Evaluation of the SPLINTS system for scrub practitioners’ non-technical skills

Background: The Scrub Practitioners’ List of Intraoperative NonTechnical Skills (SPLINTS) system is a new tool for training and assessing scrub practitioner behaviours during surgical operations. Method: Experienced scrub practitioners (n = 34) attended a single day session where they received background training in human factors and nontechnical skills and were trained to use the SPLINTS system. They then rated the scrub practitioners’ nontechnical skill performance in seven videorecorded simulated scenarios and completed a posttraining questionnaire. Results: Withingroup agreement for all three skill categories, and for six of the nine elements, was acceptable ( r wg >.70). Participants could use SPLINTS to accurately score performance compared with expert ratings and were within one scale point of expert ratings in > 90% of skill categories and elements. There was good internal consistency between elements and their categories ( M <.2 of a scale point) and participants reported that the system was complete. Conclusion: The SPLINTS system was deemed adequately reliable, for rating scrub practitioners’ nontechnical skills, using standardized filmed scenarios. Usability of the SPLINTS system in the real operating theatre environment is still to be assessed.