Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams

Abstract

Background Teamwork failures contribute to adverse events causing patient harm. Establishing and maintaining a team, and managing the tasks is an active process. Medical education largely ignores teamwork competencies. However, lack of robust instruments to measure teamwork limits evaluation of interventions to improve it. Summary of Work We aimed to develop and validate a teamwork measurement instrument. From existing literature, we developed an instrument, then used it to score videotaped simulations until raters agreed the final 21 items, were comprehensive, comprehensible and observable (Appendix 1). Forty intensive care teams participated in four simulated emergencies, all videotaped, randomised and then rated by three trained assessors. . We analysed scores using Generalisability Theory, exploratory factor analysis, measured performance over time and interviewed assessors on item performance. Summary of Results G co-efficients > 0.7 were obtained for overall performance and some individual items. Variance components and interview data provided insight into individual item performance. Exploratory factor analysis confirmed items grouped into themes. Significantly improved performance over time supported construct validity. Items predicting overall performance were identified. Conclusions / take home messages The instrument performed well as did many individual items. Information on low reliability items was used to further develop the instrument which can then be used to robustly evaluate interventions to improve teamwork in healthcare.