Scoring rubric used for holistic performance ratings. The tool used by the trained video raters to score the participant’s overall technical (i.e., medical or clinical) and behavioral (i.e., nontechnical or teamwork) performance. The raters first ascertained whether the technical performance of the hot-seat participant was either poor or excellent (Excl); if neither, it was determined to be in-between (Med). They then rated, within the selected performance bin, whether the performance was closest to lowest within that bin or highest; again, if neither, it was medium. Thus, a performance rated as a “7” was so categorized because it was overall excellent but low within that category.