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Published on: January 15, 2017
The Evaluation of the Effect of Rescuer Team Size on Nontechnical Skills in High-Fidelity Canine CPR Simulations
Darice Kim1, Sabrina Hoehne1,2, Trey DeJong3
1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
Objective:
To evaluate the effect of rescuer team size on nontechnical skills in high-fidelity canine CPR simulations using the Trauma Non-Technical Skills (T-NOTECHS) assessment tool.
Design:
Experimental study.
Setting:
Veterinary clinical simulation center.
Subjects:
Forty-eight Reassessment Campaign on Veterinary Resuscitation-certified veterinary students.
Measurements And Main Results:
Participants were divided into five stable groups of nine or 10 rescuers. Students were randomly chosen from within each group to conduct a total of three high-fidelity canine CPR simulations in configurations of four-, six-, and eight-rescuer teams, and CPR attempts were video and audio recorded. The resulting 15 recordings were evaluated using T-NOTECHS. Interrater reliability was evaluated for each T-NOTECHS domain and overall T-NOTECHS score. Normality of each domain and overall score was assessed using the Shapiro-Wilk test. Scores among team sizes were compared using one-way ANOVA and Kruskal-Wallis tests, with significance set at p < 0.05. The median (range) of overall T-NOTECHS scores of four-, six-, and eight-rescuer teams was 15 (11), 21.5 (9.5), and 18.5 (10.5), respectively, which was not statistically significant (p = 0.29). There were statistical differences among team sizes in the assessment and decision-making domain, with six-rescuer teams demonstrating higher scores than four-rescuer teams. Four-, six-, and eight-rescuer teams had mean ± SD scores of 3.00 ± 1.06, 4.60 ± 0.42, and 3.90 ± 0.55, respectively (p = 0.01). None of the other domains-leadership, cooperation and resource management, communication and interaction, and situation awareness/coping with stress-differed among rescuer team sizes.
Conclusion:
Teams of six rescuers demonstrated enhanced performance in the assessment and decision-making domain of T-NOTECHS compared with teams of four rescuers. Further study is needed to evaluate whether this difference affects CPR technical skills and patient outcomes, and whether nontechnical team skills could be improved by targeted training.
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