Distracting events involving the anaesthetist are common, but approximately two-thirds of these events have no externally visible effect. Another anaesthetist was the most common recipient of a distracting event initiated by the anaesthetist. Anaesthetists need to address themselves as causes of distractions and the potential impact on patient safety.
B oth technical skills (TSs) and nontechnical skills (NTSs) are basic to ensuring patient safety in acute care practice and effective crisis management. Such skills are taught and assessed separately. It was hypothesized that TSs and NTSs were not independent of each other; the relationship between TSs and NTSs was evaluated during a simulated intraoperative crisis scenario. The study was a retrospective analysis of performances from a previously published work. With institutional ethics approval, 50 anesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. A modified Delphi approach was used to design a TS checklist specific to the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Four independent experts evaluated each performance, with 2 experts independently rating the technical performance using the TSs checklist and 2 other experts independently rating NTSs using the Anaesthetists' Non-Technical Skills score. Technical skills and NTSs markedly correlated. During a simulated 5-minute resuscitation requiring crisis resource management, results indicate that TSs and NTSs are related. Such research forms the basis for future studies evaluating the nature of this relationship, the influence of NTSs training on the performance of TSs, and a determination of whether NTSs are generic and transferable between crises that require different TSs.
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