Table 2 Categorisation, descriptions and limitations of pre-existing taxonomies and frameworks relevant to acute care

Behavioural marker systems

“Observable, non-technical behaviours that contribute to superior or substandard performance within a work environment” [6] which have been sub-divided according to the research-derived categories relevant to a particular context and professional group [7-10].

a) Developed and validated for use within a particular context e.g. The Oxford Non-Technical Skills scale [11] is used in theatre where the challenges clearly differ substantially from those encountered when dealing with a life-threatening situation in a general ward.

b) Previous studies [12,13] indicate that there are deficits relating to knowledge base and technical skills which need to be identified, in addition to the non-technical skills addressed by behavioural marking systems.

Scenario checklists

Lists of actions or behaviours (often specific clinical tasks) relevant to an individual clinical scenario [14-16].

Most checklists developed for acute care scenarios include aspects of timed assessment (such as time taken to assess airway, breathing and circulation) [16-18] giving numerical values that primarily reveal the consequences and not the causes of error.

Resuscitation competencies

Structured resuscitation courses [19,20] use lists of competencies that have often been developed using a modified Delphi process or similar technique [20].

a) Scenario-specificity combined with granular detail make competency lists unsuitable for this study.

b) Previous work indicates that whilst technical skills are a source of concern for both junior doctors and their educational supervisors, non-technical skills such as decision-making, initiative and prioritisation are also felt to be important [21].