skill-based learning.

A Pilot Study Evaluating a Virtual Reality-Based Nontechnical Skills Training Application for Urology Trainees: Usability, Acceptability, and Impact

This study aimed to develop and evaluate a virtual reality (VR)-based nontechnical skills (NTS) training application for urology trainees and assess its effectiveness in improving their skills and confidence. A mixed-methods study was conducted to develop and evaluate a VR-based NTS training application for 32 urology trainees. The development process involved collaboration with 5 urology experts, 2 medical education specialists, and a human factors researcher. The study evaluated the application's usability, acceptability, and efficacy through 3 phases: scenario development with expert feedback integration, storyboarding and creation processes with facilitators and urology trainees, and a final evaluation by trainees. The data were collected during a 4-day urology boot camp in October 2022. Thirty-two urology trainees participated in the study and completed 2 VR scenarios designed to enhance their NTS skills RESULTS: The System Usability Scale (SUS) showed a moderate usability score of 66. The Training Evaluation Inventory (TEI) and additional feedback demonstrated positive effects on trainees' learning and confidence in their NTS abilities. Most participants found the application easy to use, and effective and they expressed interest in using similar VR applications for other aspects of surgical training. VR-based NTS training applications show potential for enhancing urology trainees' nontechnical skills. The integration of expert feedback and immersive technology offers a promising, accessible, and cost-effective solution to the challenges of delivering NTS training. Future research should explore the long-term impact of VR-based NTS training on trainees' performance and patient outcomes and consider incorporating advanced AI technologies for personalized and dynamic learning experiences.

Efficacy of an Integrated Simulation-Based Education Approach to Train Non-Technical Skills in Medical Undergraduate Students

Introduction: Non-technical skills (NTS) are essential to maintain best patient care and to enhance patient safety. Therefore, the early integration and implementation of non-technical skills (NTS) training during undergraduate medical education has not only been repeatedly emphasized but is crucial to ensure patient safety. However, there is a gap in knowledge on how to effectively convey and thereby enhance NTS in under- or postgraduate medical training. Although medical educators are eager to convey NTS, the best approach to do so is yet to be found. Next to didactic and teaching approaches, the design of the curriculum, in the sense of an integrated curricula, might have an influence in conveying NTS effectively. Therefore, we investigated if repetitive simulation-based training enhanced the NTS of medical undergraduates. Methods: 945 undergraduate students in their 1st, 2nd, 3rd and 4th year of medical studies who attended mandatory emergency simulation trainings at the medical faculty in Hamburg participated in this prospective observational study. The trainings are designed to align to a learning spiral (vertically integrated curriculum) and build upon each other, resulting in repetitive and advanced training. Each training has a preset training-specific standardized simulation scenarios. To determine progress in NTS performance, the NTS of the students were assessed during each training with the Anaesthesiology Students’ NTS (AS-NTS) taxonomy, which is composed of three dimensions. Differences in performance between the investigated cohorts of students were calculated with an analysis of variance (Welch’s ANOVA) and with a follow-up post hoc test (Games-Howell), and the significant differences were analysed. Results: The NTS of the undergraduate students improved with every ascending training and, hence, year of medical school. The overall NTS performance of the 4thyear undergraduate students differed significantly compared to the 1st, 2nd and 3rd year undergraduate students performances, F = 6.72 (4, 439.6), p ≤ 0.001. The greatest improvement was detected on dimension one of the AS-NTS (“Planning tasks, prioritising and problem-solving”) (F = 6.75 (4, 434.5), p ≤ 0.001), where 4th year undergraduates performed at a significantly higher skill level than the 1st, 2nd and 3rd year undergraduate students. On dimension two (“Teamwork and Leadership”) and three (“Team orientation”), significant differences were pronounced between the 4th year and 1st year undergraduate students (F = 3.56 (4, 442.9), p = 0.010; F = 4.50 (4, 441.0), p = 0.001). The lowest skill improvement was observed on dimension two. Conclusions: NTS are essential skills to complement technical skills and hereby ensure patient safety. The early longitudinal and vertical integration of NTS training in undergraduate medical curricula (learning spiral) is an effective approach to enhance and foster the NTS of future doctors.

