Training of Technical Versus Non-Technical Skills – a Randomised Study of what a German Paramedic Needs

Abstract

Background The working environment of pre-hospital emergency medicine represents the framework conditions of high-risk organisations. Non-technical skills are an important foundation for successful performance. In Germany, a new job profile - advanced paramedic - was introduced in 2014, which for the first time also recognized non-technical skills in the curriculum. Another special feature is that for the first time it is regulated how non-physicians proceed with selected extended procedures, such as the application of selected medication. The advanced paramedic has a mandatory annual training requirement of 30 hours. Since there are no requirements in terms of content, we investigated whether training of non-technical or technical skills improve the care of a simulated patient. The results should indicate which priorities should be set in training. Methods Teams were randomised while training and debriefing took place depending on the study arm with a focus on technical procedures and non-technical skills. Six months later, we evaluated the performance of the teams in a simulation scenario using “time key item product” score and the use of incident management methods. Results Comparing performance with CRM and technical training, we found no significant difference in TKIP-Score. There was also no difference in the application of incident management methods. Checklists were only used in small numbers. Over half of the teams failed to complete 75% of the required procedures in the scenario. Conclusion It is noticeable that only a few groups carried out all required procedures. Checklists in particular can help. The application of incident management methods should be trained intensively, as their use does not yet appear to be routine. Trial Registration As the study does not include data on real patients, it was not registered with "trial Registration"