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; ρ = .831; P = .001) and inexperienced (median score, 22.0 vs 28.0; ρ = .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; ρ = -.375; P = .229) or their more inexperienced counterparts (median score, 9.0 vs 7.0; ρ = -.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.