Learning teamworking and non-technical skills: a pilot study of a postgraduate course at the University of Florence

AbstractBackground: Non-technical skills (NTS) are the cognitive and social skills that integrate the technical skills of a worker. In healthcare systems, NTS exert positive effects on patients’ safety and healthcare professionals’ efficiency.Aim: This study aims to assess the degree of NTS knowledge, before and after a workshop administered to a group of 17 nursing students attending a critical care nursing postgraduate course at the University of Florence.Methods: A cross-over design study was conducted. The workshop was composed of short lectures on “fundamentals of teamworking” and “team building and communication”, followed by team activities and gaming. At the end of the day a medical “escape room” about a shock scenario, was developed and run by the students. A questionnaire investigating participants’ entertainment and self-evaluation of NTS use, was administered at the end of the simulation sessions.Results: A sample of 17 nurses was enrolled. Pre-posttests were completed by 16 participants. Seventy-five % (n=12) of the respondents found the team working activities exciting. Most of the participants (62.5%, n=10) considered the “escape shock room game” enjoyable and stimulating and would recommend the learning activities to other healthcare professionals (75%, n=12). Compared to pre-test scores, statistically, significant improvements in NTS understanding were found on the topics of “team building” (p<0.001; r= -0.60), “teamworking” (p= 0.001; r= -0.56), “membership” (p= 0.001; r= -0.56), “hard skills” (p= 0.001; r= -0.57), “soft skills” (p=0.001; r= -0.56) and “situational awareness” (p< 0.001; r= -0.61) items.Conclusions: The process of NTS training is well accepted by critical care nursing students and can improve their competencies. Therefore, simulation based NTS training programs and gaming activities should be periodically implemented as part of Critical Care Nursing Postgraduate Courses.

No size fits all - a qualitative study of factors that enable adaptive capacity in diverse hospital teams.

Resilient healthcare research studies how healthcare systems and stakeholders adapt and cope with challenges and changes to enable high quality care. By examining how performance emerges in everyday work in different healthcare settings, the research seeks to receive knowledge of the enablers for adaptive capacity. Hospitals are defined as complex organizations with a large number of actors collaborating on increasingly complexity tasks. Consequently, most of today's work in hospitals is team based. The study aims to explore and describe what kind of team factors enable adaptive capacity in hospital teams. The article reports from a multiple embedded case study in two Norwegian hospitals. A case was defined as one hospital containing four different types of teams in a hospital setting. Data collection used triangulation of observation (115 h) and interviews (30), followed by a combined deductive and inductive analysis of the material. The study identified four main themes of team related factors for enabling adaptive capacity; (1) technology and tools, (2) roles, procedures, and organization of work, (3) competence, experience, knowledge, and learning, (4) team culture and relations. Investigating adaptive capacity in four different types of teams allowed for consideration of a range of team types within healthcare and how the team factors vary within and across these teams. All of the four identified team factors are of importance in enabling adaptive capacity, the various attributes of the respective team types prompt differences in the significance of the different factors and indicates that different types of teams could need diverse types of training, structural and relational emphasis in team composition, leadership, and non-technical skills in order to optimize everyday functionality and adaptive capacity.

Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training

IntroductionThe influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. MethodsParticipants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. ResultsForty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], p = <0.001; [137.3 (108.9) sec] versus [51.3 (37.9)], p = <0.001; and [218.5 (105.8) sec] versus [110.8 (87.1) sec], p = <0.001; respectively. These improvements were maintained following the Vital Anaesthesia Simulation Training Course, and at 3-month retention testing. Qualitative analysis highlighted five key themes: ability to initiate cardiopulmonary resuscitation; team coordination for task allocation; empowerment; desire for training and mentorship; and advocacy for system improvement. ConclusionA modified 2-day Advanced Cardiac Life Support course improved resuscitation time indicators with retention 3-months later. Combining the Vital Anaesthesia Simulation Training Course and Advanced Cardiac Life Support led to better team coordination, empowerment to act, and advocacy for system improvement. This pairing of courses has promise for improving Advanced Cardiac Life Support skills amongst healthcare workers in low-resource settings.ClinicalTrials.gov Identifier: NCT05278884.

