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. 2016 Feb 1;2(1):12-18.
doi: 10.1136/bmjstel-2015-000068. eCollection 2016.

Teamwork evaluation during emergency medicine residents' high-fidelity simulation

Francesca Innocenti  1 , Elena Angeli  1 , Andrea Alesi  1 , Margherita Scorpiniti  1 , Riccardo Pini  1
Affiliations

Teamwork evaluation during emergency medicine residents' high-fidelity simulation

Francesca Innocenti et al. BMJ Simul Technol Enhanc Learn. .

Abstract

Background: Teamwork training has been included in several emergency medicine (EM) curricula; the aim of this study was to compare different scales' performance in teamwork evaluation during simulation for EM residents.

Methods: In the period October 2013-June 2014, we performed bimonthly high-fidelity simulation sessions, with novice (I-III year, group 1 (G1)) and senior (IV-V year, group 2 (G2)) EM residents; scenarios were designed to simulate management of critical patients. Videos were assessed by three independent raters with the following scales: Emergency Team Dynamics (ETD), Clinical Teamwork Scale (CTS) and Team Emergency Assessment Measure (TEAM). In the period March-June, after each scenario, participants completed the CTS and ETD.

Results: The analysis based on 18 sessions showed good internal consistency and good to fair inter-rater reliability for the three scales (TEAM, CTS, ETD: Cronbach's α 0.954, 0.954, 0.921; Intraclass Correlation Coefficients (ICC), 0.921, 0.917, 0.608). Single CTS items achieved highly significant ICC results, with 12 of the total 13 comparisons achieving ICC results ≥0.70; a similar result was confirmed for 4 of the total 11 TEAM items and 1 of the 8 total ETD items. Spearman's r was 0.585 between ETD and CTS, 0.694 between ETD and TEAM, and 0.634 between TEAM and CTS (scales converted to percentages, all p<0.0001). Participants gave themselves a better evaluation compared with external raters (CTS: 101±9 vs 90±9; ETD: 25±3 vs 20±5, all p<0.0001).

Conclusions: All examined scales demonstrated good internal consistency, with a slightly better inter-rater reliability for CTS compared with the other tools.

Keywords: High-Fidelity Simulation; Self-assessment; Teamwork performance.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow-chart describing the study design. EM, emergency medicine; CTS, Clinical Teamwork Scale; ETD, Emergency Team Dynamics; MAYO, Mayo High Performance Teamwork Scale OTT, Ottawa Crisis Resource Management Global Rating; TEAM, Team Emergency Assessment Measure.
Figure 2
Figure 2
Spearman's r correlation between CTS, ETD and TEAM scores, converted to percentages. TEAM, Team Emergency Assessment Measure; CTS, Clinical Teamwork Scale; ETD, Emergency Team Dynamics.
Figure 3
Figure 3
Bland-Altman plot of the CTS, ETD and TEAM percentage scores across all raters (first column) and for single raters (A–C). The solid line represents the mean difference and the dashed lines represent 95% limits of agreement. TEAM, Team Emergency Assessment Measure; CTS, Clinical Teamwork Scale; ETD, Emergency Team Dynamics.
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