Assessment of technical and nontechnical skills in surgical residents

Am J Surg. 2016 Nov;212(5):1011-1019. doi: 10.1016/j.amjsurg.2016.03.005. Epub 2016 Jun 1.


Background: Surgical 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.

Methods: Six examination stations assessing both technical and nontechnical skills, conducted yearly for surgical trainees (n = 120) between 2010 and 2014 are included.

Results: The 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).

Conclusions: Multiple samplings of integrated technical and nontechnical skills are necessary to assess overall surgical competency.

Keywords: Assessment; Collaboration; Communication; Graduate medical education; Professional; Surgical skills.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Clinical Competence*
  • Education, Medical, Graduate / methods*
  • Educational Measurement
  • Evidence-Based Practice
  • Female
  • General Surgery / education*
  • Humans
  • Internship and Residency / methods*
  • Interprofessional Relations
  • Male
  • Reproducibility of Results