Educating for Excellence: A Cohort Study on Assessing Student Nurse Anesthetist Non-Technical Skills in Clinical Practice

Non-technical skills play an integral role in providing safe and excellent anesthesia. Currently there is little standardization in the assessment of non-technical skills in clinical practice, although various instruments exist. The aim of this study was to explore the use of the Nurse Anaesthetists' Non-Technical Skills-Norway (NANTS-no) structured assessment instrument in developing and assessing non-technical skills in clinical practice. This cohort study had a longitudinal design. Twenty student nurse anesthetists' nontechnical skills were assessed by their mentors (N=31) and clinical supervisors (N=7) at three time-points over a 12-month period, after providing anesthesia to a patient. A 5-point rating scale was used for both the experts' assessments and students' self-assessments. Development of non-technical skills over time was estimated using linear mixed-effect models. The students demonstrated a significant overall development of non-technical skills (P<.001), achieving an expert assessment of 4.5 at the end of their education. The students significantly underestimated their clinical performance compared with the experts' assessments (P<.001). The structured behavioral assessment instrument appears to be reliable for assessing student nurse anesthetists' non-technical skills in clinical practice. This study may have implications for systematic assessment of non-technical skills in Norway and other countries.