Nature of medical leader non technical skills during the management of wounded people massive influx : a study from trainers perspective ; Nature des compétences non techniques du leader médical à la prise en charge d’afflux massif de victimes : une étude à partir du point de vue des formateurs

The high-risk dynamic environments management (transports, nuclear industry, medicine etc.) increases every day in our societies. A good management of these environments requires the reliability of technical and organization systems. It also requires the training of operators in non-technical skills. This thesis is focused on this last point. In the literature, the non-technical skills concept stays unclear.This works examines this concept, based on the training situations of medical leaders from the Army Health Service to wounded people massive influx in theatre operation. We adopt the point of view from trainers when they are analyzing activity of leaders.In a first part (Chap. I, II & III), we describe the training of the French army physicians and the current stakes and tools of the wounded people massive influx management training. This part also describes current non-technical skills training and trainer roles. The theoretical part describes works around non-technical skills, from its origins to its diffusion in various areas (Chap. IV & V). We describe the current NTS taxonomies which are mainly based on a divided into seven NTS categories: leadership, teamworking, communication, situation awareness, decision making, coping with fatigue and managing stress. Then, we characterize the activity of medical leader (Chap. VI). This theoretical part lead us to consider non-technical skills as technical or non-technical abilities (Chap. VII) and is conclude with the formulation of our research questions (Chap. VIII).The empirical part of this thesis starts with the elaboration of a corpus (Chap. IX) listing all the abilities linked to the leader performance. The construction of this corpus is based on twenty individual alloconfrontation interviews conducted with physician-trainers. Ten of them classified the abilities into three classes: technical (T), non-technical (NT), technical and non-technical (T-NT).The first study (Chap. X) analyses trainer classification. It shows the importance of NT class and ...