title: Simulation-based training and assessment of non-technical skills in the Norwegian Helicopter Emergency Medical Services: a cross-sectional survey.
abstract: BACKGROUND
  Human error and deficient non-technical skills (NTSs) among providers of ALS in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment.
  
  
  OBJECTIVE
  To document the current level of simulation-based training and assessment of seven generic NTSs in crew members in the Norwegian HEMS.
  
  
  METHODS
  A cross-sectional survey, either electronic or paper-based, of all 207 physicians, HEMS crew members (HCMs) and pilots working in the civilian Norwegian HEMS (11 bases), between 8 May and 25 July 2012.
  
  
  RESULTS
  The response rate was 82% (n=193). A large proportion of each of the professional groups lacked simulation-based training and assessment of their NTSs. Compared with pilots and HCMs, physicians undergo statistically significantly less frequent simulation-based training and assessment of their NTSs. Fifty out of 82 (61%) physicians were on call for more than 72 consecutive hours on a regular basis. Of these, 79% did not have any training in coping with fatigue. In contrast, 72 out of 73 (99%) pilots and HCMs were on call for more than 3 days in a row. Of these, 54% did not have any training in coping with fatigue.
  
  
  CONCLUSIONS
  Our study indicates a lack of simulation-based training and assessment. Pilots and HCMs train and are assessed more frequently than physicians. All professional groups are on call for extended hours, but receive limited training in how to cope with fatigue.
authors.affiliation: Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway National Centre for Emergency Primary Health Care, Uni Research Health, Uni Research, Bergen, Norway Department of Industrial Economics, Risk Management and Planning, University of Stavanger, Stavanger, Norway.
authors.forename: Håkon B
authors.initials: HB
authors.lastname: Abrahamsen
authors.affiliation: Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway Department of Health Sciences, University of Stavanger, Stavanger, Norway Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
authors.forename: Stephen J M
authors.initials: SJ
authors.lastname: Sollid
authors.affiliation: Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
authors.forename: Lennart S
authors.initials: LS
authors.lastname: Öhlund
authors.affiliation: Department of Health Sciences, University of Stavanger, Stavanger, Norway Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
authors.forename: Jo
authors.initials: J
authors.lastname: Røislien
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway National Centre for Emergency Primary Health Care, Uni Research Health, Uni Research, Bergen, Norway.
authors.forename: Gunnar Tschudi
authors.initials: GT
authors.lastname: Bondevik
mesh_terms: D000328:Adult; D017732:Air Ambulances; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000592:standards; D004635:Emergency Medicine / Q000193:education*; D005221:Fatigue / Q000517:prevention & control; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D008297:Male; D009664:Norway; D016544:Patient Simulation; D011795:Surveys and Questionnaires
keywords: accident prevention; assessment; critical care transport; prehospital care, helicopter retrieval; training