ANTS-AP

Anaesthetic Non-Technical Skills
for Anaesthetic Practitioners

ANTS-AP is a new behavioural rating system designed to describe the non-technical skills used by staff who assist anaesthetists. It has been developed at the University of Aberdeen by Dr John Rutherford, consultant anaesthetist, psychologists Prof Rhona Flin and Dr Amy Irwin and with the generous assistance of many anaesthetic practitioners. In the UK, the anaesthetic practitioner may be qualified as an Operating Department Practitioner (ODP) or as an Anaesthetic Nurse (qualified nurses who have undergone further specialty training to assist the anaesthetist).

ANTS-AP handbook NOW AVAILABLE
Please email john.rutherford@nhs.net for a copy.

ANTS-AP provides a taxonomy of non-technical skills, that complement technical skills to achieve safe and efficient performance. The aim of this tool is to encourage personal insight through reflection and review, and to assist education of trainee ODPs and anaesthetic nurses by identifying an essential skill set and providing a means of evaluation and feedback.

ANTS-AP was developed following a task analysis that included a

  • literature search (Rutherford et al, 2012a, interviews with ODPs and Anaesthetic nurses (n=22) and Anaesthetists (n=23) (Rutherford et al, 2012b)
  • four focus groups (n=6,7,3,4) and a
  • subject matter expert Delphi questionnaire (n=6)
  • as well as a review of critical incidents reported to AIMS (Australian Incident Monitoring System) between 2002 and 2008 (n=1,433) was also performed wich identified 69 reports where there was a use or failure of non-technical skills on the part of the anaesthetic assistant.

The ANTS-AP behavioural rating system identifies three main categories of
non-technical skill:

  • Situation awareness
  • Teamwork and communication
  • Task management

The ANTS-AP booklet (see above) describes these categories, their component elements, associated behavioural markers and a rating form.

Publications: (contact john.rutherford@nhs.net )

Rutherford, J.S., Flin, R., Irwin, A., McFadyen, A. (2015) Evaluation of the prototype Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) system: a behavioural rating system to assess the non-technical skills used by staff assisting the anaesthetist. Anaesthesia, 70, 907-914.

Rutherford, J.S., Flin, R., Mitchell, L. (2015). "They seem to be able to read your mind." An interview study to identify the cognitive non-technical skills of anaesthetic assistants. Journal of Perioperative Practice, 25, 115-119.

Rutherford, J.S., Flin, R., Irwin, A. (2015) The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008. Anaesthesia and Intensive Care, 43, 512-517.

Rutherford, J., Flin, R., Hellaby, M. & Caldwell, D. (2015). Testing the reliability, validity and usability of the prototype Anaesthetic Non-Technical Skills - Anaesthetic Practitioners (ANTS-AP) behaviour rating system. Anaesthesia, 70 (Suppl 2), 32.

Rutherford J.S., Flin R. & Mitchell L. (2012). Non-technical skills of anaesthetic assistants in the perioperative period: a literature review. British Journal of Anaesthesia, 109, 27-31.

Rutherford J.S., Flin R. & Mitchell L. (2012). Teamwork, communication and anaesthetic assistance in Scotland. British Journal of Anaesthesia, 109, 21-26.

Poster presentations

Rutherford J., Flin R., Hellaby M. & Caldwell D. Testing the reliability, validity and usability of the prototype Anaesthetic Non-Technical Skills - Anaesthetic Practitioners (ANTS-AP) behaviour rating system. This poster was presented at the winter scientific meeting of the Association of Anaesthetists of Great Britain and Ireland in London on 14th-16th January 2015. Poster

Rutherford J.S., Flin R. & Irwin A. Anaesthetic Non-Technical Skills for Anaesthetic Practitioners: the ANTS-AP system. This was presented at the 7th International meeting on Behavioural Science as Applied to Surgery and Acute Care Settings, at the Karolinska Institute in Stockholm on 18th – 19th October 2013. Poster

Email: r.flin@abdn.ac.uk