{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T12:09:31Z","timestamp":1765195771315,"version":"3.46.0"},"reference-count":43,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2025,6,23]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Anaesthesiologists\u2019 Non-Technical Skills in Denmark Form (ANTSdk) is a widely accepted, practical, and comprehensive measurement tool used by anaesthesiologists and other healthcare professionals. This study aims to adapt the ANTSdk into Turkish as a valid and reliable assessment instrument. By doing so, it will contribute to establishing a common language and standardised terminology for integrating non-technical skills into the Turkish healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a standardised cross-cultural adaptation process. The psychometric properties of the Turkish-adapted version of the ANTSdk were evaluated through observations of 81 real paediatric surgical operating room teams, assessed simultaneously by two independent observers. Validity was examined using content validity analysis and confirmatory factor analysis. Internal consistency and inter-rater reliability of the Turkish version of ANTSdk (ANTStr) were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The specified factorial model retained the same grouping of elements into four domains as in the original version of ANTSdk. All standardised factor loadings were greater than 0.3. The inter-rater reliability, measured by the intraclass correlation coefficient of the global score, was 0.98. The Cronbach\u2019s alpha coefficient for the scores provided by the first rater ranged from 0.83 to 0.94, while for the second rater, it ranged from 0.84 to 0.94. The generalisability coefficient calculated for ANTStr was exceptionally high at 0.96.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Turkish version of ANTSdk demonstrates strong psychometric properties for evaluating paediatric surgical team performance in the operating room. This translated instrument can be used to assess non-technical skills in paediatric surgical teams within real clinical settings, facilitating benchmarking and international collaboration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjoq-2024-003249","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T03:45:18Z","timestamp":1752464718000},"page":"e003249","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Anaesthesiologists\u2019 Non-Technical Skills in Denmark Form: cross-cultural adaptation, reliability and validity of Turkish version in paediatric surgery team"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0586-994X","authenticated-orcid":false,"given":"Nazmiye","family":"Celik","sequence":"first","affiliation":[{"name":"Medical Education and Informatics, Hacettepe University Faculty of Medicine, Ankara, Turkey"},{"name":"Anesthesiology and Reanimation, Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senay","family":"Sarmasoglu Kilikcier","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Nursing, Mudanya University, Bursa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulsen","family":"Tasdelen Teker","sequence":"additional","affiliation":[{"name":"Medical Education and Informatics, Hacettepe University Faculty of Medicine, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulsen","family":"Keskin","sequence":"additional","affiliation":[{"name":"Anesthesia and Reanimation, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mine","family":"Ak\u0131n","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation, Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sengul","family":"Ozmert","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation, Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melih","family":"Elcin","sequence":"additional","affiliation":[{"name":"Interprofessional Education School of Health Sciences, Springfield College, Springfield, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emrah","family":"Senel","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"2025120804051568000_14.3.e003249.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2018-008260"},{"key":"2025120804051568000_14.3.e003249.2","doi-asserted-by":"crossref","unstructured":"Flin R , O\u2019Conner P . Safety at the sharp end: a guide to non- technical skills. Burlington, VT: CRC Press, 2008. Available: https:\/\/doi.org\/10.1201\/9781315607467","DOI":"10.1201\/9781315607467"},{"key":"2025120804051568000_14.3.e003249.3","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/88.3.418"},{"key":"2025120804051568000_14.3.e003249.4","first-page":"256","article-title":"A literature review exploring common factors contributing to Never Events in surgery","volume":"30","author":"Koleva","year":"2020","journal-title":"J Perioper Pract"},{"key":"2025120804051568000_14.3.e003249.5","doi-asserted-by":"crossref","unstructured":"Donaldson L , Ricciardi W , Sheridan S , et al . Textbook of patient safety and clinical risk management. 