Self vs expert assessment of technical and non-technical skills in high fidelity simulation

BACKGROUND: Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS: Twenty-five surgeons performed a laparoscopic cholecystectomy (LC) in a simulated operating room. Technical and nontechnical performance was assessed by participants and faculty members using the validated Objective Structured Assessment of Technical Skills (OSATS) and the Non-Technical Skills for Surgeons scale (NOTSS). RESULTS: Assessment of technical performance correlated between self and faculty members' ratings for experienced (median score, 30.0 vs 31.0; rho = .831; P = .001) and inexperienced (median score, 22.0 vs 28.0; rho = .761; P = .003) surgeons. Assessment of nontechnical skills between self and faculty members did not correlate for experienced surgeons (median score, 8.0 vs 10.5; rho = -.375; P = .229) or their more inexperienced counterparts (median score, 9.0 vs 7.0; rho = -.018; P = .953). CONCLUSIONS: Surgeons can accurately self-assess their technical skills in virtual reality LC. Conversely, formal assessment with faculty members' input is required for nontechnical skills, for which surgeons lack insight into their behaviours. (C) 2011 Elsevier Inc. All rights reserved.