Objective assessment of surgical trainees' non-technical skills: Improved performance following a two-year program of instruction

Abstract

Background: Non-technical skills (NTS) encompass personal skills such as communication, situational awareness, decision making, teamwork and leadership. Poor performance of these skills has been shown to contribute to medical error. The Royal College of Surgeons in Ireland (RCSI) has delivered a mandatory program of instruction in NTS to all surgical trainees since 2005. We investigated whether the NTS of surgical trainees improved after the first two years of this program.

Methods: Baseline data was collected in a three-station OSCE assessment of NTS at the beginning of Year one and again at end of Year two of surgical training.

Results: Trainees' mean percentage NTS scores improved significantly over the two-year period for the NTS assessment (P < .001). A significant difference was demonstrated using within-subject (paired) t-tests between the Year one and two time points for all three OSCE stations: Consent (-5.39; P < .001); Colleague Conflict (-8.63; P < .001); and Disclosure of Error (-7.56; P < .001).

Conclusions: RCSI offers a unique mandatory program of instruction in NTS. There was a statistically and practically significant improvement in the NTS scores of surgical trainees over the two-year period of the program.

Keywords: Assessment; Human factors; Non-technical skills; Simulation; Surgery; Surgical education.