Exploring medical students’ understanding of non-technical skills: a thematic analysis

Introduction Non-technical skills (NTS) are a developing area of clinical education, partly due to the recognition that poor NTS can contribute to adverse patient events. Simulation is an appropriate teaching environment to consider these skills. Post-scenario discussions often focus on specific NTS, but these may not necessarily be what the participants think of when considering NTS. The aim of this study was therefore to analyse what one group of healthcare professionals, medical students, focused on when observing the NTS of their colleagues in simulated clinical scenarios.   Method Medical students from two English universities were asked to observe simulated acute medicine scenarios. They were instructed to document their observations on written worksheets focusing on specific NTS comprising communication, teamwork, task management, decision making, situational awareness and, for the last scenario, a general worksheet asking the students to consider all the NTS discussed so far. These worksheets were then transcribed and analysed using thematic analysis to elicit themes that best outlined the students’ perceptions.   Results Five themes were discovered from analysis of the five NTS from all six worksheets: team dynamics, team communication, awareness of self and events, coping under pressure and misinterpretation of NTS. These themes showed a difference between what the students concentrated on compared to what they were asked to consider. Analysis of these themes gave us an initial understanding of the prior knowledge and assumptions medical students bring with them to discussions on NTS.   Conclusions Understanding prior assumptions and interpretations of NTS can better help us understand how to teach the skills effectively and build upon what our students consider important, to help construct new knowledge and skills. As analyses of adverse events in clinical practice often point to errors of NTS as causative factors, improving these skills is an essential aspect of clinical education.