How to ‘10-for-10’: a qualitative research protocol to determine best practice use of the 10-for-10 principle
- 1Berlin Simulation and Training Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
- 2Charite Universitatsmedizin Klinik fur Anasthesiologie mit Schwerpunkt Operative Intensivmedizin Campus Virchow-Klinikum, Berlin, Germany
- 3Department of Anaesthesia and Pain Medicine, Counties Manukau Health, Auckland, New Zealand
Abstract
Introduction Critical situations in clinical medicine are associated with high cognitive load, time pressure and an increased risk to patient safety. Crisis Resource Management aims to address these challenges through skills such as communication, situational awareness, task management, team performance and decision-making. The ‘10-for-10 principle’, which encourages clinicians to pause briefly to reassess and plan ahead, is widely taught in simulation-based training and applied in clinical practice throughout German-speaking countries. Despite its widespread use, the principle lacks a clear scientific definition and has not been systematically investigated. This study aims to develop an empirically informed conceptual understanding of this principle based on expert perspectives as an early exploration, a foundation for future research and educational model development.Methods and analysis This qualitative study will use 15–20 semistructured expert interviews to explore current applications, variations, structural components and perceived barriers related to the 10-for-10 principle, aiming to provide an early exploration of the principle across German-speaking countries. Participants will be purposively sampled from clinical and simulation-based education contexts. Data collection and analysis will be conducted concurrently using the iterative content-structuring qualitative approach as described by Kuckartz and Rädiker. Deductive codes derived from existing conceptual descriptions will be combined with inductively developed codes informed by expert narratives to identify core categories across interviews. Findings will be synthesised into a taxonomy organised by expert-perceived relevance and frequency of reference.Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Charité—Universitätsmedizin Berlin (EA 1/093/25). Written informed consent will be obtained from all participants. Data will be pseudonymised and handled in accordance with institutional and data protection regulations. Study findings will be disseminated through peer-reviewed publication and conference presentations and are intended to inform future empirical research and the development of simulation-based educational approaches related to the 10-for-10 principle.
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BibTeX
@article{beilstein202610for10,
title = {{How to ‘10-for-10’: a qualitative research protocol to determine best practice use of the 10-for-10 principle}},
author = {Jakob Beilstein and Torsten Schröder and Robert Gintrowicz and Sonja Hermann and Eva Kornemann and Joanna Eller},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-119734},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119734},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - How to ‘10-for-10’: a qualitative research protocol to determine best practice use of the 10-for-10 principle
AU - Jakob Beilstein
AU - Torsten Schröder
AU - Robert Gintrowicz
AU - Sonja Hermann
AU - Eva Kornemann
AU - Joanna Eller
PY - 2026
DA - 2026/10/30
JO - BMJ Open
DO - 10.1136/bmjopen-2026-119734
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119734
AB - Introduction Critical situations in clinical medicine are associated with high cognitive load, time pressure and an increased risk to patient safety. Crisis Resource Management aims to address these challenges through skills such as communication, situational awareness, task management, team performance and decision-making. The ‘10-for-10 principle’, which encourages clinicians to pause briefly to reassess and plan ahead, is widely taught in simulation-based training and applied in clinical practice throughout German-speaking countries. Despite its widespread use, the principle lacks a clear scientific definition and has not been systematically investigated. This study aims to develop an empirically informed conceptual understanding of this principle based on expert perspectives as an early exploration, a foundation for future research and educational model development.Methods and analysis This qualitative study will use 15–20 semistructured expert interviews to explore current applications, variations, structural components and perceived barriers related to the 10-for-10 principle, aiming to provide an early exploration of the principle across German-speaking countries. Participants will be purposively sampled from clinical and simulation-based education contexts. Data collection and analysis will be conducted concurrently using the iterative content-structuring qualitative approach as described by Kuckartz and Rädiker. Deductive codes derived from existing conceptual descriptions will be combined with inductively developed codes informed by expert narratives to identify core categories across interviews. Findings will be synthesised into a taxonomy organised by expert-perceived relevance and frequency of reference.Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Charité—Universitätsmedizin Berlin (EA 1/093/25). Written informed consent will be obtained from all participants. Data will be pseudonymised and handled in accordance with institutional and data protection regulations. Study findings will be disseminated through peer-reviewed publication and conference presentations and are intended to inform future empirical research and the development of simulation-based educational approaches related to the 10-for-10 principle.
SN - 2044-6055
SN - 2044-6055
ER -