June 12, 2024By Erin Carn Bennett

Building Non-Technical Skills into Clinical Simulation Team Training

Non-technical skills are a huge focus of team-based healthcare simulation scenarios. Clinical skills are of huge importance to successful outcomes of patients. However, patient outcomes can be hugely impacted without successful and adequate non-technical skills that hone team performance to maximum capabilities. Comparison of healthcare to professional sports teams in regards to practice time spent (clinical simulation) to game time (real-life critical event) is much reduced, yet the stakes are so much higher. This article by Erin Carn-Bennett, MSN, RN, will consider non-technical skills that relate to teamwork that can be prioritized to improve team function. Clinical simulation practice time that healthcare teams are allocated is incredibly precious. A focus on non-technical skills can ensure that this precious time has more of a chance to translate into improved patient outcomes.

Non-Technical Skills in Relation to Human Factors and Ergonomics

Human factors and ergonomics are terms used interchangeably, which also relate to the term non-technical skills for team members of a healthcare team. Ergonomics in healthcare is described as the physical aspects of the environment in the clinical or clinical simulation-based space. Human factors are more comprehensive systems that impact how people work or don’t work within a clinical environment as a team, which impacts patient care and outcomes. Non-technical skills is another umbrella term within these definitions, which will be used to describe skills that can be incorporated into clinical simulation to improve team and patient outcomes.


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Clinical simulation scenarios, which are multidisciplinary and incorporate team members who attend actual life events, are the perfect place to infuse non-technical skills into educational outcomes. Civility among healthcare teams has demonstrated improvement in patient safety. Some of these non-technical skills include interpersonal skills such as communication, leadership, teamwork, and decision-making under pressure. These non-technical skills are an excellent basis for all foundational elements of clinical simulation educational objectives in relation to teamwork, particularly in a multidisciplinary team clinical simulation scenario.


View the LEARN CE/CME Platform Webinar SOS Help! A Guide to Healthcare Simulation Operations for Non-Technical Clinical Professionals to learn more!


Non Technical Leadership Skills are Great to Practice

Situational awareness skills-perception is incredibly important, particularly for leaders, and this can be taught by being a hands-off leader. The tendency is for leaders of critical events to get drawn into clinical skills for completion, particularly if the skill mix is low within the multidisciplinary team present. Intentionally not placing any hands on the patient as a leader can be a useful non-technical skill to infuse into leaders. Clinical simulation is a perfect environment for new leaders to practice and hone these non-technical skills.


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Communication skills that can be infused into multidisciplinary team-based scenarios include regular updates (or recaps), how to minimize disruptions with silence, encouragement of psychological safety as a leader, and to encourage team members to speak up for safety with any concerns. Clinical simulation is a great place for staff to practice in a critical event the use of name tags and the use of each other’s names when assigning clinical skills to one another. In a critical event, the ability to communicate and be assertive yet empowering for all team members is a skill that requires practice. Clinical simulation scenarios are the perfect place to spend time on these skills.

Interpersonal and Communication Skills can Be Taught as Non-Technical Skills

Interpersonal skills that promote patient and environmental safety and also complement clinical skills should be encouraged in clinical simulation. These skills can also be used to be transferred into real-life events as well. These skills may be as subtle as the practice to speak up when unable to find a piece of equipment under pressure or not being confident to perform a clinical skill due to lack of experience. These skills seem easy, but under pressure, particularly with any hierarchy at play can be more difficult for clinical staff to speak up when this matters.

A leader of a critical event should not feel alone in decision-making under pressure. Shared decision-making and communication skills that surround this are ideal to practice within a clinical simulation scenario environment. These non-technical skills can be emphasized in clinical simulation with skills such as to ask for input from other team members after regular updates. The invitation for others’ input can help with the cognitive overload of all team members and improve patient outcomes with non-technical skills practiced in clinical simulation.



Stress management can be practiced through non-technical skills awareness in clinical simulation. For example, awareness of body language and the use of a hands-off leader can assist to pick up staff who are stressed and struggling to perform clinical skills that have been tasked. An awareness of the whole critical event and the body language of others can be useful in the consideration of reassignment of roles or redelegation of resources to expedite patient care and team effectiveness. Understanding team strengths and limitations and constantly reevaluating these within an event is another essential non-technical skill that can be practiced within clinical simulation scenarios.

Human factors and ergonomics are disciplines on their own and are a specialty with certification and degrees available within these specializations. However, despite being incredibly specialized, these specialties are foundational to all team-based clinical simulation scenarios. As clinical simulationists, clinicians, and healthcare team members, there should be a constant desire to radically improve non-technical skills even when clinical skills aren’t as optimal as desired. Non-technical skills can ensure a great patient outcome with a lower skill mixed clinical team.

Non-technical skills are improved, honed, and perfected through regular and deliberate practice. Clinical simulation is the perfect educational modality for teams to practice and focus on non-technical skills in critical events. Leadership and non-technical skills can be learned that relate to clinical practice, even if some individuals are not as confident in these skills. Clinical simulation is the perfect environment for the learner who is not confident in non-technical skills to practice, learn, and advance these skills.

This article has looked at non-technical skills that can be intentionally focused on, practiced, and improved in team-based clinical simulation scenarios. Non-technical skills is another umbrella term that relates to human factors and ergonomics. Interpersonal, communication, and leadership skills are incredibly important skills that can be taught within the clinical simulation. For even the most reserved clinical simulation participant, non-technical skills to enhance teamwork can be taught and refined in the clinical simulation environment.

Learn More About How Clinical Simulation Helps Strengthen Soft Skills!


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