# Non-technical skills of Norwegian medical students at different training sites: a comparative, observational cohort study

## TL;DR

Medical students in a rural area showed better non-technical skills than those in urban and regional hospitals.

## Contribution

This study compares non-technical skills of medical students across different training sites in Norway.

## Key findings

- Students in Finnmark had significantly higher NTS scores than those in Tromsø and Bodø.
- Finnmark students outperformed others in most NTS categories.
- Bodø and Tromsø students showed no significant differences in NTS performance.

## Abstract

Mastering non-technical skills (NTS) is a fundamental part of the training of new physicians to perform effectively and safely in the medical practice environment. Ideally, they learn these skills during medical school. Decentralized medical education is being implemented increasingly worldwide. Two of the three training sites studied, Bodø (a regional hospital) and Finnmark (a rural local hospital), implemented decentralized medical education. The third training site was the main campus in Tromsø, located at an urban university hospital. The training in Finnmark emphasised training in non-technical skills using simulation to a larger extent than the two other university campuses. This study aimed to compare the NTS performance of medical students in their last year of education at three different training sites of the same university.

This blinded cohort study included students from the three training sites who participated in identical multi-professional simulations over a six-year period. Eight raters evaluated the video recordings of eight students from each training site using the Norwegian Medical Students Non-Technical Skills (NorMS-NTS) tool. The NorMS-NTS tool, which comprises four categories and 13 elements, assesses the NTS of Norwegian medical students and assigns an overall global score. Pairwise significant differences in the NTS performance levels between the training sites studied were assessed using Tukey’s test.

The overall NTS performance levels of the medical students from Finnmark (mean 4.5) were significantly higher than those of the students from Tromsø (mean 3.8) and Bodø (mean 3.5). Similarly, the NTS performance levels at category-level of the students in Finnmark were significantly higher than those of the students from Bodø and Tromsø. Except for one category, no significant differences were observed between the students from Bodø and Tromsø in terms of the overall or category-level NTS performance.

The NTS performance levels of the medical students from Finnmark, which implements rural, decentralized medical education, were significantly higher than those of the students from Tromsø and Bodø.

The online version contains supplementary material available at 10.1186/s12909-024-05597-7.