title: Self vs expert assessment of technical and non-technical skills in high fidelity simulation.
abstract: 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.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, UK. sonal.arora06@imperial.ac.uk
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
authors.forename: Danilo
authors.initials: D
authors.lastname: Miskovic
authors.forename: Louise
authors.initials: L
authors.lastname: Hull
authors.forename: Krishna
authors.initials: K
authors.lastname: Moorthy
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Helgi
authors.initials: H
authors.lastname: Johannsson
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gautama
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
mesh_terms: D017081:Cholecystectomy, Laparoscopic; D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D013502:General Surgery / Q000193:education; D006801:Humans; D009873:Operating Rooms; D012647:Self-Assessment