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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Pregnancy and Childbirth 1/2017

Adaptation of non-technical skills behavioural markers for delivery room simulation

BMC Pregnancy and Childbirth > Ausgabe 1/2017
Fabrizio Bracco, Michele Masini, Gabriele De Tonetti, Francesca Brogioni, Arianna Amidani, Sara Monichino, Alessandra Maltoni, Andrea Dato, Claudia Grattarola, Massimo Cordone, Giancarlo Torre, Claudio Launo, Carlo Chiorri, Danilo Celleno
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12884-017-1274-z) contains supplementary material, which is available to authorized users.



Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room).


The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected.


The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories.


The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.
Additional file 1: NTS Team Behavioural markers observation form for the team performance in the delivery room. (PDF 170 kb)
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