Clinical use of the revised Japanese SPLINTS: A pilot evaluation of non-technical skills in scrub practitioners

BACKGROUND: Non-technical skills are important for perioperative patient safety. The Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) system provides a structured framework for observing scrub practitioners' non-technical skills, but its clinical application in Japan remains limited. OBJECTIVE: To evaluate the clinical feasibility and preliminary reliability of the revised Japanese Scrub Practitioners' List of Intraoperative Non-Technical Skills in actual operating room practice. METHODS: Seven Certified Nurses in Perioperative Nursing used the revised Japanese Scrub Practitioners' List of Intraoperative Non-Technical Skills to observe and rate 18 scrub nurses. Clinical observability, internal consistency, and exploratory correlations among the three Scrub Practitioners' List of Intraoperative Non-Technical Skills categories were examined. RESULTS: Cronbach's alpha was 0.967 for Situation Awareness, 0.963 for Communication and Teamwork, and 0.949 for Task Management. Some behaviours received not-rated responses, suggesting that observability may depend on the surgical context. Correlations among the three categories were positive (ρ = 0.47-0.81). CONCLUSIONS: The revised Japanese Scrub Practitioners' List of Intraoperative Non-Technical Skills supported structured observation of non-technical skills in actual surgical practice. These preliminary findings support further evaluation and practical implementation in Japanese perioperative settings.