• Br J Anaesth · Jan 2013

    How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills.

    Excellent anaesthetists were identified by anaesthesia nurses as being:

    1. Organised & focused: structured, responsible, and focused approach to work tasks.
    2. Good communicators: clear and informative, briefing of team about the plan before induction.
    3. Respectful of complexity: humble to the complexity of anaesthesia, admitting own fallibility.
    4. Patient-centred: personal contact with the patient before induction.
    5. Good situational awareness: fluent in practical work without losing overview.
    6. Calm and clear in critical situations, being able to change to a strong leading style.
    summary
    • J Larsson and I K Holmström.
    • Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. jan@trolin.net
    • Br J Anaesth. 2013 Jan 1; 110 (1): 115121115-21.

    BackgroundTeaching trainees to become competent professionals who can keep the complex system of anaesthesia safe is important. From a safety point of view, non-technical 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.MethodsThe 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.ResultsSix 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.ConclusionsExperienced 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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    This article appears in the collections: Non-technical qualities of anesthesiology and Decision Making in Anaesthesia & Critical Care.

    Notes

    summary
    1

    Excellent anaesthetists were identified by anaesthesia nurses as being:

    1. Organised & focused: structured, responsible, and focused approach to work tasks.
    2. Good communicators: clear and informative, briefing of team about the plan before induction.
    3. Respectful of complexity: humble to the complexity of anaesthesia, admitting own fallibility.
    4. Patient-centred: personal contact with the patient before induction.
    5. Good situational awareness: fluent in practical work without losing overview.
    6. Calm and clear in critical situations, being able to change to a strong leading style.
    Daniel Jolley  Daniel Jolley
    pearl
    1

    Non-technical skills are of equal importance to technical anaesthesia skills, but are more challenging to define, measure and acquire.

    Daniel Jolley  Daniel Jolley
     
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