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Application and Evaluation of a Formative Feedback Rubric on Nontechnical Skills Using Retrospective SIMPL App Data
Madeline R Cloonan1, Elizabeth R Maginot1, Kelsey R Tieken1
1Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
Objective:
To determine the frequency of nontechnical skills (NTS) feedback provided by attending surgeons through narrative comments and assess its effectiveness using a validated formative feedback rubric.
Design:
This retrospective cross-sectional study used SIMPL operative assessments. We coded the narrative comments for feedback on NTS, technical skills, both, or neither. We used validated rubric to evaluate the comments based on clarity, specificity, actionability, tone, and overall resident quality rating. We analyzed factors associated with the presence of NTS feedback and rubric-rated effective feedback using chi-squared tests and logistic regression.
Setting:
A single academic general surgery residency program in the Midwest US.
Participants:
Attending surgeon evaluations with narrative comment data of general surgery residents between July 2020 and April 2024 (n = 1880).
Results:
Of 1880 narrative comments, 445 (23.6%) included NTS feedback. Most comments addressed a single domain, most commonly leadership. Among comments including NTS, 89 (20.0%) were classified as rubric-rated effective. Among comments that included technical skills feedback, 386 of 1669 (23.1%) were classified as rubric-rated effective. Technical skills feedback was more likely to be clear, specific, and actionable than NTS feedback.
Conclusions:
Narrative comments on NTS were rare, and only 1 in 5 comments satisfied the rubric criteria for effective feedback. Feedback on technical skills scored higher than feedback on NTS in terms of clarity, specificity, and actionability. These findings suggest that feedback on NTS may remain limited unless structured prompts, rubrics, and faculty development are built into routine surgical assessment.
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