Psychometric evaluation of a structured assessment tool for nurse anesthetists' non-technical skills.

Background: Non-technical skills are the essential cognitive, social, and personal resources contributing to safe and efficient task performance. An assessment tool can facilitate the development and teaching of non-technical skills. The nurse anesthetist non-technical skills tool includes four categories and fifteen elements and is an adaptation of the existing tools for physician anesthetists and Danish nurse anesthetists. The ratings are on a five-step scale, with an option to select "Not Relevant". Since there doesn't exist an assessment tool for Swedish nurse anesthetists' non-technical skills, the aim of the study was to translate and adapt the assessment tool for nurse anesthetists' non-technical skills to a Swedish context and test its psychometric qualities among nurse anesthetists with experience in teaching nurse anesthetist students and junior nurse anesthetists in clinical settings.

Methods: In this prospective psychometric evaluation study, sixteen nurse anesthetists were recruited. They rated 12 video clips of simulated anesthesia scenarios after participating in a three-hour calibration workshop. Four weeks later, a test-retest was conducted, which included five video clips. Internal consistency, Interrater reliability, and test-retest reliability were examined.

Results: Internal consistency showed acceptable results on the element level and Interrater reliability indicated good results. Retest reliability showed poor to moderate reliability. The use of "Not Relevant" varied significantly depending on the length of the video clip and the provider being rated. The raters considered the assessment tool suitable but initially challenging to use for rating non-technical skills among nurse anesthetists and articulate non-technical skills in anesthesia nursing.

Conclusions: This initial testing of the Swedish nurse anesthetists' non-technical skills tool shows acceptable psychometric qualities and gives a foundation for future research. However, the rating "Not Relevant" poses challenges that need to be addressed. Nevertheless, the participants consider the assessment of non-technical skills in Swedish nurse anesthetists to be appropriate.