Dr Sharon Ong, Senior Consultant, Department of Surgical Intensive Care, SGH, shares more about the ANTS study.
Our project entitled “Non-technical skills necessary for anaesthesia senior residents (SRs) to practise with distant supervision: A Mixed-Methods Study” was conceived after some residents who passed their Part 2 (now Part B) exams felt that they were not ready to assume a SR call role. Exploring faculties’ views and a literature search led us to the ANTS (Anaesthesia Non-Technical Skills) framework which comprises of four categories of situation awareness, task management, decision making and teamwork.
The categories are further sub-divided into elements of recognising/understanding, anticipating, gathering information, planning/preparing, prioritising, providing and maintaining standards, identifying and utilising resources, identifying option, balancing risks/selecting options, re-evaluating, coordinating activities, exchanging information, using authority and assertiveness, assessing capabilities and supporting others. The primary aim of our study was to identify the key ANTS needed for SRs to practise with distant supervision (i.e. the specialist is not on site but available for consult and call back).
We found that the four most highly ranked ANTS identified for distant supervision were anticipating, prioritising, balancing risks and options and exchanging information.
Faculty, nurses, and residents of SHARP were invited to participate in an online survey to identify the key ANTS as outlined in our study aim. Survey participants were subsequently invited to a Focus Group Discussion. We found that the four most highly ranked ANTS identified for distant supervision were anticipating, prioritising, balancing risks and options and exchanging information. Other skills identified beyond the ANTS framework included assertive leadership, stress, and conflict management. Role modelling was also important for learning ANTS. Hierarchy and culture can influence its practice.
This is the first qualitative research project that my team and I have undertaken. We not only learnt about qualitative research and how to conduct a qualitative research project, but the rich information gathered enabled us to identify and close the gaps in the residency curriculum to better prepare junior residents to assume a SR call role. This project has also taught me the value of academic medicine, i.e. how research, education and clinical care are intricately related to achieve better patient care and outcomes.
PI: Sharon Ong
Team members: Tan Li Hoon, Evangeline Lim, Tay Sook Muay, Chong Shin Yuet, Adeline Leong, Wong Loong Tat, Dong Chao Yan.