METHODS The study is designed to explore the reliability of the ratings made by surgeons as well as to examine whether the reliability improves with training. The study setting will be a one day course in which surgeons are asked to rate the non-technical performance of surgeons in simulated video scenarios. Two distinct sets of ratings will be obtained. The first at the beginning of the day when the surgeons have had no prior training in or knowledge of rating non-technical skills and at the end of the day after 5 hours of training.