BackgroundBoth technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario.MethodsThis study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score.ResultsTS and NTS were significantly correlated to each other (r=0.45, P<0.05).ConclusionsDuring a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

T he random nature of adverse patient events and the vagaries of clinical exposure make assessment of pediatric anesthesia trainees complicated. Nonetheless, such assessment is critical to improving patient safety. In earlier studies, a multiple-scenario assessment offered reliable and valid measurements of the abilities of anesthesia residents. A set of relevant simulated pediatric perioperative scenarios was developed, and its effectiveness in assessing anesthesia residents and pediatric anesthesia fellows was ascertained. Ten simulation scenarios were created to reflect situations found in perioperative anesthesia care. Thirty-five anesthesiology residents and fellows agreed to participate and were debriefed after each scenario. Each scenario was scored by 2 anesthesiologists using a key action checklist. The psychometric properties, such as reliability and validity, were studied. Those with more experience in administering pediatric anesthetics usually outperformed those with less experience. Variations in scores that were attributable to raters were low, which resulted in greater interrater reliability. This method of assessment can potentially contribute to pediatric anesthesia performance, but more measures of validityVincluding correlations with more direct measures of clinical performanceVare needed to confirm the usefulness of this approach.

SummaryWhile previous studies have investigated the country of origin of anaesthetic publications, they have generally used a MEDLINE computer search to identify original articles and have often excluded non-English language articles. We undertook a hand-search of journals in the Journal Citation Reports Ò using the subject category of Anesthesiology. We quantified the number of original articles, editorials, review articles, case reports and correspondence attributed to each country. We also calculated the proportion of articles of each type from countries of each national income category. We analysed 9684 articles published in 2007 and

After a single simulation training session, improvements in cricothyroidotomy skills are retained for at least 1 yr. These findings suggest that high-fidelity simulation training, along with practice and feedback, can be used to maintain complex procedural skills for at least 1 yr.