Doctors’ experiences and awareness of non-technical skills, a way to the development of a behavioral marker system for patient management

Abstract

ABSTRACT:
Background: The complement technical skills, contributes to efficient task performance and improve ‘safe practice’ by health professionals. Success with non-technical skills training in other industries is achieved has led to widespread permutation to healthcare education, with non-technical skills. We explore the junior doctor’s awareness and application of nontechnical skills needed to work in hospitals. The cognitive, social and personal resource skill that complements technical skill, and contributes to safe and efficient task performance is called nontechnical skill. There is growing awareness that non-technical skills are essential for competent practice and non-technical skills are the integral part of many training programs.
OBJECTIVE: To rank the importance and determine the awareness of non-technical skills by the junior doctors essential to work efficiently and safely at hospitals.
DESIGN &SETTING: A cross-sectional study was conducted among the post graduate trainee doctors and house officers at department of medicine services hospital Lahore. Two hundred doctors participated in the study.
Data collection technique: Two questionnaires were distributed simultaneously to each participant. First one was structured to inquire about the ranking of ten nontechnical skills in the terms of importance from one to ten. The other questionnaire indirectly assessed these skills by scenario based questions taken from text book of medicines.

RESULTS: In the study ‘Analysis of situation’ was ranked as the most important non-technical skill and dealing with the patients in clinical isolation as least important. Significant difference was observed among non-technical skills mean rank score (p < 0.001). Analysis of situation was most important followed by fatigue management and task prioritization. Stage of medical training was associated with differences in ranking patterns for analysis of situation (p<0.001), decision making (p=0.046), communication skills (p<0.001), team working (p<0.001), leadership (p<0.001), fatigue management (p<0.001), task prioritization (p<0.001), and planning of work at call (p=0.001). 52% doctors were aware of proper use of non-technical skills (p-0.476).
CONCLUSION: It is observed that there is a discrepancy between the awareness and experience of junior doctor about non-technical skills. This suggests a training gap. There is a need for to update the medical education at undergraduate and postgraduate levels to adequately train the doctors in all the non-technical skills for further improvement in health care. These skills can be improved at institutional levels by simulation based training or by direct observation at workplace. These skills need to be integrated in medical curricula as a countermeasure for human error. Poor nontechnical skills are a significant cause of adverse medical events in patients presenting with accidents and other emergencies.