Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 1;5(3):130-139.
doi: 10.1136/bmjstel-2018-000310. eCollection 2019.

Medical Students' Non-Technical Skills (Medi-StuNTS): preliminary work developing a behavioural marker system for the non-technical skills of medical students in acute care

Ailsa L Hamilton  1 , Joanne Kerins  1 , Marc A MacCrossan  2 , Victoria R Tallentire  1
Affiliations

Medical Students' Non-Technical Skills (Medi-StuNTS): preliminary work developing a behavioural marker system for the non-technical skills of medical students in acute care

Ailsa L Hamilton et al. BMJ Simul Technol Enhanc Learn. .

Abstract

Introduction: Good non-technical skills (NTS) are critical to the delivery of high-quality patient care. It is increasingly recognised that training in such skills should be incorporated into primary medical training curricula. This study aimed to develop an NTS behavioural marker system (BMS), specifically applicable to medical students, for use within simulated acute care scenarios.

Methods: The methodology used to develop other BMS was adopted and modified. Following ethical approval, 16 final year medical students participated in acute care simulated scenarios. Semistructured interviews were performed to gauge the understanding of NTS. A panel meeting of subject matter experts was convened to translate key NTS into skill elements and observable behaviours. A second expert panel was consulted to refine aspects of the BMS. Further refinement and initial face validity was undertaken by a third panel of experts using the prototype BMS to observe prerecorded simulation scenarios.

Results: Five categories of NTS were identified: situation awareness, teamwork and communication, decision-making and prioritisation, self-awareness, and escalating care. Observable behaviours in each category describe good and poor performance. Escalating care was identified as a unique component that incorporated behaviours related to each of the other four skill categories. A 5-point rating scale was developed to enable both peer-to-peer and tutor-to-student feedback.

Conclusion: The Medi-StuNTS (Medical Students' Non-Technical Skills) system is the first BMS for the NTS of medical students. It reinforces the importance of escalating care effectively. It provides an exciting opportunity to provide feedback to medical students and may ultimately aid their preparedness for professional practice.

Keywords: acute care; medical students; non-technical skills; simulation.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart illustrating methodology. BMS, behavioural marker system; Medi-StuNTS,  Medical Students’ Non-Technical Skills; NTS, non-technical skills.
Figure 2
Figure 2
Medi-StuNTS (Medical Students’ Non-Technical Skills)—behavioural marker system. (SBAR - Situation; background; assessment; recommendation)
Figure 3
Figure 3
Rating form for the Medi-StuNTS (Medical Students’ Non-Technical Skills) system.
See this image and copyright information in PMC

References

    1. Flin RH, O’Connor P, Crichton M. Safety at the sharp end: a guide to non-technical skills: Aldershot, England; Burlington, VT: Ashgate, 2008:317.
    1. Institute of Medicine (US) Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System [Internet]. In: Kohn LT, Corrigan JM, Donaldson MS, eds. Washington (DC): National Academies Press (US), 2000. http://www.ncbi.nlm.nih.gov/books/NBK225182/ (accessed 3 Jan 2017). - PubMed
    1. Hogan H, Healey F, Neale G, et al. . Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study. BMJ Qual Saf 2012;21:737–45. 10.1136/bmjqs-2011-001159 - DOI - PMC - PubMed
    1. Thomson R. The fifth report from the Patient Safety Observatory - Safer care for the acutely ill patient: learning from serious incident. [Internet]: NHS National Patient Safety Agency, 2007. http://www.nrls.npsa.nhs.uk/resources/?EntryId45=59828 (accessed 2 Jan 2017).
    1. McCulloch P, Mishra A, Handa A, et al. . The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Quality and Safety in Health Care 2009;18:109–15. 10.1136/qshc.2008.032045 - DOI - PubMed

LinkOut - more resources