Abstract
Introduction: Team effectiveness consists in team performance (procedures, algorithms) and team process (Crisis Resource Management - CRM). Although CRM scales and a few team performance checklists exist, to our knowledge, no team performance assessment scale covering all critical conditions in adults and children exists. Objective: The objective was to develop and assess a clinical team average performance assessment scale (TAPAS) evaluating clinical performance during immersive simulation of critical conditions. Methods: Three experts selected items from PALS, EPLS, NLS, ACLS, and ATLS courses. The final TAPAS included 129 items, rated 0/1/2, with a total over 100. Items were preselected according to each scenario, making the score a reflection of the percentage of the best performance for a given scenario. Psychometric analysis was tested on 159 simulations. Scenarios were acute life-threatening conditions in neonates, children and adults (medical, trauma) (SimNewB and ALS, Laerdal*). Two independent observers among a group of 8, assessed performance, and were surveyed on TAPAS ease of use. Analysis included: comparison between observers of means and SD, linear logistic regression, coefficient correlation, discordance; Cronbach alpha (CA), intra-class coefficient (ICC), and comparison at two training times. Results: TAPAS score was 46.6 ± 15.5 (18-83.5). Analysis showed: CA=0.745, ICC=0.862. Observers' scores were not different (means and SD), highly correlated (coefficient=0.838, p=0.0011, R2 =0.64), and with a discordance <7%. TAPAS scores increased after training (p<0.0001). TAPAS were found to be easy to use. Conclusions: TAPAS was a valuable team performance assessment instrument, easy to use in team simulation, in different age groups (neonatal, pediatric, adult) and critical conditions (medical, trauma).
Highlights
Team effectiveness consists in team performance and team process (Crisis Resource Management - CRM)
Team Average Performance Assessment Scale (TAPAS) was a valuable team performance assessment instrument, easy to use in team simulation, in different age groups and critical conditions
The so-called ‘global team effectiveness’ relies upon two separate components: team process referring to Crisis Resource Management (CRM) principles, and team performance [4]
Summary
Team effectiveness consists in team performance (procedures, algorithms) and team process (Crisis Resource Management - CRM). Healthcare providers train as individuals, yet function as teams, thereby creating a gap between training and reality [1]. Teamwork failure is a primary threat to patient safety [2]. The challenge is to distinguish team process from team performance in team-based assessment efforts and training [3]. The so-called ‘global team effectiveness’ relies upon two separate components: team process referring to Crisis Resource Management (CRM) principles, and team performance (technical procedures & algorithms) [4]. It is used to train multi-professional teams, to identify errors and to modify behaviors in view of improving performance [5]. Teamwork training constitutes a core approach to enhanced levels of quality and safety
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