Beyond The Maritime Education Classrooms: Analysis Of Life Skills Gained From Maritime Trainings

Intensive maritime education and training cultivate the competence of students in their future career. As the industry evolves, it also requires professionals who can apply their skills in real-life scenarios. This investigation explored the life skills gained from maritime trainings by analyzing the experiences of maritime students (n=15). The participants in the one-on-one interview were purposively sampled based on several demographic characteristics i.e., a college student, have maritime units (&gt;50), have been in curriculum-specified trainings. Findings of the study indicated that maritime students gained life-essential skills, including career-based, health-related, and emergency skills, through undergoing rigorous training programs. These acquired skills empower students to effectively address practical challenges and contribute positively to their career progression, personal growth, and well-being. As maritime students undergo specialized training and gain proficiency in technical and non-technical skills, their self-confidence and self-efficacy in addressing challenges and excel in their careers could be enhanced. The students' recognition of the practical use of their acquired skills in real-world scenarios highlights their self-efficacy, influencing their motivation, critical thinking, and problem-solving capabilities. It is the responsibility of maritime education industry to raise awareness and provide comprehensive education to aspiring seafarers.

Nontechnical Skills for Surgeons as a Framework to Evaluate Cardiopulmonary Bypass Management Skills of Resident Trainees

Nontechnical skills are critical in cardiac surgery but currently there is no formal paradigm to teach these in residency training. We investigated the use of the Nontechnical skills for surgeons (NOTSS) system as a framework to assess and teach nontechnical skills related to cardiopulmonary bypass (CPB) management. Single-center retrospective analysis of Integrated and Independent pathway thoracic surgery residents who participated in dedicated nontechnical skills evaluation and training. Two CPB management simulation scenarios were utilized. All residents received a lecture on CPB fundamentals and then individually participated in the first simulation (“Pre-NOTSS”). Immediately following this, nontechnical skills were rated by self-assessment and by a NOTSS trainer. All residents then underwent group NOTSS training followed by the second individual simulation (“Post-NOTSS”). Nontechnical skills were rated as before. NOTSS categories assessed included Situation Awareness, Decision Making, Communication and Teamwork, and Leadership. Nine residents were divided into 2 groups: Junior (n = 4, PGY1-4) and Senior (n = 5, PGY5-8). Pre-NOTSS resident self-ratings were higher for Senior than Junior in the categories of Decision Making, Communication and Teamwork, and Leadership while trainer ratings were similar between the groups. Post-NOTSS, resident self-ratings were higher for Senior than Junior in Situation Awareness and Decision Making while trainer scores were higher for both groups in Communication and Teamwork and Leadership. The NOTSS framework in conjunction with simulation scenarios provides a practical framework to evaluate and teach nontechnical skills related to CPB management. NOTSS training can lead to improvements in both subjective and objective ratings of nontechnical skills for all PGY levels.

Crisis Scenarios for Simulation-Based Nontechnical Skills Training for Cardiac Surgery Teams: A National Survey Among Cardiac Anesthesiologists, Cardiac Surgeons, Clinical Perfusionists, and Cardiac Operating Room Nurses.

Nontechnical skills in cardiac surgery are vital in ensuring patient safety in the operating room (OR). To train these skills in a simulation-based scenario, a collection of commonly accepted crisis scenarios is needed to serve as a framework for a simulation-based training program. The objective of this study was to identify and reach consensus on a collection of relevant crisis scenarios in cardiac surgery suitable for simulation-based team training focusing on nontechnical skills. Using the Delphi method, a national assessment was performed among cardiac surgeons, cardiac anesthesiologists, clinical perfusionists, and cardiac OR nurses in the Netherlands. In the first Delphi round, potential crisis scenarios for simulation-based team training in cardiac surgery were identified. In the second round, the identified scenarios were rated using a 5-point Likert scale. Finally, based on consensus (two-thirds majority), scenarios were prioritized and explored for feasibility. One hundred fourteen experts participated in the study (26 cardiac anesthesiologists, 24 cardiac surgeons, 25 clinical perfusionists, and 39 OR nurses), representing all 16 cardiac surgical centers in the Netherlands. In the first round, 237 scenarios were identified. After eliminating duplicates and grouping similar scenarios, 44 scenarios were scored in round 2, which finally resulted in 13 relevant crisis scenarios with an expert consensus higher than 67%. Thirteen crisis scenarios relevant to simulation-based team training were identified by an expert panel consisting of all members of the cardiac surgical team. Further research is needed to evaluate the educational value of the respective scenarios.

