Non-Technical Skills

Current Projects

Paramedics' non-technical skills

Allan Shields

Email: wshields@nhs.net

There is growing awareness of the need to identify the non-technical (CRM) skills of paramedics, who work in an equally demanding, safety critical domain.  This MSc project is using task analysis to identify the non-technical skills which paramedics require in order to do their job safely and effectively.  In addition to the technical and clinical knowledge and skills which paramedics possess, it is expected that non-technical skills such as situation awareness, decision making, communication, leadership and team work must also be used to complete tasks effectively.  Interviews with subject matter experts are being conducted to identify which non-technical skills paramedics use in their role.

Publications

Shields, A. & Flin, R. (2012). Paramedics' non-technical skills: a literature review. Emergency Medical Journal, doi:10.1136/emermed-2012-201422.

http://emj.bmj.com/content/early/2012/07/11/emermed-2012-201422

Shields, A. (2011). Paramedic non-technical skills: aviation style behavioural rating systems. Journal of Paramedic Practice, 3, 676-680.

http://www.paramedicpractice.com/cgi-bin/go.pl/library/article.cgi?uid=88155;article=pp_3_12_676_680

Non-technical skills in anaesthetic assistants

Dr John Rutherford

Email: john.rutherford@nhs.net

In the UK, anaesthesia is administered under the supervision of a trained anaesthetist, with dedicated assistance from anaesthetic assistants.  Anaesthetic assistants are important members of the surgical team and have the potential to minimise or contribute towards critical incidents.  The aim of this PhD project is to analyse the use of non-technical skills by anaesthetic assistants in the peri-operative period.  Currently there is no framework of non-technical skills specific to anaesthetic assistants, this research intends to contribute to the development of such a taxonomy.

Publications

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

http://bja.oxfordjournals.org/content/109/1/27

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

http://bja.oxfordjournals.org/content/109/1/21

Pharmacists' non-technical skills

Dr Amy Irwin

Email: a.irwin@abdn.ac.uk

Non-technical skills refer to the human factors that may influence job performance, but which are distinct from the technical or practical skills required to complete a task.  Non-technical skills are generally divided into two sub-groups: 1) cognitive skills (decision-making, situational awareness) and 2) social skills (teamwork, communication).  Despite the potential importance of these skills in pharmacists, particularly in light of links between non-technical skills and patient safety, there is little research directly examining the potential influence of non-technical skills upon the effective functioning of a pharmacy.  The aim of the current project is to determine if non-technical skills are commonly used within pharmacy practice, and to identify the essential skills for safe and effective functioning within the pharmacy team.

This project is funded by the Scottish Funding Council (2009 – 2012).

Publications

In preparation

Completed Projects

Scrub practitioners' non-technical skills (SPLINTS)

Project leads: Prof Rhona Flin and Dr Lucy Mitchell

Non-technical skills are not explicitly taught or assessed for healthcare professionals. This is why non-technical skills taxonomies and behavioural rating systems for anaesthetists (ANTS), surgeons (NOTSS) and now scrub practitioners (SPLINTS) have been developed by our research team.  In the current project task analyses were used to identify the critical non-technical skills for the scrub practitioner.  A literature review, observations and an interview study with experienced scrub practitioners and consultant surgeons indicated that situation awareness, communication and teamwork, as well as skills relating to task management were critical.  A skills taxonomy and behavioural rating method were developed and produced as a SPLINTS handbook. This tools details the skill categories and underlying elements, each with examples of poor and good practice to guide the user of the system, and provides a rating form. 

Jointly funded by NHS Education Scotland (2007-2009) and the Scottish Funding Council (2009–2011).

Tools

SPLINTS handbook: www.abdn.ac.uk/iprc/splints

Publications

Mitchell, L., Flin, R., Yule, S., Mitchell, J., Coutts, K. & Youngson, G. (2012). Evaluation of the Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) system.  International Journal of Nursing Studies, 49, 201-211. 

http://www.ncbi.nlm.nih.gov/pubmed/21974792

Mitchell, L., Flin, R., Yule, S., Mitchell, J., Coutts, K. & Youngson, G. (2011). Thinking ahead of the surgeon. An interview study to identify scrub nurses' non-technical skills. International Journal of Nursing Studies, 48, 818-828.

http://www.ncbi.nlm.nih.gov/pubmed/21190685

Mitchell, L & Flin, R. (2008). Non-technical skills of the operating theatre scrub nurse: literature review. Journal of Advanced Nursing, 63, 15-24.

http://www.ncbi.nlm.nih.gov/pubmed/18598248

Surgeons' non-technical skills (NOTSS)

Project lead: Prof Rhona Flin 

Email: r.flin@abdn.ac.uk

This project identified the non-technical skills (eg, decision making, teamworking, communication) necessary for effective surgical practice. A behavioural marker system to support training and development has been developed and trialled in Scotland.

