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Integrating Non-Technical Skills into Anaesthetists’ Workplace-based Assessment. In this chapter, the authors will provide a brief account of the development of the Anaesthetists’ Non-Technical Skills (ANTS) system and then consider how this system may find a suitable home in the UK anaesthetic curriculum (Anaesthetists’. Non-Technical Skills System Handbook).. But first, what are non-technical skills (NTS)? Within the context of anaesthesia...
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Technical skills. Communication skills – Patient Communication skills – Staff Clinical judgement Organization/efficiency Professionalism Overall clinical care. Non-Technical Skills and Anaesthetists’ Workplace-based Assessment Tools 185. It is important to note that use of the approach outlined above does not suggest that the MiniCEX, DOPS or CBD should replace the ANTS system. However the training of consultant anaesthetists to become trainers...
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Frame of Reference training (FOR): Increase rating accuracy by focusing on the different levels of performance (Salas et al. Reportedly, it is seemingly straightforward to train a single group of raters and achieve a relatively high level of inter-rater agreement and accuracy when compared to a standard set rated by an expert (Salas et al. The rate of between-group rater...
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Specifically, on the individual level, relevant factors include technical competence, heterogeneous knowledge (Rosen et al. 2008), high work commitment (Nyssen et al. 2003) and a variety of attitudes towards the interpersonal aspect of one’s work and the effects of stress on performance (Flin et al. On the team level, anaesthetic teams are mostly crew-like (Arrow et al. 2000, Tschan et...
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Grabbing an instrument out of the hand of a team member without explanation.. Technical alarm Includes technical (acoustic) warning signals from one of the machines.. Only the fair Kappa value for implicit information coordination points out the need for further refining of the respective categories. The specific strengths of the taxonomy are (a) the precise assessment of explicit as well...
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Yule et al 2006) and systematic behavioural task analysis (Manser and Wehner 2002, Weinger et al. In the patient safety literature, it has been widely recognized that team performance is crucial to providing safe patient care and that many of the factors contributing to adverse events in healthcare originate from flawed teamwork rather than from a lack of clinical skills....
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In a current project (see also Chapter 13 by Kolbe et al. This research aims at improving instruments and procedures for team performance assessment by comparing and potentially integrating two observation systems for coordination behaviour. The results of this study will provide an important contribution to improving systems used to assess coordination as a central aspect of team performance. If...
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We also observed 45 handovers, of which 35 took place in the recovery room, 6 in the operating theatre and 2 in the theatre corridor leading to the recovery room.. There were transitions related to physical movement – from ward, to anaesthetic room, into theatre, into recovery and then back to the ward. There was also movement of the patient...
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There does not seem to be a great deal in the research literature on how relationships between members of the interprofessional team are negotiated. In the context of handovers, there is a substantial body of research on nurse-to-nurse handovers (Kerr 2002, Manias and Street 2000, Sherlock 1995), and some recent interest in handovers between doctors (Horn et al. 2004, Solet...
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The ASA score subjectively categorizes patients into five sub-groups by preoperative physical fitness and appear in Table 16.2 (Mazzocco et al. The ASA score was devised in 1941 by the ASA as a statistical tool for retrospective analysis of hospital records and has been revised periodically (Walker 2002). In nine patients, the ASA score was not recorded in either the...
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Finally, a recent study reported a significant correlation between subjective ratings of teamwork with postoperative morbidity (Davenport et al. some studies in other areas have found only marginal benefit for patients (Nielsen et al. We believe that there are two broad lines of research that should be pursued and that will ultimately converge in the form of effective team training...
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Our recent research in the OR has elaborated a theory of interprofessional team communication that describes tension catalysts, reveals interpretive patterns, and classifies recurrent failures (Lingard et al. The instrument is a checklist of types of communication failure and their outcomes based on our classification of ‘communication failure’ in the OR, framed by rhetorical theory (Lingard et al. The observational...
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The OR-coordinator arrives and then the PSA. The staff surgeon finally asks again: ‘Are we getting another tower?’ The circulating nurse pages a second PSA, returns and asks this PSA if there’s another in the office. The circulating nurse disappears without indicating that she’s going. PSA1 and the circulating nurse (who is now back in the room) set up new...
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The specialized field of activity for the anaesthesiologists is thus more realistic than for the other occupation groups.. Since the content of the communication is determined by specialist activity, in this study we investigated only the anaesthesiologists’ communication, not that of the surgeons or the nursing staff.. Complete standardization is not possible, because the behaviour of the anaesthesiologists influences the...
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Quality of Communication in Critical Situations. Quality of Communication as Evaluated by the Behavioural Markers. How well do the participants fulfil the expectations concerning good communication that we formulated as behavioural markers? The number of behavioural markers confirmed in the utterances of each participant showed a rather weak performance. In fact, only 58 percent of the expected behaviours were shown...
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(Figure 19.1). Other relevant data were recorded, including operative duration (first incision to final closing suture), tourniquet time and the composition of the surgical team. For the purposes of the study, risk was classified at levels. One operation was a TKR revision, but was classed at low risk as it involved only the removal of the existing prosthesis. Events were...
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Instances of reduced safety consciousness were also high, which was surprising considering the well- recognized and highly undesirable effect that nosocomial infection can have on the outcome of joint replacement surgery (Gao et al. Though equivocal evidence has been offered for the effectiveness of mask discipline for control of nosocomial infection (McLure et al. 1998, Mitchell and Hunt 1991), protocols...
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it to be labelled a PM situation, there would not be an additional reminder about the intention.. The execution action, putting the intention into practice, is considered a separate phase in the model. It can contain specific errors, e.g., related to the ability to perform the intended task or meta-cognitive abilities to monitor the success of the intention implementation.. Finally,...
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base on surgical training and technical performance, the technical skill of the surgeon (i.e., surgeons’ motor skill) has been recognized as a factor that mediates the relationship between patient risk factors and patient outcomes (e.g., Aggarwal et al. In the past five years, it has been proposed that this relationship should be qualified further. Because of its multi-factorial perspective on...
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ratings were not significantly different from trainee surgeons’ self-ratings (t(37. 0.05), thus indicating agreement in the assessment of skill.. In the second series of simulations, decision-making was rated significantly lower than all other skills (all ps <. Moreover, there was a significant pre-post training improvement in the ratings of decision-making for the surgical trainees (M Pre-training = 2.51 vs. From...