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
. 2023 Nov 29;8(1):28.
doi: 10.1186/s41077-023-00268-x.

Observation of behavioural skills by medical simulation facilitators: a cross-sectional analysis of self-reported importance, difficulties, observation strategies and expertise development

Lars Mommers  1   2 , Daniëlle Verstegen  3 , Diana Dolmans  3 , Walther N K A van Mook  3   4   5
Affiliations

Observation of behavioural skills by medical simulation facilitators: a cross-sectional analysis of self-reported importance, difficulties, observation strategies and expertise development

Lars Mommers et al. Adv Simul (Lond). .

Abstract

Background: The association between team performance and patient care was an immense boost for team-based education in health care. Behavioural skills are an important focus in these sessions, often provided via a mannikin-based immersive simulation experience in a (near) authentic setting. Observation of these skills by the facilitator(s) is paramount for facilitated feedback with the team. Despite the acknowledgement that trained facilitators are important for optimal learning, insight into this observation process by facilitators is limited.

Objectives: What are the self-reported current practices and difficulties regarding the observation of behavioural skills amongst facilitators during team training and how have they been trained to observe behavioural skills?

Methods: This cross-sectional study used a pilot-tested, content-validated, multi-linguistic online survey within Europe, distributed through a non-discriminative snowball sampling method. Inclusion was limited to facilitators observing behavioural skills within a medical team setting.

Results: A total of 175 persons filled in the questionnaire. All aspects of behavioural skill were perceived as very important to observe. The self-perceived difficulty of the behavioural skill aspects ranged from slightly to moderately difficult. Qualitative analysis revealed three major themes elaborating on this perceived difficulty: (1) not everything can be observed, (2) not everything is observed and (3) interpretation of observed behavioural skills is difficult. Additionally, the number of team members health care facilitators have to observe, outnumbers their self-reported maximum. Strategies and tools used to facilitate their observation were a blank notepad, co-observers and predefined learning goals. The majority of facilitators acquired observational skills through self-study and personal experience and/or observing peers. Co-observation with either peers or experts was regarded as most learn some for their expertise development. Overall, participants perceived themselves as moderately competent in the observation of behavioural skills during team training.

Conclusions: Observation of behavioural skills by facilitators in health care remains a complex and challenging task. Facilitators' limitations with respect to attention, focus and (in)ability to perform concomitant tasks, need to be acknowledged. Although strategies and tools can help to facilitate the observation process, they all have their limitations and are used in different ways.

Keywords: Behavioural skills; Current practice; Interprofessional education; Nontechnical skills; Self-reported competence; Simulation; Soft skills; Team training.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overview of responses
Fig. 2
Fig. 2
Strategies and tools used in the observation of NTS
See this image and copyright information in PMC

References

    1. Mazzocco K, Petitti DB, Fong KT, Bonacum D, Brookey J, Graham S, et al. Surgical team behaviors and patient outcomes. Am J Surg. 2009;197(5):678–685. doi: 10.1016/j.amjsurg.2008.03.002. - DOI - PubMed
    1. Siu J, Maran N, Paterson-Brown S. Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents. Surgeon. 2016;14(3):119–128. doi: 10.1016/j.surge.2014.06.005. - DOI - PubMed
    1. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6):614–621. doi: 10.1067/msy.2003.169. - DOI - PubMed
    1. Institute of Medicine Committee on Quality of Health Care in A . To err is human: building a safer health system. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington (DC): National Academies Press (US) Copyright 2000 by the National Academy of Sciences. All rights reserved; 2000. - PubMed
    1. Dedy NJ, Bonrath EM, Zevin B, Grantcharov TP. Teaching nontechnical skills in surgical residency: a systematic review of current approaches and outcomes. Surgery. 2013;154(5):1000–1008. doi: 10.1016/j.surg.2013.04.034. - DOI - PubMed

LinkOut - more resources