Reliability of Three Non-Technical Skills Assessment Instruments in Video-Recorded High-Fidelity Simulations of Canine Cardiopulmonary Resuscitation

High-quality cardiopulmonary resuscitation (CPR) is dependent on individual and team competency. Historically, CPR training has focused on technical skills, but recognition of the importance of non-technical skills (NTS) is increasing. No veterinary-specific instruments for evaluation of NTS exist, and the utility of human medical instruments is unknown. The aim of this study was to assess the potential utility and reliability of the Anaesthetists' Non-Technical Skills (ANTS), Ottawa Crisis Resource Management Global Rating Scale (OGRS), and Trauma Non-Technical Skills (T-NOTECHS) instruments in simulated canine CPR. Three investigators reviewed seven video recordings of high-fidelity canine CPR simulations and assessed NTS using the three instruments. Average and individual degree of agreement of the raters was calculated for overall and for individual domain scores using a two-way random model intra-class correlation coefficient (ICC). Overall reliability based on average- and single-measures ICC was good to excellent for ANTS (0.803 and 0.925), moderate to good for OGRS (0.726 and 0.888), and moderate to good for T-NOTECHS (0.716 and 0.883). Poor to moderate agreement (ICC<0.75) was observed for several individual domains of all instruments. The assessment of overall NTS in video recordings of simulated canine CPR by ANTS, OGRS, and T-NOTECHS had sufficient reliability when used by three raters. More extensive, standardized user training or the development of veterinary-specific domain anchor points might be required to improve the inter-rater reliability and utility of the instruments in assessing specific NTS domains.