The need for non-technical skills education in orthopedic surgery

BackgroundThe issue of surgical safety has increased significantly over the last few decades. Several studies have established that it is linked to non-technical performance, rather than clinical competencies. Non-technical skills can be blended with technical training in the surgical profession to improve surgeons’ abilities and enhance patient care and procedural skills. The main goal of this study was to determine orthopedic surgeons’ requirements of non-technical skills, and to identify the most pressing issues.MethodsWe conducted a self-administered online questionnaire survey in this cross-sectional study. The questionnaire was piloted, validated, pretested, and clearly stated the study’s purpose. After the pilot, minor wording and questions were clarified before starting the data collection. Orthopedic surgeons from the Middle East and Northern Africa were invited. The questionnaire was based on a five-point Likert scale, the data were analyzed categorically, and variables were summarized as descriptive statistics.ResultsOf the 1713 orthopedic surgeons invited, 60% completed the survey (1033 out of 1713). The majority demonstrated a high likelihood of participating in such activities in the future (80.5%). More than half (53%) of them preferred non-technical skills courses to be part of major orthopedic conferences, rather than independent courses. Most (65%) chose them to be face-to-face. Although 97.2% agreed on the importance of these courses, only 27% had attended similar courses in the last three years. Patient safety, infection prevention and control, and communication skills were ranked at the top as topics to be addressed. Moreover, participants indicated they would most likely attend courses on infection prevention and control, patient safety and teamwork, and team management.ConclusionThe results highlight the need for non-technical skills training in the region and the general preferences regarding modality and setting. These findings support the high demand from orthopedic surgeons’ perspective to develop an educational program on non-technical skills.

In situ simulation-based team training and its significance for transfer of learning to clinical practice—A qualitative focus group interview study of anaesthesia personnel

BackgroundAnaesthesia personnel are an integral part of an interprofessional operating room-team; hence, team-based training in non-technical skills (NTS) are important in preventing adverse events. Quite a few studies have been done on interprofessional in situ simulation-based team training (SBTT). However, research on anaesthesia personnel’s experiences and the significance for transfer of learning to clinical practice is limited. The aim of this study is to explore anaesthesia personnel’s experience from interprofessional in situ SBTT in NTS and its significance for transfer of learning to clinical practice.MethodsFollow-up focus group interviews with anaesthesia personnel, who had taken part in interprofessional in situ SBTT were conducted. A qualitative inductive content analysis was performed.ResultsAnaesthesia personnel experienced that interprofessional in situ SBTT motivated transfer of learning and provided the opportunity to be aware of own practice regarding NTS and teamwork. One main category, ‘interprofessional in situ SBTT as a contributor to enhance anaesthesia practice’ and three generic categories, ‘interprofessional in situ SBTT motivates learning and improves NTS’, ‘realism in SBTT is important for learning outcome’, and ‘SBTT increases the awareness of teamwork’ illustrated their experiences.ConclusionsParticipants in the interprofessional in situ SBTT gained experiences in coping with emotions and demanding situations, which could be significant for transfer of learning essential for clinical practice. Herein communication and decision-making were highlighted as important learning objectives. Furthermore, participants emphasized the importance of realism and fidelity and debriefing in the learning design.

[Cardiopulmonary resuscitation in special circumstances].

The standard process of basic and advanced life support can be complicated by a number of special circumstances. Over the last decade, the European Resuscitation Council developed an increasingly detailed guideline regarding the diagnosis and therapy of these situations. In our short review, we summarize the most important recommendations for the management of cardiopulmonary resuscitation in special circumstances. The proper training in non-technical skills and teamwork is crucial in the management of these situations. In addition, extracorporeal circulatory and respiratory support play an increasingly important role in some special circumstances with appropriate patient selection and timing. We also summarize the therapeutic options regarding the reversible causes of cardiac arrest as well as the steps of diagnostic and treatment methods in some special situations (cardiopulmonary resuscitation in the operating room, after cardiac surgery, in a catheterisation laboratory, after sudden cardiac arrest at dentistry or dialysis station) and among special patient populations (patient with asthma or COPD, neurologic disorders, obese patient, pregnant woman). Orv Hetil. 2023; 164(13): 488-498.