Table 2.
Categorisation, descriptions and limitations of pre-existing taxonomies and frameworks relevant to acute care
Sub-categorisation of pre-existing frameworks | Description | Limitations in relation to this work |
---|---|---|
Behavioural marker systems | “Observable, non-technical behaviours that contribute to superior or substandard performance within a work environment” [6] which have been sub-divided according to the research-derived categories relevant to a particular context and professional group [7-10]. | a) Developed and validated for use within a particular context e.g. The Oxford Non-Technical Skills scale [11] is used in theatre where the challenges clearly differ substantially from those encountered when dealing with a life-threatening situation in a general ward. |
b) Previous studies [12,13] indicate that there are deficits relating to knowledge base and technical skills which need to be identified, in addition to the non-technical skills addressed by behavioural marking systems. | ||
Scenario checklists | Lists of actions or behaviours (often specific clinical tasks) relevant to an individual clinical scenario [14-16]. | Most checklists developed for acute care scenarios include aspects of timed assessment (such as time taken to assess airway, breathing and circulation) [16-18] giving numerical values that primarily reveal the consequences and not the causes of error. |
Resuscitation competencies | Structured resuscitation courses [19,20] use lists of competencies that have often been developed using a modified Delphi process or similar technique [20]. | a) Scenario-specificity combined with granular detail make competency lists unsuitable for this study. |
b) Previous work indicates that whilst technical skills are a source of concern for both junior doctors and their educational supervisors, non-technical skills such as decision-making, initiative and prioritisation are also felt to be important [21]. |