2021. Available: https:\/\/library.oapen.org\/handle\/20.500.12657\/46117","DOI":"10.1007\/978-3-030-59403-9"},{"key":"2025120804051568000_14.3.e003249.6","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12709"},{"key":"2025120804051568000_14.3.e003249.7","doi-asserted-by":"crossref","first-page":"S131","DOI":"10.1016\/j.jviscsurg.2020.03.001","article-title":"Learning non-technical skills in surgery","volume":"157","author":"Allard","year":"2020","journal-title":"J Visc Surg"},{"key":"2025120804051568000_14.3.e003249.8","doi-asserted-by":"crossref","first-page":"106583","DOI":"10.1016\/j.nedt.2025.106583","article-title":"Crisis management in the operating room: A systematic review of simulation training to develop non-technical skills","volume":"147","author":"Redjem","year":"2025","journal-title":"Nurse Educ Today"},{"key":"2025120804051568000_14.3.e003249.9","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jss.2019.10.012","article-title":"Observational Tools That Quantify Nontechnical Skills in the Operating Room: A Systematic Review","volume":"247","author":"McMullan","year":"2020","journal-title":"J Surg Res"},{"key":"2025120804051568000_14.3.e003249.10","doi-asserted-by":"publisher","DOI":"10.1518\/001872008X375009"},{"key":"2025120804051568000_14.3.e003249.11","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2012-131168"},{"key":"2025120804051568000_14.3.e003249.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9346-1"},{"key":"2025120804051568000_14.3.e003249.13","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013678","article-title":"Do failures in non-technical skills contribute to fatal medical accidents in Japan? A review of the 2010-2013 national accident reports","volume":"7","author":"Uramatsu","year":"2017","journal-title":"BMJ Open"},{"key":"2025120804051568000_14.3.e003249.14","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes125"},{"key":"2025120804051568000_14.3.e003249.15","unstructured":"Wiener EL , Kanki BG , Helmreich RL . Cockpit resource management. San Diego, CA: Academic Press, 1993."},{"key":"2025120804051568000_14.3.e003249.16","doi-asserted-by":"crossref","unstructured":"Kanki B , Helmreich RL , Anca J , eds. Crew resource management. San Diego, CA: Elsevier, 2010.","DOI":"10.1016\/B978-0-12-374946-8.10004-4"},{"key":"2025120804051568000_14.3.e003249.17","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/00000542-198809000-00017","article-title":"A comprehensive anesthesia simulation environment: re-creating the operating room for research and training","volume":"69","author":"Gaba David","year":"1998","journal-title":"Anesthesiology"},{"key":"2025120804051568000_14.3.e003249.18","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10111-014-0306-y","article-title":"Development of instruments for assessment of individuals\u2019 and teams\u2019 non-technical skills in healthcare: a critical review","volume":"17","author":"Jepsen","year":"2015","journal-title":"Cogn Tech Work"},{"key":"2025120804051568000_14.3.e003249.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2018-008712"},{"key":"2025120804051568000_14.3.e003249.20","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s10111-004-0158-y","article-title":"Rating non-technical skills: developing a behavioural marker system for use in anaesthesia","volume":"6","author":"Fletcher","year":"2004","journal-title":"Cognit Technol Work"},{"key":"2025120804051568000_14.3.e003249.21","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg112"},{"key":"2025120804051568000_14.3.e003249.22","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000229877.45125.CC"},{"key":"2025120804051568000_14.3.e003249.23","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31802b68ee"},{"key":"2025120804051568000_14.3.e003249.24","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2007.024760"},{"key":"2025120804051568000_14.3.e003249.25","doi-asserted-by":"publisher","DOI":"10.5116\/ijme.54be.8f08"},{"key":"2025120804051568000_14.3.e003249.26","doi-asserted-by":"crossref","first-page":"111008","DOI":"10.1016\/j.jclinane.2022.111008","article-title":"Cross-cultural adaptation and validation of the Spanish version of the Anesthetists\u2019 Non-Technical