Nontechnical skills for crisis resource management improved with training, as measured by the Anesthetists' Non-Technical Skills scale. Crisis resource management can be taught, with measurable improvements. Effective teaching of nontechnical skills can be achieved through formative self-assessment even when instructors are not available.

Computer-based multimedia instruction is an effective method of teaching nontechnical skills in simulated crisis scenarios and may be as effective as personalized oral debriefing. Multimedia may be a valuable adjunct to centers when debriefing expertise is not available.

T he random nature of adverse patient events and the vagaries of clinical exposure make assessment of pediatric anesthesia trainees complicated. Nonetheless, such assessment is critical to improving patient safety. In earlier studies, a multiple-scenario assessment offered reliable and valid measurements of the abilities of anesthesia residents. A set of relevant simulated pediatric perioperative scenarios was developed, and its effectiveness in assessing anesthesia residents and pediatric anesthesia fellows was ascertained. Ten simulation scenarios were created to reflect situations found in perioperative anesthesia care. Thirty-five anesthesiology residents and fellows agreed to participate and were debriefed after each scenario. Each scenario was scored by 2 anesthesiologists using a key action checklist. The psychometric properties, such as reliability and validity, were studied. Those with more experience in administering pediatric anesthetics usually outperformed those with less experience. Variations in scores that were attributable to raters were low, which resulted in greater interrater reliability. This method of assessment can potentially contribute to pediatric anesthesia performance, but more measures of validityVincluding correlations with more direct measures of clinical performanceVare needed to confirm the usefulness of this approach.

Introduction: Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated. Methods: We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences. Results: Seventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r = 0.67, p < 0.01. Conclusions: MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.