The development and measurement properties of the trauma NOn-TECHnical skills (T-NOTECHS) scale: A scoping review

Stevenson, Christina; Bhangu, Avneesh; Jung, James J.; MacDonald, Aidan; Nolan, Brodie

doi:10.1016/j.amjsurg.2022.05.027

Cited by 12 publications

(16 citation statements)

References 30 publications

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“…17 A commonly used tool for assessing nontechnical skills in trauma care teams is the Non-Technical Skills Scale for Trauma (T-NOTECHS), which is a five-item scale that has been validated in both real-life and simulation scenarios and is associated with improved performance of trauma teams. 18,19 The T-NOTECHS includes the Assessment and Decision Making domain, which evaluates the team's ability to perform orderly and complete primary and secondary surveys and effectively communicate their findings and plan. Research suggests that nontechnical skills play an important role in the performance of prehospital ALS teams, 20,21 as they may impact the time for diagnosis and treatment and ultimately benefit patient outcomes by reducing prehospital stabilization time and expediting prompt evacuation to definitive care.…”

Section: Discussionmentioning

confidence: 99%

“…The skills of primary survey and injury recognition are considered nontechnical, as they rely on cognitive, social, and personal resources 17 . A commonly used tool for assessing nontechnical skills in trauma care teams is the Non-Technical Skills Scale for Trauma (T-NOTECHS), which is a five-item scale that has been validated in both real-life and simulation scenarios and is associated with improved performance of trauma teams 18,19 . The T-NOTECHS includes the Assessment and Decision Making domain, which evaluates the team's ability to perform orderly and complete primary and secondary surveys and effectively communicate their findings and plan.…”

Section: Discussionmentioning

confidence: 99%

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Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Mitchnik

Talmy

Feldman

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND Trauma care teams play a crucial role in determining the outcomes of trauma victims. The composition and training of these teams can vary. Our study seeks to examine the characteristics of successful military Advanced Life Support (ALS) teams and the factors that affect them. METHODS A retrospective study was conducted at the Israel Defense Force (IDF) Military Medical Academy throughout 2021, where prehospital medical teams were observed in trauma care simulations. Teams were led by ALS providers (military physicians or paramedics) trained in IDF Military Trauma Life Support. Demographic and training data were collected. Teams were categorized into high or subpar performance groups based on simulation scores. Specific skills were assessed by trauma instructors using a points system. Scores were compared between the groups and analyzed for correlations with demographic and training data. RESULTS Overall, 63 team simulations were analyzed, with teams led by a military paramedic in 78% of simulations. The mean overall simulation performance was 81% ±6.2, and there were no differences in scores of single or multicasualty simulations. A total 3% of the teams achieved successful results and were more likely to have a paramedic as the ALS provider (p = 0.028). A sensitivity analysis excluding physicians was conducted and showed that high-performance teams had significantly higher skill assessments for primary survey (p = 0.004), injury recognition (p = 0.002), exposure (p = 0.006), adherence to clinical practice guidelines (p = 0.032), and medical device use (p = 0.002). CONCLUSION Our study found that ALS provider is associated with overall simulation performance in prehospital ALS teams, with military paramedics more likely to be successful. These findings have implications for the training and staffing of prehospital ALS teams, suggesting that teams should be composed accordingly and that training should focus on skills affected by the ALS provider type. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Mitchnik

Talmy

Feldman

et al. 2023

J Trauma Acute Care Surg

View full text Add to dashboard Cite

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“…The relevancy of quality improvement, case scenarios and communication course modules to the study subjects will be rated on a 3-point scale based on their subjective impression as (3=very relevant, 2=relevant, 1=not relevant), in conformity with previous researchers 30 . Post course feedback on team performance will be provided in accordance with the standard RTTDC expected trauma technical team member assigned skills and the validated (T-NOTECHS) 29 . Three trainers will consistently deliver each session of the training throughout the study period to minimise inter-operator variation.…”

Section: Methodsmentioning

confidence: 99%

“…Each domain will be evaluated on a Likert scale of 1-5 where 5 represents an ideal flawless team performance whereas 1 indicates performance that 10 did not demonstrate teamwork behaviour as described by Steinemann et al 28 . This tool has been validated and found to be reliable for evaluation and measurement of non-technical skills during training of trauma teams 29 . In return, participants will give their immediate feedback on the training through a structured post-course evaluation form and complete the post-training trauma based MCQs at 3-months follow-up.…”

Section: Scope Of the Study Trainingmentioning

confidence: 99%

Rural trauma team development amongst medical trainees and traffic law enforcement professionals in a low-income country: A protocol for a prospective multi-center interrupted time series of interventional training

Lule,

Mugerwa,

SSebuufu

et al. 2023

Preprint

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BackgroundRoad traffic injuries and their resulting mortality disproportionately affect rural communities in low-middle-income countries (LMICs) due to limited human and infrastructural resources for post-crash care. Evidence from high income countries show that trauma team development training could improve the efficiency, care, and outcome of injuries. A paucity of studies has evaluated the feasibility and applicability of this concept in resource constrained settings. The aim of this study protocol is to establish the feasibility of rural trauma team development and training in a cohort of medical trainees and traffic law enforcement professionals in Uganda.MethodsMuti-center interrupted time series of prospective interventional trainings, using the rural trauma team development course (RTTDC) model of the American College of Surgeons. A team of surgeon consultants will execute the training. A prospective cohort of participants will complete a before and after training validated trauma related multiple choice questionnaire (MCQ) during September 2019-November 2023. The difference in mean pre-post training percentage MCQ scores will be compared using ANOVA-test at 95% CI. Time series regression models will be used to test for autocorrelations in performance. Acceptability and relevance of the training will be assessed using 3- and 5-point Likert scales, respectively. All analyses will be performed using Stata 15.0. Ethical approval was obtained from Research and Ethics Committee of Mbarara University of Science and Technology (Ref: MUREC 1/7, 05/05-19) and Uganda National Council for Science and Technology (Ref: SS 5082) prior recruitment. Retrospective registration was accomplished with Research Registry (UIN: researchregistry9490).HighlightsInjury related mortality significantly impact LMICs.Rural trauma teams could improve the efficiency of injury care in LMICs.This study will assess the effect of rural trauma team development training, viewing medical trainees and traffic police as potential human resources for health.The results could inform the implementation of future trauma teams in rural settings.

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“…In simplest form, the impact of team variance on teamwork could be assessed during simulation sessions to compare teams with no or little variance to high variance. There are reliable and validated tools available to assess the teamwork, such as the T-NOTECHS tool [22][23][24]. Third, interventions to effectively reduce team variation could be developed, tested and implemented into practice.…”

Section: Further Researchmentioning

confidence: 99%

Variation of in-hospital trauma team staffing: new resuscitation, new team

et al. 2022

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Background Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.

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The development and measurement properties of the trauma NOn-TECHnical skills (T-NOTECHS) scale: A scoping review

Cited by 12 publications

References 30 publications

Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Rural trauma team development amongst medical trainees and traffic law enforcement professionals in a low-income country: A protocol for a prospective multi-center interrupted time series of interventional training

Variation of in-hospital trauma team staffing: new resuscitation, new team

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