title: Adaptation of non-technical skills behavioural markers for delivery room simulation.
abstract: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room).
  
  
  
  The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected.
  
  
  
  The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories.
  
  
  
  The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.
authors.affiliation: Department of Educational Sciences, University of Genoa, Corso A. Podestà, 2, 16128, Genoa, Italy. fabrizio.bracco@unige.it.|V.I.E. srl, Spinoff of the University of Genoa, Genoa, Italy. fabrizio.bracco@unige.it.|Advanced Simulation Center, University of Genoa, Genoa, Italy. fabrizio.bracco@unige.it.|M.G. Vannini Hospital, Rome, Italy. fabrizio.bracco@unige.it.
authors.forename: Fabrizio
authors.identifier: 0000-0001-9430-1389
authors.initials: F
authors.lastname: Bracco
authors.affiliation: V.I.E. srl, Spinoff of the University of Genoa, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Masini
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: De Tonetti
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Brogioni
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Amidani
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Monichino
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Maltoni
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dato
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Grattarola
authors.affiliation: IRCCS Giannina Gaslini Children's Research Hospital, Genoa, Italy.|Advanced Simulation Center, University of Genoa, Genoa, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cordone
authors.affiliation: Advanced Simulation Center, University of Genoa, Genoa, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Torre
authors.affiliation: Advanced Simulation Center, University of Genoa, Genoa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Launo
authors.affiliation: Department of Educational Sciences, University of Genoa, Corso A. Podestà, 2, 16128, Genoa, Italy.|V.I.E. srl, Spinoff of the University of Genoa, Genoa, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Chiorri
authors.affiliation: M.G. Vannini Hospital, Rome, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Celleno
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education; D002983:Clinical Competence; D003071:Cognition; D003142:Communication; D003696:Delivery Rooms; D004461:Eclampsia / Q000628:therapy*; D004630:Emergencies; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D016389:Maternal-Child Nursing / Q000193:education; D008875:Middle Aged; D008880:Midwifery / Q000193:education; D009774:Obstetrics / Q000193:education; D010348:Patient Care Team; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012640:Seizures / Q000209:etiology / Q000628:therapy*; D000066908:Simulation Training; D066107:Social Skills; D014592:Uterine Hemorrhage / Q000628:therapy; D014593:Uterine Inertia / Q000628:therapy*; D055815:Young Adult
keywords: Clinical Skills; Education; Medical Education; Obstetric emergency; Patient Simulation; Social Skills