• K Gjeraa, R M H G Jepsen, M Rewers, D Østergaard, and P Dieckmann.
• Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark.
• Acta Anaesthesiol Scand. 2016 Jan 1; 60 (1): 36-47.

BackgroundA combination of non-technical skills (NTS) and technical skills (TS) is crucial for anaesthetic patient management. However, a deeper understanding of the relationship between these two skills remains to be explored. We investigated the characteristics of trainee anaesthesiologists' NTS and TS in a simulated unexpected difficult airway management scenario.MethodsA mixed-method approach was used to explore the relationship between NTS and TS in 25 videos of 2nd year trainee anaesthesiologists managing a simulated difficult airway scenario. The videos were assessed using the customised version of the Anaesthetists' Non-Technical Skills System, ANTSdk, and an adapted TS checklist for calculating the correlation between NTS and TS. Written descriptions of the observed NTS were analysed using directed content analysis.ResultsThe correlation between the NTS and the TS ratings was 0.106 (two-tailed significance of 0.613). Inter-rater reliability was substantial. Themes characterising good NTS included a systematic approach, planning and communicating decisions as well as responding to the evolving situation. A list of desirable, concrete NTS for the specific airway management situation was generated.ConclusionThis study illustrates that anaesthesiologist trainees' NTS and TS were not correlated in this setting, but rather intertwined and how the interplay of NTS and TS can impact patient management. Themes describing the characteristics of NTS and a list of desirable, concrete NTS were developed to aid the understanding, training and use of NTS.© 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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