Non-technical skills for anaesthetists: developing and applying ANTS.

This article examines the non-technical skills approach to enhancing operational safety, with particular reference to anaesthesia. Training and assessing the non-technical skills of staff in safety-critical occupations is accepted by high-risk industries, most notably aviation, but has only recently been adopted in health care. These authors explain the background to the concept of non-technical skills that was first adopted in relation to the behaviours of airline pilots and could enhance or jeopardise safety. Then, this article considers one particular non-technical skills framework for doctors, the Anaesthetists' Non-Technical Skills (ANTS) taxonomy and behaviour-rating tool. This was the first non-technical skills framework specifically designed for anaesthetists, and the authors explain how ANTS was designed as well as its use for selection, training and assessment. Finally, the article mentions similar tools available for surgeons (NOTSS) and scrub nurses (SPLINTS), as well as research activities to develop behavioural rating systems for obstetric anaesthetists and anaesthetic assistants.