Translatability and validation of non-technical skills scale for trauma (T-NOTECHS) for assessing simulated multi-professional trauma team resuscitations

Abstract

BackgroundThe 5-item non-technical skills scale for trauma (T-NOTECHS) with five response categories is developed to assess non-technical skills in trauma team resuscitations. This validated instrument assesses behavioral aspects in teamwork. Outcome instruments should undergo a robust adaptation process followed by psychometric validation to maintain their measurement properties when translated into different languages. The translatability of the T-NOTECHS into a non-Anglo-Saxon language has not been thus far unraveled. The authors aimed to assess whether the T-NOTECHS would be translatable into a non-Anglo-Saxon language and to investigate its psychometric properties for simulated multi-professional trauma team resuscitations.MethodsThe T-NOTECHS (scores: 1 = poor; 5 = excellent) was translated and cross-culturally adapted into Finnish. Data was derived from 61 real hospital trauma team resuscitation simulations with 193 multi-professional participants. Floor-ceiling effects, internal consistency, and inter-rater reliability were analyzed. An exploratory factor analysis was conducted to test construct validity.ResultsAfter pre-testing, minor changes were made to the Finnish translation of the T-NOTECHS. Mean scores of two raters were 3.76 and 4.01, respectively. The T-NOTECHS instrument showed no floor-effect either in single items or in the total score. The total score of the T-NOTECHS instrument showed a percentage of maximum scores of 1.6 and 4.9% by the Raters 1 and 2, respectively. Internal consistency (Cronbach’s alpha) was 0.70 with inter-item correlation of 0.54. The intraclass correlation coefficient was 0.54 and coefficient of repeatability 1.53. The T-NOTECHS loaded on one factor.ConclusionsThe T-NOTECHS translated well into a difficult non-Anglo-Saxon language. The rigorous adaptation process used here can be recommended in the translation of observational performance assessment instruments. The translated version demonstrated fair reliability and good construct validity for assessing team performance in simulated multi-professional trauma team resuscitations. The translated T-NOTECHS instrument can be used to assess the efficacy of simulated in-situ trauma team resuscitations allowing benchmarking and international collaboration.

Validación en castellano de la escala de Ottawa para habilidades no técnicas en personal de salud en situación de crisis

“…Los autores aclaran que es imposible desligar las HT de las HNT, existiendo la dificultad de limitar la apreciación de las HT al evaluar el desempeño no técnico de los participantes, por lo que la elección de la escala comparativa para evaluar el constructo divergente no fue la mejor. Al respecto, Brunckhorst, O et al (28) concluyeron que todos los componentes individuales de HNT demostraron una fuerte correlación con todos los parámetros de HT, independientemente del entrenamiento en el ámbito quirúrgico, y Krage et al (29) en un estudio de simulación en residentes de anestesia, demostraron que al aumentar los estresores externos en crisis, se ven afectadas las HNT y al mismo tiempo las HT y el trabajo en equipo. Sin embargo, los autores resaltan la ejecución de un protocolo claro que permitió a los participantes capacitarse adecuadamente en las HT de la crisis a simular.…”

A scoping review of nontechnical skill assessment tools to evaluate trauma team performance

“…Trauma Nontechnical Skills Scale has widely been used in a trauma setting for teaching purposes and to assess the learning outcomes and teamwork skills of multidisciplinary trauma teams 45 . Trauma Nontechnical Skills Scale is a simple and validated instrument in assessing the nontechnical skills of trauma teams, which may be rapidly adopted by raters of varying expertise (medical students to experienced clinicians) after minimal training 46 .…”

“…Trauma Nontechnical Skills Scale has widely been used in a trauma setting for teaching purposes and to assess the learning outcomes and teamwork skills of multidisciplinary trauma teams. 45 Trauma Nontechnical Skills Scale is a simple and validated instrument in assessing the nontechnical skills of trauma teams, which may be rapidly adopted by raters of varying expertise (medical students to experienced clinicians) after minimal training. 46 However, studies such as conducted by Wieck et al 43 suggest that T-NOTECHS may still benefit from further refinement, such as increasing the accuracy of the scoring system through mixing expert and self-reported assessments for different domains.…”

Costs of hospital trauma team simulation training: a prospective cohort study

“…Data were collected prospectively and anonymously between 2017 and 2018 by expert raters (an anaesthesiologist and a nurse teacher) using the T-NOTECHS scale. 10 Answering the self-assessment questionnaire was voluntary. The courses were attended by 475 participants in 81 teams.…”

“… 12 The scale has proven to have strong structural validity and acceptable reliability for assessing performance in simulation-based multiprofessional trauma team resuscitations. 10 It has also been widely adopted for assessing simulation performance. 9 11 13–23 …”