A novel use of the anesthetists' non-technical skills (ants) instrument to measure congruence of graduate nurse anesthesia student self-evaluation and faculty evaluation
Diehl, Margaret Roseann
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The purpose of this study was to determine if a correlation existed between faculty evaluation of students NTS and student self-evaluation of NTS after a simulated anesthesia scenario using the ANTS tool. This protocol also explored written perceptions of students and faculty using the ANTS tool. Thirty senior graduate nurse anesthesia students individually participated in a high fidelity simulated anesthesia scenario that also included 3-4 live actors. Post-simulation each student self-evaluated NTS performance using the ANTS tool and this evaluation was compared to faculty evaluation of student performance using the ANTS tool. Written perceptions regarding using the ANTS tool were collected from students and faculty and transcribed verbatim. Data sources included demographic data, ANTS tool numeric score data from both faculty and participants, and written comments from both faculty and participants using the ANTS tool. Significant correlation between participant and faculty ratings was found in one ANTS tool category, “Situation Awareness.” Two elemental variables also showed significant correlations, anticipating in the “Situation Awareness” category and re-evaluating in the “Decision-Making” category. Three major themes emerged from these comments by students and faculty: adapting to changes, challenges in communicating, and hypervigilance. Participant subthemes emerged within the themes adapting to changes (feeling rushed) and challenges in communicating (feeling alone). Other themes were identified unique to participant comments (uncertainty) and faculty comments (seeing the big picture). Comparing student ANTS tool self evaluation to faculty evaluation of students’ simulated performance re-affirmed that students do not have accurate insight into their own clinical performance and need faculty input. This study re-confirmed that hypervigilance exists and is a natural part of learning in simulation. This study also revealed that students need more practice in communication using dynamic simulated scenarios. These scenarios brought out that students feel alone and use the surgical drape as a physical and emotional barrier. The ANTS tool should be investigated further using high fidelity simulation and could be useful in evaluating clinical NTS performance in the clinical milieu.