Jointly funded by the Royal College of Surgeons (Edinburgh) and NHS Education Scotland, (2003 - 2006).

Tools

NOTSS handbook: http://www.abdn.ac.uk/iprc/notss/

Selected Publications

Yule, S., Rowley, D., Flin, R., Maran, N., Youngson, G., Duncan, J., Paterson-Brown, S. (2009). Experience matters: Comparing novice and expert ratings of non-technical skills using the NOTSS system. ANZ Journal of Surgery 79, 154-160.

http://www.ncbi.nlm.nih.gov/pubmed/19317781

Yule, S., Flin, R., Maran, N., Rowley, D. R., Youngson, G.G. & Paterson-Brown, S. (2008). Surgeons' non-technical skills in the operating room: Reliability testing of the NOTSS behaviour rating system. World Journal of Surgery, 32, 548-556.

http://www.ncbi.nlm.nih.gov/pubmed/18259809

Yule, S., Flin, R., Rowley, D., Mitchell, A., Youngson, G., Maran, N. and Paterson-Brown, S. (2008). Debriefing surgeons on non-technical skills (NOTSS). Cognition, Technology & Work, 10, 265-274.

http://dl.acm.org/citation.cfm?id=1417028

Flin, R., Youngson, G., & Yule, S. (2007). How do surgeons make intraoperative decisions? Quality and Safety in Healthcare 16, 235-239.

http://www.ncbi.nlm.nih.gov/pubmed/17545353

Flin, R., Yule, S., Paterson-Brown, S., Maran, N., Rowley, D., & Youngson, G. (2007). Teaching surgeons about non-technical skills. The Surgeon, 5, 86-89.

http://www.ncbi.nlm.nih.gov/pubmed/17450689

Anaesthetists' non-technical skills (ANTS)

Project leads: Prof Rhona Flin, (School of Psychology), Drs Ronnie Glavin, Nikki Maran (Scottish Clinical Simulator Centre), and Dr Rona Patey (Aberdeen Royal Infirmary)

Email: r.flin@abdn.ac.uk

This project identified the non-technical skills (eg, decision making, teamworking, communication) necessary for effective anaesthetic practice and then developed these into a behavioural marker system that can be used to support training and assessment. The output of the first stage of the project was the Anaesthetists' Non-Technical Skills (ANTS) System, which contains fifteen skill elements grouped into four main skill categories with behavioural markers describing good and poor practice for each element. The ANTS System was then evaluated in a number of trials organised by the Royal College of Anaesthetists to ensure it can be used reliably to assess anaesthetists' non-technical skills in both simulator and operating theatre environments.

Funded by NHS Education Scotland, and then later the Scottish Clinical Simulation Centre (SCSC) (from September 1999).

Tools

ANTS handbook: http://www.abdn.ac.uk/iprc/ants/

Publications

Fletcher, G., Flin, R., McGeorge, P., Glavin, R., Maran, N. & Patey, R. (2004). Rating non-technical skills: Developing a behavioural marker system for use in anaesthesia. Cognition, Technology & Work, 6, 165-171. To replace this placeholder, please upload the original image (C:\Users\psy495\AppData\Local\Temp\msohtmlclip1\01\clip_image001.gif) on server and insert it in the document.Download pdf article (184 kb)

Fletcher, G., Flin, R., McGeorge, P., Glavin, R., Maran, N., & Patey, R. (2003). Anaesthetists' Non-Technical Skills (ANTS): Evaluation of a behavioural marker system. British Journal of Anaesthesia, 90, 580-588. To replace this placeholder, please upload the original image (C:\Users\psy495\AppData\Local\Temp\msohtmlclip1\01\clip_image001.gif) on server and insert it in the document.Download pdf article (229 kb)

Flin, R., Fletcher, G., McGeorge, P., Sutherland, A. & Patey, R. (2003). Anaesthetists attitudes to teamwork and safety. Anaesthesia, 58, 233-242. To replace this placeholder, please upload the original image (C:\Users\psy495\AppData\Local\Temp\msohtmlclip1\01\clip_image001.gif) on server and insert it in the document.Download pdf article (118 kb)

Fletcher, G., McGeorge, P., Flin, R., Glavin, R.  & Maran, N. J. (2002). The role of non-technical skills in anaesthesia: A review of current literature. British Journal of Anaesthesia, 88, 418-429. To replace this placeholder, please upload the original image (C:\Users\psy495\AppData\Local\Temp\msohtmlclip1\01\clip_image001.gif) on server and insert it in the document.Download pdf article (125 kb)

Email: r.flin@abdn.ac.uk