Development of a behavioural rating system for scrub nurses' non-technical skills

In the first study, a literature review and semi-structured interviews with experienced scrub nurses (n=25) and consultant surgeons (n=9), identified ‘communication’, ‘teamwork’, ‘situation awareness’ and ‘coping with stress’ skills as important skills for scrub practitioners. The second study used focus groups (n=4 groups) of experienced scrub nurses (total n=16 participants) to sort and label the extracted non-technical skill data, from study 1, into skill categories and underlying elements. The focus groups also generated ‘behavioural markers’ describing good and poor performance of those elements. This preliminary taxonomy contained eight categories with 28 underlying elements. An expert panel, comprising two psychologists and a subject matter expert used an iterative process, with reference to the system design guidelines, to refine the taxonomy. The resulting prototype was called the Scrub Practitioners’ List of Intraoperative Non-Technical Skills (SPLINTS) system which had three skill categories – ‘Situation awareness’; ‘Communication and teamwork’; ‘Task management’, each of which had three underlying elements. The third study tested the psychometric properties of the prototype SPLINTS system. Scrub practitioners (n=34) attended a single-day evaluation session where they received training (5 hours) and practice (1 hour) using the SPLINTS system before rating the scrub practitioner’s behaviour seen in standardized surgical video scenarios (n=7) (1 hour). Within-group agreement was acceptable (rwg >.7) for the three skill categories and for six of the nine elements. Future work will assess the usability of SPLINTS system in the operating theatre environment. This project has provided scrub practitioners with a structured method for training and assessing an important aspect of performance, which could help to reduce adverse events in the operating theatre.EThOS - Electronic Theses Online ServiceGBUnited Kingdo