Non-Technical and Cognitive Skills (NTCS) Self- Reflection and Faculty Evaluation Tools

Abstract This module contains a set of tools that bring together key concepts to evaluate and assess nontechnical skills, including the cognitive psychology of medical decision making. They focus on the important but often overlooked concepts of leadership, teamwork, communication, resource utilization, situation awareness, and decision making. They also incorporate cognitive errors, or thought process traps that occur despite adequate clinical knowledge and availability of information. Because the categories of non-technical and cognitive skills apply ubiquitously across medical specialties, these tools may be used by any discipline, but are particularly suited to acute critical care encounters. The tools may be used following simulated or real clinical encounters. At the University of California Los Angeles David Geffen School of Medicine, simulation sessions are typically about 20 minutes in length, and about ten minutes are required for both faculty and residents to complete these surveys in a thoughtful manner. Following the completion of these surveys is a 45-minute debriefing session, during which residents and faculty discuss performance, allowing for discussion of any items on these surveys as well. The surveys are generally self-explanatory, and do not require special training. The impact of this tool to assess resident insight into strengths and weaknesses, and to assess impact of the use of the tool on resident-driven learning is currently being studied. Residents are randomized to either use this tool or not, and then to self-identify areas for further learning or practice improvement, based upon performance during a simulated emergency session. Preliminary data reveals that residents who use the Non-Technical and Cognitive Skills Tools as a self-reflection technique identify more nontechnical skills as areas for practice improvement, compared with residents who do not use the tool. We are also evaluating whether residents in fact seek information about those self-identified areas during their debriefing sessions with faculty. This ongoing work is funded by the Foundation for Anesthesia Education and Research, and by the Society for Education in Anesthesia.