Development of an astronaut crew behavioral skills taxonomy for medical event management on future long duration exploration missions

Unexpected medical events during long-duration space missions may significantly impact crew health and compromise mission success. Significant factors impacting the outcome of medical events include limited options for premature return to Earth and mission designs scenarios that include delayed communication with ground control. The high acuity, low frequency nature of medical events in spaceflight mirror those occurring in terrestrial surgical environments. Non-technical skills (NTS), including situation awareness, leadership and team coordination, have been shown to increase patient safety and improve outcomes. NTS are behavioural skills; theorized to act through the reduction of performance errors and unexpected events. This study described an approach to developing a NTS taxonomy and behavioural marker system to support medical event management during future long duration exploration missions. This program is comprised of several stages, beginning with an expert panel prioritizing nontechnical skills and medical conditions for simulation and scenario design. A spacecraft themed simulator was designed, constructed and used to simulate and film medical events deemed most likely to occur in spaceflight. The overarching goal is to create a simulation-based training program for astronauts on long duration space missions, improve outcomes in spaceflight medical events, and reduce the overall health risk on long duration exploration missions.