Assessing teamwork in medical education and practice: Relating behavioural teamwork ratings and clinical performance

Abstract

Background: Problems with communication and team coordination are frequently linked to adverse events in medicine. However, there is little experimental evidence to support a relationship between observer ratings of teamwork skills and objective measures of clinical performance.

Aim: Our main objective was to test the hypothesis that observer ratings of team skill will correlate with objective measures of clinical performance.

Methods: Nine teams of medical students were videotaped performing two types of teamwork tasks: (1) low fidelity classroom-based patient assessment and (2) high fidelity simulated emergent care. Observers used a behaviourally anchored rating scale to rate each individual on skills representative of assertiveness, decision-making, situation assessment, leadership, and communication. A checklist-based measure was used to assess clinical team performance.

Results: Moderate to high inter-observer correlations and moderate correlations between cases established the validity of a behaviourally anchored team skill rating tool for simulated emergent care. There was moderate to high correlation between observer ratings of team skill and checklist-based measures of team performance for the simulated emergent care cases (r = 0.65, p = 0.06 and r = 0.97, p < 0.0001).

Conclusions: These results provide prospective evidence of a positive relationship between observer ratings of team skills and clinical team performance in a simulated dynamic health care task.

Additional information

Notes on contributors

Melanie C. Wright

MELANIE C. WRIGHT, PhD is an Assistant Professor in Anesthesiology and the Director of Research for the Human Simulation and Patient Safety Center at Duke University Medical Center.

Barbara G. Phillips-bute

BARBARA G. PHILLIPS-BUTE, PhD is an Assistant Professor in the Departments of Anesthesiology (Division of Biostatistics and Outcomes Research) and Psychiatry at Duke University Medical Center.

Emil R. Petrusa

EMIL R. PETRUSA, PhD is Professor of Medical Education and Administration and Director of the Center for Outcomes Research in Education at Vanderbilt University Medical Center

Kathleen L. Griffin

KATHLEEN L. GRIFFIN is a Masters student in the Ergonomics program in the Department of Psychology at North Carolina State University.

Gene W. Hobbs

GENE W. HOBBS, CHT is Coordinator and Technician of the Human Simulation and Patient Safety Center at Duke University Medical Center.

Jeffrey M. Taekman

JEFFREY M. TAEKMAN, MD is an Assistant Professor of Anesthesiology, Director of the Human Simulation and Patient Safety Center, and Assistant Dean for Educational Technology in the School of Medicine at Duke University.