Non-technical skills in pre-hospital care in the Czech Republic: a prospective multicentric observational study (NTS study)

David Peran, Roman Sykora, Jana Vidunova, Ivana Krsova, Jaroslav Pekara, Metodej Renza, Nikola Brizgalova, Patrik Ch Cmorej, David Peran, Roman Sykora, Jana Vidunova, Ivana Krsova, Jaroslav Pekara, Metodej Renza, Nikola Brizgalova, Patrik Ch Cmorej

Abstract

Background: Non-technical skills (NTS) are important for the proper functioning of emergency medical ambulance crews but have hardly been researched in the conditions of clinical pre-hospital care. The primary objective of this study, therefore, is to describe the use of NTS in practice. The secondary objective is to compare if the performance of NTS varies according to the type of case.

Methods: In this multicentric observational study the modified Team Emergency Assessment Measure (TEAM) score was used to assess the performed NTS of two or more crews on site. The evaluation consisted of leadership, teamwork and task management, rated by a field supervisor. The study observations took place in real clinical pre-hospital emergency medical cases when two or more crews were dispatched between October 2019 and August 2020. The sample size was determined by researchers prior to the study to at least 100 evaluated events per each of the three participating emergency medical services. The results are presented as median and interquartile range. The internal reliability, consistency and validity of test items and results were evaluated. The Kruskal-Wallis test and the post hoc Mann-Whitney U test with Bonferroni correction were used for multiple comparisons of three groups.

Results: A total of 359 events were evaluated. Surprisingly, the median value for all eight items was as high as 3.0 with a similar interquartile range of 1.0. There were no differences observed by case type (CPR vs. TRAUMA vs. MEDICAL) except from item 1. A post hoc analysis revealed that this difference is in favour of a higher rated performance of non-technical skills in CPR.

Conclusions: The overall result of the performance of non-technical skills can be regarded as very good and can serve for further evaluations. The crews achieved better parameters of NTS in leadership in resuscitation situations in comparison with general medical events.

Trial registration: The study is registered at Clinical Trials under the ID: NCT04503369 .

Keywords: Communication; Decision-making; Emergency medical services; Non-technical skills; Pre-hospital care; Situational awareness; Task management; Team leading; Teamwork.

Conflict of interest statement

The authors declare no conflicts of interest.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Modified Team Emergency Assessment Measure questionnaire (TEAM). For each item of TEAM questionnaire the rating of presented performance of non-technical skill was noted and subsequently converted to a numeric value and recorded to the final dataset: never/hardly ever = 0; seldom = 1; about as often as not = 2; very often = 3; always/nearly always = 4
Fig. 2
Fig. 2
Study flow diagram

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