Building Surgical Character: A Dynamic Simulation Curriculum for Nontechnical Skills

Area of Science:

• Medical Education
• Surgical Training
• Simulation-based Learning

Background:

• Traditional nontechnical skills training often isolates communication or empathy from technical skills.
• Existing feedback mechanisms typically involve a single rater.
• There is a need for comprehensive curricula addressing a broader range of nontechnical skills.

Purpose of the Study:

• To develop and pilot an expanded simulation curriculum focusing on the situational performance of character attributes.
• To evaluate the feasibility and participant receptivity of this novel curriculum.
• To assess the utility of a new psychometric rating tool for nontechnical skills.

Main Methods:

• A 2-part simulation requiring both technical and nontechnical skills demonstration.
• Formal assessment of nontechnical skills (empathy, courage, composure, humility, clarity) by external raters using a novel tool, standardized patients, and self-assessment.
• Post-simulation self-reflection, personalized feedback, and a satisfaction survey.

Main Results:

• The curriculum was feasible and well-received by general surgery residents and medical students.
• Interrater reliability for the novel rating tool was generally fair to excellent.
• The tool showed partial validity, with strong correlation for empathy scores compared to the validated CARE Measure.
• Participants overwhelmingly found these character attributes important and under-taught.

Conclusions:

• The expanded simulation curriculum effectively addresses character attributes as crucial nontechnical skills for surgeons.
• The novel psychometric rating tool demonstrates potential for assessing these attributes.
• This curriculum offers a unique approach to deliberate practice and structured assessment of essential surgeon qualities.