Teaching Anesthesia Residents to Identify Non-technical and Cognitive Skill Deficiencies

Background Effective management of life-threatening emergencies requires non-technical and cognitive skills such as teamwork and decision-making, in addition to sound medical knowledge. We evaluated the impact of a self-reflection tool on trainees’ identification of non-technical and cognitive skill (NTCS) deficiencies after managing simulated emergencies. We also examined whether trainees pursued further learning on self-identified weaknesses during simulation debriefing. Methods Seventy-five anesthesiology residents participated in this prospective study embedded in an existing simulation curriculum. Residents managed a simulated emergency and were randomized to one of two reflective exercises (i.e., using the NTCS Tool or not). They were then asked to self-identify three areas for performance improvement. Next, all subjects participated in a debriefing session with faculty using a learner-focused protocol. We compared the frequency of NTCS domains in the self-identified areas for improvement between the two groups. We also evaluated whether residents asked to explore those self-identified areas during the debriefing. Results The NTCS group identified a greater number of NTCS themes compared to the control group ( N = 64, 55% vs. N = 41, 38%, p = 0.01). Eighty percent of residents addressed at least one self-identified weakness during the debriefing. Conclusions This instructional intervention effectively primed residents to consider NTCS themes when evaluating their own performance. Explicit reflection on performance may help residents direct their learning behaviors to mirror their learning needs.