Skills (ANTS) assessment tool","volume":"84","author":"Delfino","year":"2023","journal-title":"J Clin Anesth"},{"key":"2025120804051568000_14.3.e003249.27","unstructured":"Copenhagen Academy for Medical Education and Simulation . Anaesthesiologists\u2019 non-technical skills i\u0307n Denmark (ANTSdk). n.d. Available: https:\/\/www.regionh.dk\/CAMES\/Forskning\/Showcases\/Documents\/160224%20ANTSdk%20info%20UK%20word%20version%202.2.pdf"},{"key":"2025120804051568000_14.3.e003249.28","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12939"},{"key":"2025120804051568000_14.3.e003249.29","doi-asserted-by":"crossref","unstructured":"Demir M . Determination of operating room nurses\u2019 use of non-technical skills . Istanbul Ac\u0131badem University, 2014 doi:10.31067\/acusaglik.847345","DOI":"10.31067\/acusaglik.847345"},{"key":"2025120804051568000_14.3.e003249.30","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1016\/j.burns.2021.11.014","article-title":"Impact of interprofessional in situ simulations on acute pediatric burn management: Combining technical and non-technical burn team skills","volume":"48","author":"Sarmasoglu Kilikcier","year":"2022","journal-title":"Burns"},{"key":"2025120804051568000_14.3.e003249.31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2007.01064.x"},{"key":"2025120804051568000_14.3.e003249.32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6570.1975.tb01393.x"},{"key":"2025120804051568000_14.3.e003249.33","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-10-82","article-title":"Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) checklist","volume":"10","author":"Mokkink","year":"2010","journal-title":"BMC Med Res Methodol"},{"key":"2025120804051568000_14.3.e003249.34","first-page":"67","article-title":"A method for quantifying content validity of health-related questionnaires","volume":"21","author":"Veneziano","year":"1997","journal-title":"Am J Health Behav"},{"key":"2025120804051568000_14.3.e003249.35","unstructured":"American Educational Research Association, American Psychological Association, National Council on Measurement in Education . Standards for educational and psychological testing. Washington, DC American Educational Research Association; 2014. Available: https:\/\/www.testingstandards.net\/uploads\/7\/6\/6\/4\/76643089\/standards_2014edition.pdf"},{"key":"2025120804051568000_14.3.e003249.36","unstructured":"Tabachnick BG , Fidell LS . Using multivariate statistics. 6th edn. 2013."},{"key":"2025120804051568000_14.3.e003249.37","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2923.2002.01320.x"},{"key":"2025120804051568000_14.3.e003249.38","unstructured":"G\u00fcler N . Generalizability Theory and Comparison of the Results of G and D Studies Computed by SPSS and GENOVA Packet Programs. Education and Science 2009;34."},{"key":"2025120804051568000_14.3.e003249.39","doi-asserted-by":"publisher","DOI":"10.1097\/01.nmd.0000230392.83607.c5"},{"key":"2025120804051568000_14.3.e003249.40","unstructured":"Kline RB . Principles and practice of structural equation modeling. New York: The Guilford Press, 2011."},{"key":"2025120804051568000_14.3.e003249.41","first-page":"1","article-title":"Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis","volume":"10","author":"Costello","year":"2005","journal-title":"Practical Assessment Research & Evaluation"},{"key":"2025120804051568000_14.3.e003249.42","unstructured":"Klampfer B , Flin R , Helmreich RL , et al . Enhancing performance in high risk environments: recommendations for the use of behavioural markers. Ladenburg Daimler-Benz Shiftung; 2001. Available: https:\/\/www.raes-hfg.com\/reports\/notechs-swiss.pdf"},{"key":"2025120804051568000_14.3.e003249.43","first-page":"1629","article-title":"Comparison of the Results of the Generalizability Theory with the Inter-Rater Agreement Coefficients","volume":"14","author":"Eser","year":"2022","journal-title":"International Journal of Curriculum and Instruction"}],"container-title":["BMJ Open Quality"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjoq-2024-003249","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T12:05:27Z","timestamp":1765195527000},"score":1,"resource":{"primary":{"URL":"https:\/\/qir.bmj.com\/lookup\/doi\/10.1136\/bmjoq-2024-003249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,7,13]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bmjoq-2024-003249"],"URL":"https:\/\/doi.org\/10.1136\/bmjoq-2024-003249","relation":{},"ISSN":["2399-6641"],"issn-type":[{"type":"electronic","value":"2399-6641"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}