Pilot Study for Assessing Nontechnical Skills in Emergency Medicine Residents: Why We Should C.A.R.E.

Article Figures & Data

Table 1.

Rating Percentages by Domain

Domain	Acceptable, n (%)	Unacceptable, n (%)	Not Applicable, n (%)
Connect
Attentiveness	105 (95.5)	5 (4.5)	0 (0.0)
Speaking appropriately	97 (89.0)	12 (11.0)	1 (0.9)
Customized conversations	73 (68.9)	33 (31.1)	4 (3.6)
Adjust
Delivery of information	94 (87.9)	13 (12.1)	3 (2.7)
Ensures understanding	100 (94.3)	6 (5.7)	4 (3.6)
Resolve
Patient requests owned with urgency	78 (92.9)	6 (7.1)	26 (23.6)
Empathize
Demonstrates respect and empathy	108 (98.2)	2 (1.8)	0 (0.0)

Note: The not-applicable data were not used to calculate the percentages shown for acceptable and unacceptable ratings. Those percentages were calculated by dividing the number of acceptable (or unacceptable) ratings by the sum of acceptable and unacceptable ratings. The percentages shown in the not-applicable column are based on the denominator of 110 (total number of ratings).

Table 2.

Comments on Unacceptable and Acceptable Behaviors by Domain

Domain	Unacceptable Behavior	Acceptable Behavior
Connect	TV was on and volume was up. This was distracting.	Did well to accommodate the patient's hearing difficulty. Got down to her level.
	Calls pt “bud.”	Dr XXX got close to patient, leaning down to pt level. Recognized the pt was uncomfortable and adjusted bed.
	Called the patient darling, dear, and sweetie.
	There was a family member in the room who was never addressed.
Adjust	Medical jargon used for medications and explanation of procedure.	Well explained after the mother asked question when she didn’t understand.
	Never asked if patient had questions or understanding.	Used “butt” and “belly” to improve patient understanding.
	Did not explain next steps or confirm understanding.	Asked if any questions.
Resolve	Did not explain why NGT was in place and what was needed before it could be removed when patient asked.	This was a patient transfer for admission that likely didn’t need to be admitted. The resident did a good job of not making the patient feel bad about being there.
	Pt requesting sedative. Resident does not address.	Pt was upset about not getting pain meds and the resident took ownership and followed up with nurse.
Empathize		Held hand during IV start.
		Excellent–wiped wound dry.