Surgical EducationAssessment of technical and nontechnical skills in surgical residents

- Assessment for surgical competency requires assessing both technical and nontechnical skills.
- Context specificity likely accounts for low interstation reliability identified in our study.
- Nontechnical skills are not consistently correlated with technical skills.
- Multiple stations testing both skills are therefore needed for surgical competency assessments.

BackgroundSurgical competence encompasses both technical and nontechnical skills. This study seeks to evaluate the validity evidence for a comprehensive surgical skills examination and to examine the relationship between technical and nontechnical skills.MethodsSix examination stations assessing both technical and nontechnical skills, conducted yearly for surgical trainees (n = 120) between 2010 and 2014 are included.ResultsThe assessment tools demonstrated acceptable internal consistency. Interstation reliability for technical skills was low (alpha = .39). Interstation reliability for the nontechnical skills was lower (alpha range −.05 to .31). Nontechnical skills domains were strongly correlated, ranging from r = .65, P < .001 to .86, P < .001. The associations between nontechnical and technical skills were inconsistent, ranging from poor (r = −.06; P = .54) to moderate (r = .45; P < .001).ConclusionsMultiple samplings of integrated technical and nontechnical skills are necessary to assess overall surgical competency.