Correlation Of Medical Knowledge And Non-Technical Skills Assessment In Anesthesia Residents

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 knowledge scores showed moderate correlation with non-technical skills assessment results except teamwork. Non-technical skills are required to be trained and assessed together with knowledge to enhance the patient’s safety and outcome.