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Purpose <p>Assessment of nontechnical skills during trauma resuscitations has previously been validated by expert reviewers and associated with more efficient resuscitations. We hypothesized that a modified Trauma-Non-Technical Skills (T-NOTECHS) scale used during trauma video review would yield a reliable assessment of trauma leadership and communication, independent of assessors’ experience in the evaluation of non-technical skills.</p> Methods <p>Video recordings of highest-level trauma activations at two Level 1 trauma centers from one year were included. We utilized a modification of the T-NOTECHS instrument to measure five domains on a 3-point scale. Assessments were conducted at a video review session by raters from various disciplines. Inter-rater reliability was categorized as poor, some, good, or excellent. Factors affecting non-technical performance were reviewed.</p> Results <p>One thousand three hundred sixty-nine modified NOTECHS scorecards from 230 video reviews were submitted. When assessing per video review, 75% of videos had “good” agreement of scores, and more than half had “excellent” agreement. In contrast, when grouped by individual trauma attendings, agreement coefficients were significantly lower (median = 0.81 vs. 0.66, <i>p</i> &lt; 0.001). Subset analysis demonstrated better performance for transfer patients and worse performance for patients requiring intubation.</p> Conclusions <p>The modified NOTECHS score is a reliable objective instrument for rating nontechnical skills, even when performance is assessed by a variety of disciplines of different skill levels and not only expert reviewers. Having a scoring tool that can reliably be used by individuals of different levels makes it versatile and adaptable across a multitude of situations which can enhance the tool’s utility in diverse settings and team compositions.</p>

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More than non-technical skills: trauma resuscitation teamwork performance affected by patient and provider factors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月5日

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  • Maria Sfakianos,
  • Eric Klein,
  • Daniel Jafari,
  • Manuel Beltran del Rio,
  • Cristy Meyer,
  • Lynn Pellicci,
  • Rashmeet Gujral,
  • Jacob Buchner,
  • Ella Rastegar,
  • Susan Steinemann,
  • Bilge Kalyon,
  • Gene Coppa,
  • Matthew Bank

摘要

Purpose

Assessment of nontechnical skills during trauma resuscitations has previously been validated by expert reviewers and associated with more efficient resuscitations. We hypothesized that a modified Trauma-Non-Technical Skills (T-NOTECHS) scale used during trauma video review would yield a reliable assessment of trauma leadership and communication, independent of assessors’ experience in the evaluation of non-technical skills.

Methods

Video recordings of highest-level trauma activations at two Level 1 trauma centers from one year were included. We utilized a modification of the T-NOTECHS instrument to measure five domains on a 3-point scale. Assessments were conducted at a video review session by raters from various disciplines. Inter-rater reliability was categorized as poor, some, good, or excellent. Factors affecting non-technical performance were reviewed.

Results

One thousand three hundred sixty-nine modified NOTECHS scorecards from 230 video reviews were submitted. When assessing per video review, 75% of videos had “good” agreement of scores, and more than half had “excellent” agreement. In contrast, when grouped by individual trauma attendings, agreement coefficients were significantly lower (median = 0.81 vs. 0.66, p < 0.001). Subset analysis demonstrated better performance for transfer patients and worse performance for patients requiring intubation.

Conclusions

The modified NOTECHS score is a reliable objective instrument for rating nontechnical skills, even when performance is assessed by a variety of disciplines of different skill levels and not only expert reviewers. Having a scoring tool that can reliably be used by individuals of different levels makes it versatile and adaptable across a multitude of situations which can enhance the tool’s utility in diverse settings and team compositions.