Simulators in Self-Assessment

Abstract

This article is highly interesting as its findings mirror our own research into non-technical skills. Evaluating ward-based surgical peri-operative management is an important1 but neglected area in surgery, which is amenable to simulation techniques.2,3 At our institution, realistic specialist registrar, ward-based scenarios have been developed using the METI HPS adult mannequin. Common peri-operative complications, such as cardio-vascular problems may be simulated. In our study, pairs of specialist general surgical registrars worked together for 10–15 min. This allows assessment of decision-making, team-work, leadership and organisational skills by experienced consultants, other specialist registrars and by the participants themselves. Our participant analysis has identified good correlation between the consultant and peer assessments of performance (Pearson rank correlation 0.514; P = 0.05). However, as discussed in this article, significant correlation was not found between self and consultant or peer assessments. Reported self-assessment did not correspond to year of training as an indirect marker of experience. A trend was found for those who scored above or below average by their peers to under or over scoring their own performance, respectively. Together, these articles offer caution to self-assessment of abilities. Employing expert feedback in training, and specifically when using ward-based and practical skill simulations, is essential.