Table 1.
Overview of categories, dimensions and items, with definitions and examples and the descriptive results
| ED | ICU | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline (n=179) | Follow-up (n=199) | Baseline (n=179) | Follow-up (n=199) | ||||||
| Categories, dimensions and items | Definitions of the categories and dimensions and examples of the items | N | % | N | % | N | % | N | % |
| Overall EPOC score | All verbal expressions taken together | 1439 | 100 | 1887 | 100 | 22979 | 100 | 20854 | 100 |
| Self category | Expressing non-technical skills in relation to oneself | 11 | 0.74 | 4 | 0.21 | 136 | 0.59 | 210 | 1.01 |
| 1. Assertiveness | Takes action on his/her own accord; stands up for him/herself | ||||||||
| Expresses concerns | ‘I'm not sure that this is going to end well’ | 4 | 0.27 | 2 | 0.11 | 97 | 0.42 | 197 | 0.94 |
| Speaks up even when faced with resistance | ‘I already said that I was too fatigued for these tasks’ | 7 | 0.47 | 2 | 0.11 | 29 | 0.13 | 13 | 0.06 |
| Speaks up aggressively (–)* | ‘I am fed up with it!’ | 1 | 0.07 | 0 | 0.00 | 10 | 0.04 | 0 | 0 |
| Neglects others (–)* | 1 | 0.07 | 0 | 0.00 | |||||
| Human interaction category | Expressing non-technical skills in relation to others | 1300 | 87.07 | 1760 | 93.27 | 21637 | 94.16 | 18746 | 89.89 |
| 2. Working with others | Takes initiative and remains an active part of the team; interacts with others | 726 | 48.63 | 1062 | 56.28 | 18639 | 81.11 | 15699 | 75.28 |
| Reacts to suggestions from others† | ‘Yes, you are right’ | 2317 | 10.08 | 2393 | 11.48 | ||||
| Asks others for contributions | ‘Does the medicine cabinet need refilling?’ | 24 | 1.61 | 12 | 0.64 | 2213 | 9.63 | 2055 | 9.85 |
| Gives suggestions | ‘Shall we turn her on her left side?’ | 52 | 3.48 | 38 | 2.01 | 2441 | 10.62 | 2112 | 10.13 |
| Confirms task | ‘Yes, I will do that’ | 196 | 13.13 | 357 | 18.92 | 2390 | 10.40 | 1198 | 5.74 |
| Repeats task† | ‘Yes, I will lower the bed’ | 188 | 0.82 | 204 | 0.98 | ||||
| Asks for confirmation about information† | ‘Did you understand what I just said?’ | 457 | 1.99 | 453 | 2.17 | ||||
| Asks for confirmation about tasks | ‘Do you know what you have to do?’ | 238 | 15.94 | 465 | 24.64 | 340 | 1.48 | 266 | 1.28 |
| Tells others what he/she is going to do | ‘I am going to prepare patient X for transfer’ | 144 | 9.65 | 142 | 7.53 | 1106 | 4.84 | 1150 | 5.51 |
| Asks ‘follow-up’ questions for clarification† | ‘What do you mean by that?’ | 1031 | 4.49 | 801 | 3.84 | ||||
| Gives contributions† | Saying something without an explicit cause, like a question | 2819 | 12.27 | 2367 | 11.35 | ||||
| Answers a question† | In answer to a question about the result of a test: ‘It was negative’ | 3058 | 13.31 | 2253 | 10.8 | ||||
| Checks the correctness of the information | ‘So the patient received 200 ml you said?’ | 60 | 4.02 | 41 | 2.17 | 279 | 1.21 | 447 | 2.14 |
| Demonstrates self-control in the case of errors | 0 | 0.00 | 2 | 0.11 | |||||
| Takes part in decision making | 12 | 0.80 | 5 | 0.26 | |||||
