Use of Generalizability Theory for Exploring Reliability of and Sources of Variance in Assessment of Technical Skills: A Systematic Review and Meta-Analysis.

G-theory is increasingly being used to examine reliability of technical skills assessment in medical education, but more rigor in reporting is warranted. Contextual factors can potentially affect variance components and thereby reliability estimates and should be considered, especially in high-stakes assessment. Reliability analysis should be a best practice when developing assessment of technical skills.