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Table 1 Examples of poor and good behaviors for each of the elements (categories and elements are adopted from the ANTS) [13]

From: The reliability and usability of the Anesthesiologists’ Non-Technical Skills (ANTS) system in simulation research

Category Element Poor behavioral marker Good behavioral marker
Task Management Planning and Preparing Starting to intubate the patient, while the intubation materials are not prepared Timely preparation of medication (e.g., Amiodarone) before needing to administer it
Prioritizing Actively attending to the patients family member during complicated tasks Mentioning the order in which tasks need to be performed (i.e., after defibrillation, I would like to intubate the patient)
Providing and Maintaining Standards Not checking whether anyone touches the bed while defibrillating Double check of medication
Identifying and Utilizing Resources Not checking the capabilities of the co-workers and therefore not making use of their skills Call for the resuscitation team
Team Working Coordinating Activities with Team Not giving specific orders to one person, but giving several tasks to the whole team in general Asking the team members who they are, e.g., are you the intern?
Exchanging Information Starting with tasks without explaining what s/he is doing and why s/he is doing the task Mentioning the patients status, e.g., we need to resuscitate the patient
Using Authority and Assertiveness Forgets to give team members tasks and tries to perform all the tasks him/herself Clearly indicates the next steps and who needs to perform which tasks, e.g., if we still do not have a sinus rhythm after defibrillation, I want you to prepare 300 mg adrenaline.
Assessing Capabilities Gives orders to the intern, without checking whether s/he has sufficient knowledge to perform the task correctly Asking the intern whether s/he knows how to give basic life support?
Supporting Others Negative or defensive tone when answering the team members’ questions Complimenting team members
Situation Awareness Gathering Information Actively conducting tasks while not paying attention to the patient’s situation Regularly checking the monitor, asking team members what they know about the patient
Recognizing and Understanding Not noticing that the patient is intubated incorrectly Immediately recognizing that the patient needs to be resuscitated
Anticipating Not preparing for potential problems or possible next steps Mentioning the next steps, e.g., in 2 min, we will defibrillate again; until then, I would like you to call the on-call cardiologist.
Decision Making Identifying Options Not mentioning options when decisions need to be made Considering reasons why the patient has a VT/VF
Balancing Risks and Selecting Options No verbal considerations about the options and risks of the options Initiates discussion on what to do next
Re-evaluating Does not show any verbal re-evaluation of the situation Evaluates the situation and considers treatment options