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Reliability of the assessment of non-technical skills by using video-recorded trauma resuscitations

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Purpose Non-technical skills have gained attention, since enhancement of these skills is presumed to improve the process
of trauma resuscitation. However, the reliability of assessing non-technical skills is underexposed, especially when using
video analysis. Therefore, our primary aim was to assess the reliability of the Trauma Non-Technical Skills (T-NOTECHS)
tool by video analysis. Secondarily, we investigated to what extent reliability increased when the T-NOTECHS was assessed
by three assessors [average intra-class correlation (ICC)] instead of one (individual ICC).
Methods As calculated by a pre-study power analysis, 18 videos were reviewed by three research assistants using the
T-NOTECHS tool. Average and individual degree of agreement of the assessors was calculated using a two-way mixed
model ICC.
Results Average ICC was ‘excellent’ for the overall score and all five domains. Individual ICC was classified as ‘excellent’
for the overall score. Of the five domains, only one was classified as ‘excellent’, two as ‘good’ and two were even only ‘fair’.
Conclusions Assessment of non-technical skills using the T-NOTECHS is reliable using video analysis and has an excellent
reliability for the overall T-NOTECHS score. Assessment by three raters further improve the reliability, resulting in an
excellent reliability for all individual domains.


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