Use of the Anesthetists’ Non-technical Skills (ANTS) Framework with screen-based simulation for nurse anesthetists

Background: Non-technical skills (NTS) include situational awareness, teamwork, decision making, and leadership. Intraoperative errors and adverse patient outcomes are associated with providers lacking NTS. Screen-based simulation (SBS) can be used to teach NTS. Methods: Using Kane's validity framework, the validity of a multiplayer SBS versus manikin-based simulation (MBS) as a platform for NTS education and assessment of Certified Registered Nurse Anesthetists (CRNA) using the Anesthetist's NTS (ANTS) Framework was examined. Scripted scenarios were recorded in a commercial platform for SBS and mirrored in a MBS. Expert panelists completed the SBS scenario, and rated performances, SBS fidelity, and platform utility. Results: Expert panelists agreed the scenario was relevant to CRNA practice, ANTS was an appropriate assessment tool with SBS, and the SBS platform was appropriate for CE activities yet inappropriate for high-stakes assessments. Kane's extrapolation inference was supported, while scoring, generalization, and implication inferences require further investigation. Conclusions: The evaluated SBS platform and scenario could be used to teach CRNAs NTS, yet the use of SBS for high-stakes assessments requires further validation.

Duke Scholars

Author Virginia Chris Simmons School of Nursing