Anaesthesiologists' Non-Technical Skills in Denmark Form: cross-cultural adaptation, reliability and validity of Turkish version in paediatric surgery team.

Abstract

Background: The Anaesthesiologists' Non-Technical Skills in Denmark Form (ANTSdk) is a widely accepted, practical, and comprehensive measurement tool used by anaesthesiologists and other healthcare professionals. This study aims to adapt the ANTSdk into Turkish as a valid and reliable assessment instrument. By doing so, it will contribute to establishing a common language and standardised terminology for integrating non-technical skills into the Turkish healthcare system.

Methods: We conducted a standardised cross-cultural adaptation process. The psychometric properties of the Turkish-adapted version of the ANTSdk were evaluated through observations of 81 real paediatric surgical operating room teams, assessed simultaneously by two independent observers. Validity was examined using content validity analysis and confirmatory factor analysis. Internal consistency and inter-rater reliability of the Turkish version of ANTSdk (ANTStr) were also assessed.

Results: The specified factorial model retained the same grouping of elements into four domains as in the original version of ANTSdk. All standardised factor loadings were greater than 0.3. The inter-rater reliability, measured by the intraclass correlation coefficient of the global score, was 0.98. The Cronbach's alpha coefficient for the scores provided by the first rater ranged from 0.83 to 0.94, while for the second rater, it ranged from 0.84 to 0.94. The generalisability coefficient calculated for ANTStr was exceptionally high at 0.96.

Conclusion: The Turkish version of ANTSdk demonstrates strong psychometric properties for evaluating paediatric surgical team performance in the operating room. This translated instrument can be used to assess non-technical skills in paediatric surgical teams within real clinical settings, facilitating benchmarking and international collaboration.