Journal Article

Anaesthetists’ Non‐Technical Skills (ANTS): evaluation of a behavioural marker system

G. Fletcher, R. Flin, P. McGeorge, R. Glavin, N. Maran and R. Patey

in BJA: British Journal of Anaesthesia

Published on behalf of the British Journal of Anaesthesia

Volume 90, issue 5, pages 580-588
Published in print May 2003 | ISSN: 0007-0912
Published online May 2003 | e-ISSN: 1471-6771 | DOI:
Anaesthetists’ Non‐Technical Skills (ANTS): evaluation of a behavioural marker system†

Show Summary Details


Background. Non‐technical skills are critical for good anaesthetic practice but are not addressed explicitly in normal training. Realization of the need to train and assess these skills is growing, but these activities must be based on properly developed skills frameworks and validated measurement tools. A prototype behavioural marker system was developed using human factors research techniques. The aim of this study was to conduct an experimental evaluation to establish its basic psychometric properties and usability.

Method. The Anaesthetists’ Non‐Technical Skills (ANTS) system prototype comprises four skill categories (task management, team working, situation awareness, and decision making) divided into 15 elements, each with example behaviours. To investigate its experimental validity, reliably and usability, 50 consultant anaesthetists were trained to use the ANTS system. They were asked to rate the behaviour of a target anaesthetist using the prototype system in eight videos of simulated anaesthetic scenarios. Data were collected from the ratings forms and an evaluation questionnaire.

Results. The results showed that the system is complete, and that the skills are observable and can be rated with acceptable levels of agreement and accuracy. The internal consistency of the system appeared sound, and responses regarding usability were very positive.

Conclusions. The findings of the evaluation indicated that the ANTS system has a satisfactory level of validity, reliability and usability in an experimental setting, provided users receive adequate training. It is now ready to be tested in real training environments, so that full guidelines can be developed for its integration into the anaesthetic curriculum.

Br J Anaesth 2003; 90: 580–8

Keywords: Keywords: anaesthetists; education, training

Journal Article.  5155 words.  Illustrated.

Subjects: Anaesthetics

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or login to access all content.