How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills (original) (raw)

2013, British Journal of Anaesthesia

† Excellent performance requires a mix of technical and non-technical skills (NTS). † Specialist training programmes pay inadequate attention to NTS. † In Sweden, highly trained anaesthetic nurses work closely with physician anaesthetists. † The investigators have identified groups of NTS associated with excellent performance by anaesthetists, based on structured interviews to elicit the views of experienced anaesthetic nurses. Background. Teaching trainees to become competent professionals who can keep the complex system of anaesthesia safe is important. From a safety point of view, nontechnical skills such as smooth cooperation and good communication deserve as much attention as theoretical knowledge and practical skills, which by tradition have dominated training programmes in anaesthesiology. This study aimed to describe the way excellent anaesthetists act in the operating theatre, as seen by experienced anaesthesia nurses. Methods. The study had a descriptive and qualitative design. Five focus group interviews with three or four experienced Swedish anaesthesia nurses in each group were conducted. Interviews were analysed by using a qualitative method, looking for common themes. Results. Six themes were found: (A) structured, responsible, and focused way of approaching work tasks; (B) clear and informative, briefing the team about the action plan before induction; (C) humble to the complexity of anaesthesia, admitting own fallibility; (D) patient-centred, having a personal contact with the patient before induction; (D) fluent in practical work without losing overview; and (F) calm and clear in critical situations, being able to change to a strong leading style. Conclusions. Experienced anaesthesia nurses gave nuanced descriptions of how excellent anaesthetists behave and perform. These aspects of the anaesthetist's work often attract too little attention in specialist training, notwithstanding their importance for safety and fluency at work. Creating role models based on studies like the present one could be one way of increasing safety in anaesthesia.

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Trainee anaesthetists understand their work in different ways: implications for specialist education

British Journal of Anaesthesia, 2004

Background. Traditionally, programmes for specialist education in anaesthesia and intensive care have been based on lists of attributes such as skills and knowledge. However, modern research in the science of teaching has shown that competence development is linked to changes in the way professionals understand their work. The aim of this study was to de®ne the different ways in which trainee anaesthetists understand their work.

Assessing Nurse Anaesthetists' Non-Technical Skills in the operating room

Acta Anaesthesiologica Scandinavica, 2014

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Identifying Training Requirements in Perioperative Care for Anaesthetists

Journal of Biomedical Education, 2013

Education and training in anaesthesia have traditionally focused on the preparation and delivery of intraoperative anaesthesia but are evolving to incorporate aspects of perioperative medical care. The expansion of continued professional development and postgraduate courses in this field has gathered pace, with the aim of teaching anaesthetists and allied professionals to improve patients' surgical care. We surveyed a population of UK-based anaesthetists to establish their views on professional development within perioperative medicine, their role as perioperative medical experts of the future, and the training and educational needs of this cohort. The majority of anaesthetists acknowledged their evolving role in perioperative patient care and recognised a need to train for the task. Only 50% of the senior anaesthetists surveyed believed they had sufficient knowledge and skills to undertake perioperative care with the majority believing the current training curriculum must advance to support professional development. In line with other international healthcare systems, UK-based anaesthetic practice is adopting a responsibility for perioperative medical practice, and this survey has demonstrated willingness amongst anaesthetists of all grades to embrace change, recognise training needs, and improve the outcome for surgical patients.

How novice and expert anaesthetists understand expertise in anaesthesia: a qualitative study

BMC Medical Education

Background The development of expertise in anaesthesia requires personal contact between a mentor and a learner. Because mentors often are experienced clinicians, they may find it difficult to understand the challenges novices face during their first months of clinical practice. As a result, novices’ perspectives may be an important source of pedagogical information for the expert. The aim of this study was to explore novice and expert anaesthetists understanding of expertise in anaesthesia using qualitative methods. Methods Semi-structured interviews were conducted with 9 novice and 9 expert anaesthetists from a German University Hospital. Novices were included if they had between 3 and 6 months of clinical experience and experts were determined by peer assessment. Interviews were intended to answer the following research questions: What do novices think expertise entails and what do they think they will need to become an expert? What do experts think made them the expert person an...

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Swiss Medical Weekly, 2013

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BJA: British Journal of Anaesthesia, 2000

One of the responsibilities of a consultant is to identify the clinical competence of trainees by observing them at work. The attributes of clinical competence in anaesthesia were defined by interviewing a group of consultants and trainees. Observation of practice was believed to be important in monitoring competence and the supervising consultants all believed that they could recognize competent performance. The account of the structure of observation provided by the anaesthetists is used as the basis of advice on how to conduct an assessment of trainees' developing professionalism by use of the specialist's professional judgement.

Factors influence anaesthesia technician work in intensive care unit (ICU): Qualitative study

Open Journal of Biomedical Research

Purpose: Anaesthesia technicians are part of the ICU medical team, their profession is critical to the healthcare environment for achievement and delivery of adequate care and they do the respiratory therapists jobs/roles as well. The aim of the current study was to find out factors affecting anaesthesia technicians working in ICU. Materials and Methods: This was a qualitative single center study utilizing focus-group interviews (FGI’s), and in-depth individual interviews. Twenty anaesthesia technicians working in the ICU were enrolled until data saturation was reached. Data were analyzed using Colaizz’s method. Results: Through data analysis, three themes including system-related factors, environmental-related factors, and individual-related factors were found. Conclusion: The present study provided clear understanding of factors affecting anaesthesia technician’s working in ICU and these were found to be longstanding. The factors included system, environmental and individual relat...

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