Correlation of Medical Knowledge and Non-Technical Skills Assessment in Anesthesia Residents

Abstract

Objective: Non-technical skills training and assessment has been implemented in anesthesia residency training program to improve quality of patient care but have not been properly assessed. We hypothesized that trainees with good knowledge correlated with good cognitive parts of non-technical skills.Methods: Seventy anesthesia residents (24 PGY-1, 24 PGY-2 and 22 PGY-3) were assessed for their knowledge by 180-item MCQs, 5 key-feature essay questions, and 18-station OSCE’s. Subsequently, a perioperative anesthesia crisis situation was set up in the simulation lab for all residents and was video recorded. Non-technical skills were assessed by 2 independent trained raters using Anesthetists’ Non-Technical Skills (ANTS) behavioral markers. The residents’ scores were calculated to find the correlation within the ANTS rating scale.Results: The mean scores of knowledge tests were 164.3 ±18.4 out of 300 [165.5 ±18.0, 154.7 ±16.3 and 173.6 ±16.4 for PGY-1, PGY-2 and PGY-3 respectively]. The mean scores of ANTS was divided into 4 categories (rating scale 1 to 4): task management 2.9 (±0.6), teamworking 3.0 (±0.5), situation awareness 2.9 (±0.8) and decision making 2.8 (±0.7). The knowledge test results moderately correlated with ANTS score in task management, situation awareness and decision making [r=0.382 (p<0.01), r=0.433 (p<0.001) and r=0.350 (p<0.01) respectively] and weakly correlated with the teamworking category (r=0.166, p=0.16).Conclusion: Resident’s scores showed moderate correlation with non-technical skills assessment results in cognitive skills. Non-technical skills are required to be trained and assessed together with knowledge to enhance the patient’s safety and outcome.

Development and applications of the Anaesthetists’ Non-Technical Skills behavioural marker system: a systematic review

“…Yee et al noted that certain parts of the ANTS tool, although designed to assess NTS, were inherently related to technical performance and skills 62. In one study, residents’ theoretical knowledge scores were also moderately correlated with assessment results of all NTS categories, task management, teamwork, situational awareness and decision-making 65. It is also worth considering whether teaching and training NTS to the same extent as TS in educational programmes might improve the performance of anaesthesia residents in the operating room 66.…”

“… 62 In one study, residents’ theoretical knowledge scores were also moderately correlated with assessment results of all NTS categories, task management, teamwork, situational awareness and decision-making. 65 It is also worth considering whether teaching and training NTS to the same extent as TS in educational programmes might improve the performance of anaesthesia residents in the operating room. 66 Further studies are necessary to investigate the nature and direction of the relationship between TS and NTS.…”

Are Technical Skills Assessed Using Medical Knowledge Associated with Non-technical Skill Knowledge in Anaesthesia Resident Training?

“…We used midterm examinations (MCQ/SAQ/ OSCE) to represent technical skill in anaesthesia training, which was similar to what was done in Raksamani's study. 12 The difference was that the MCQs, which comprised all four ANTS categories (SA/TM/TW/DM), was implemented instead of assessing ANTS behaviours among residents to correspond with non-technical skills. Moreover, to minimise the measurement bias, technical skills, as assessed by midterm examinations and the ANTS workshop, were performed in the same evaluation period (Fig 1).…”

Effectiveness of the SBAR-Based training program in self-efficacy and clinical decision-making of undergraduate anesthesiology nursing students: a quasi-experimental study

“…While technical skills are thought to be the foundation of medical sciences education, nontechnical skills such as clinical and self-efficacy skills are also emerging phenomena in nursing education that receive less attention [ 17 ]. In addition, a bachelor’s degree in anesthesiology nursing is a novel major in medical education, and despite the increase in courses, particularly practical ones, the infrastructure needed for the implementation of the main educational goals and identification of shortcomings and deficiencies have not yet been realized.…”