| 3. Task-oriented leadership | Plan and organise the crew's tasks | 151 | 10.11 | 83 | 4.40 | 1576 | 6.86 | 1193 | 5.72 |
| Coordinates tasks | ‘You are going to wash this patient’ | 13 | 0.87 | 3 | 0.16 | 717 | 3.12 | 416 | 1.99 |
| Checks and corrects tasks | ‘I said 5 ml, but you gave 50 ml’ | 66 | 4.42 | 27 | 1.43 | 295 | 1.28 | 337 | 1.62 |
| Uses authority | ‘I'm the physician, so I will make that call’ | 0 | 0.00 | 0 | 0.00 | 5 | 0.02 | 3 | 0.01 |
| Gives instructions, coaches | ‘It is more comfortable for the patient if you do it this way’ | 72 | 4.82 | 53 | 2.81 | 559 | 2.43 | 437 | 2.10 |
| 4. People-oriented leadership | Motivate and encourage crew cooperation for performing tasks | 423 | 28.33 | 615 | 32.59 | 1422 | 6.19 | 1854 | 8.89 |
| Provides support and shows appreciation | ‘You have done this perfectly!’ | 21 | 1.41 | 13 | 0.69 | 336 | 1.46 | 425 | 2.04 |
| Gives others space | A senior to a junior: ‘Do you want to add anything else?’ | 1 | 0.07 | 1 | 0.05 | 38 | 0.17 | 64 | 0.31 |
| Shows that one is listening | When someone else is talking: ‘Yes’ | 394 | 26.39 | 599 | 31.74 | 1048 | 4.56 | 1365 | 6.55 |
| Appreciate suggestions | 7 | 0.47 | 2 | 0.11 | |||||
| Environment category | Expressing non-technical skills in relation to the environment and the situation | 182 | 12.19 | 123 | 6.52 | 1206 | 5.25 | 1898 | 9.10 |
| 5. Situation awareness | Be aware of the operational situation based on relevant factors | 84 | 5.63 | 58 | 3.07 | 99 | 0.43 | 296 | 1.42 |
| Names environmental factors that influence the situation | ‘The constant ringing of the phone distracts me’ | 6 | 0.40 | 0 | 0.00 | 57 | 0.25 | 148 | 0.71 |
| Takes action based on these environmental factors | ‘I'm leaving the receiver off the hook’ | 0 | 0.00 | 0 | 0.00 | 4 | 0.02 | 4 | 0.02 |
| Keeps an overview of all the patients | While treating patient X: ‘How is patient Y doing?’ | 78 | 5.22 | 58 | 3.07 | 38 | 0.17 | 144 | 0.69 |
| 6. Planning and anticipation | Plan and structure actions | 98 | 6.56 | 65 | 3.44 | 1107 | 4.82 | 1602 | 7.68 |
| Discusses expectations that can influence the situation | ‘It is likely that another patient will be admitted to the unit today’ | 12 | 0.80 | 6 | 0.32 | 141 | 0.61 | 232 | 1.11 |
| Specifies goal | ‘The aim is to transfer this patient to the ward today’ | 1 | 0.07 | 0 | 0.00 | 56 | 0.24 | 176 | 0.84 |
| Indicates priorities | ‘There has to be a bed available before we can admit a new patient’ | 6 | 0.40 | 7 | 0.37 | 71 | 0.31 | 94 | 0.45 |
| Indicates what has to be done | ‘This bed has to be lowered’ | 71 | 4.76 | 49 | 2.60 | 41 | 0.18 | 59 | 0.28 |
| Adjusts the plan if necessary | ‘The aim was to use treatment X, but seeing the condition of this patient, treatment Y is better’ | 8 | 0.54 | 3 | 0.16 | 798 | 3.47 | 1041 | 4.99 |
Note: Contact author for the extensive EPOC handbook.
*Results of negative items are not part of the sum score of the dimensions and categories.
†Added verbal behaviours that were not part of the preliminary version of the EPOC that was used in the ED study.
ED, emergency department; EPOC, explicit professional oral communication; ICU, intensive care unit.