Are Technical Skills Assessed Using Medical Knowledge Associated with Non-technical Skill Knowledge in Anaesthesia Resident Training?

Objective: We examined the association between midterm examinations and anaesthetists’ non-technical skills (ANTS) knowledge using multiple choice questions (MCQs) for anaesthesia training. 
Materials and Methods: A prospective cross-sectional study was implemented based on two cohort studies conducted in November 2017 and November 2019 at the university hospital in southern Thailand. Each cohort consisted of MCQs, short answer questions (SAQs), objective structured clinical examinations (OSCEs), and MCQs after ANTS simulation workshops during the midterm examinations. The main exposure variable was the midterm examination (MCQs/ SAQs/ OSCEs) whereas the ANTS MCQs were the outcome. The potential predictors were the residents’ role, sex, PGY (1-3), and competency. Associations between midterm examinations and ANTS MCQ scores were analysed using Pearson’s correlation coefficients (r) and multivariate linear regression analysis, and presented as beta coefficient (β) and 95% confidence limit (CL). 
Results: Forty-eight anaesthesia residents were recruited for the study. After adjusting for PGY, knowledge score, and attitude evaluated by the staff, OSCE was found to be significantly associated with the pretest ANTS scores (β [95% CL]= 1.02 (0.06, 1.98)) and MCQ scores were significantly associated with the posttest ANTS scores (β [95% CL]= 0.14 (0.04, 0.24)). SAQ scores had negative associations with the pretest (β [95% CL]=-0.11 (-0.21, -0.01)) and posttest (β [95% CL]=-0.16 (-0.27, -0.05)) ANTS scores. It was found that there was a significant relationship between midterm examinations and posttest ANTS scores (r=0.52). 
Conclusion: Technical skills using OSCE and midterm MCQ examination scores were associated with non-technical skill knowledge in anaesthesia training.