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Table 1 Non-technical skills (NTS) categories and examples of literature relevant for the conduct and debriefing of Hand-it-on

From: “Hand-it-on”: an innovative simulation on the relation of non-technical skills to healthcare

ANTS categories [16]

Underlying and related concepts and further references

Examples of relations to Hand-it-on and participants’ behavior

Situation awareness

• Situation awareness is composed of the three elements: perception, comprehension and projection into the future [46].

• The concept of situation awareness as a single variable was challenged and its division into sub-dimensions requested [47].


• Who recognizes the workload of other team members?

• Do all participants hear the instructions given or ideas that come from team members?


• How do the different participants involved interpret the instructions given?


• Does the group anticipate further challenges from more processes?

• Do they discuss obstacles to the implementation of improvement ideas during a debriefing round?

Decision making

• Decision making can be analyzed from a more analytical or from a more intuitive angle [48].

• Processing numerical information to reach sound decisions depends to a large extent on how the information is presented and rules of thumb often help in this process [6].

• What kinds of decisions were taken during the simulation (e.g., to assign a leader)?

• What kinds of criteria were considered when making these decisions?

• To what extent was the decision process analytical vs. intuitive?

• Was there any numerical information used?

• Were all participants aware of the decisions taken?

Team working

• Co-ordination behavior in a team can be described along two dimensions in care situations: “explicit vs. implicit” and “actions vs. information” [49].

• How explicit is the information shared in the group and/or between the two groups in the version for two groups?

• Is the co-ordination more action-oriented or more information-oriented?

• How does the co-ordination pattern change over time?

• What verbal cues are used in the co-ordination process? What non-verbal cues were used?

• What is the relationship between plans and their implementation?

Task management

• Task management needs to be adjusted to the different context and the persons involved adapt their actions to the changing dynamic of the situation [50].

• What kinds of adjustment are made (e.g., establishing a “task force” for the unexpected event)?

• What triggers such adjustments (e.g., task overload, time, discussion)?

• What are obstacles to implement such changes (e.g., slowing down of the core process)?