Cross-cultural adaptation and validation of the Spanish version of the Anesthetists' Non-Technical Skills (ANTS) assessment tool.

STUDY OBJECTIVE: Establish the transcultural validity of Anesthetists Non-Technical Skills (ANTS) in a Spanish-speaking country. DESIGN: Prospective cohort. SETTING: Clinical simulation center. SUBJECTS: Forty-two Anesthesia PY2 and PY3 residents participated in the study. INTERVENTIONS: Four clinical scenarios simulating anesthesia crises were assessed with a Spanish version of ANTS. Every simulated scenario was run twice with a time span of 3 to 4 months between them. MEASUREMENTS: Two anesthesiologists independently assessed all simulated sessions using ANTS. The ANTS indicators of construct validity were obtained by confirmatory factor analysis. Various goodness-of-fit indices of the factorial model were calculated: Comparative Fit Index (CFI); Tucker-Lewis Adjustment Index (TLI) and Root Mean Square Error of Approximation (RMSEA). The standardized factor loadings and the determination coefficient (R2) was also estimated. MAIN RESULTS: A total of 212 clinical scenarios were analyzed. The specified factorial model had the same grouping of elements in four domains as the original version of ANTS. The CFI index and the TLI were 0.99 and the RMSEA reached 0.07 (95% CI 0.06-0.08). All the standardized factor loadings were found to be >0.4. Also, the elements obtained an R2 value that fluctuated between 0.54 and 0.92. CONCLUSIONS: The Spanish version of ANTS is a valid, reliable and a useful tool to assess non-technical skills in Spanish-speaking countries. The applicability of the instrument was comparable to the original setting. The high reliability of ANTS in our setting allows us to propose its use not just in an educational and research setting; it can be used as an assessment tool of non-technical skills.

Construction and validation of questionnaire to assess recreational noise exposure in university students.

Recreational noise exposure and its impact on hearing is a problem to which increasing attention is being paid. In Spanish, it is necessary to have a reliable and valid instrument that is capable of describing the extent of noise exposure. The aim was to create and validate an instrument to determine listening habits and levels of recreational noise exposure in young people. We performed a transversal questionnaire validation study using university students. We assessed the validity of the content and appearance of the "Recreational Hearing Habits Questionnaire" (CHAR in Spanish) through experts' judgment. Then we piloted the administration of semantic adaptation with 30 students. Finally, the instrument was applied to 335 Chilean university students, obtaining with these indicators that demonstrated convergent validity of the construct, criterion and reliability. We used exploratory and confirmatory factor analysis, as well as correlation and agreement tests. It was confirmed that 14 questions in the questionnaire have a good item-test correlation, having also a factorial structure that indicates the existence of three-dimensions. The questionnaire has good internal consistency and convergent validity with the Noise Exposure Questionnaire. In addition, the score obtained in the CHAR is a predictor of the presence of notch at frequencies of 4 kHz in the right ear and 6 kHz in the left. The CHAR is useful for determining listening habits and thereby recreational noise exposure, indicating good psychometric properties.