title: Are general surgeons able to accurately self-assess their level of technical skills?
abstract: BACKGROUND
  Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether self-assessment is an accurate form of technical skills appraisal in general surgery.
  
  
  METHODS
  The PubMed, MEDLINE(®), Embase(™) and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence.
  
  
  RESULTS
  Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation).
  
  
  CONCLUSIONS
  Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.
authors.affiliation: Cardiff University , UK.
authors.forename: C
authors.initials: C
authors.lastname: Rizan
authors.affiliation: Welsh Institute for Minimal Access Therapy , UK.
authors.forename: J
authors.initials: J
authors.lastname: Ansell
authors.affiliation: Cardiff University , UK.
authors.forename: T W
authors.initials: TW
authors.lastname: Tilston
authors.affiliation: Welsh Institute for Minimal Access Therapy , UK.
authors.forename: N
authors.initials: N
authors.lastname: Warren
authors.affiliation: Cardiff and Vale University Health Board , UK.
authors.forename: J
authors.initials: J
authors.lastname: Torkington
mesh_terms: D002983:Clinical Competence; D013502:General Surgery; D006801:Humans; D015203:Reproducibility of Results; D012647:Self-Assessment; D066231:Surgeons / Q000592:standards*; D000078329:Workforce
keywords: General surgery; Self-assessment; Technical skills