O3 Reliability and feasibility of the team emergency assessment measure (TEAM) for self- and external rating of teamwork in paediatric interprofessional simulation

Abstract

Introduction/Background Teamwork training for acute healthcare professionals is a recognised priority for risk reduction associated with improved team performance and improved clinical outcomes for patients.1The Team Emergency Assessment Measure (TEAM) is validated as an objective teamwork rating tool for real-life resuscitations, where teamwork is scored across multiple domains using observed behaviours and scored with an overall impression of teamwork performance using a global rating scale.2 The literature suggests a gap for comparing participant self-rating in interprofessional simulation with multiple external rater scores.3 Methods Validity evidence supporting the use of TEAM to assess self- and external rating of teamwork in 15 interdisciplinary paediatric in situ simulations was evaluated. 77 healthcare professionals were recruited across multiple disciplines in 2 hospitals. Using TEAM, participants self-rated their team’s performance in simulation scenarios contemporaneously; two external raters also retrospectively rated all simulations. Interrater reliability, internal consistency of the instrument, intraclass correlation coefficients, effect and generalisability analysis were calculated, and feedback was collated from all raters to explore feasibility. Results Older participant raters gave higher total TEAM scores (P=0.001), as did nurses over doctors (P=0.05). Linear modelling demonstrated that the association between participant rater age and score given was cumulative. Good correlation was noted between the total TEAM score and the Global Score for participant and external raters. The total TEAM score demonstrated superior intraclass correlation coefficient for external raters compared to the global score. There was moderate agreement between external and participant raters which was significant (P Discussion, Conclusions and Recommendations The TEAM tool is a reliable self-rating tool for multiple raters in paediatric interprofessional teams, where it is used by at least 6 external raters or 9 or more self-raters. Nurses and older participants rate team performance more highly. The TEAM tool demonstrated good or very good internal consistency across the majority of items and the TEAM total score was the more reliable measure, rather than the Global Rating Score. It is best suited for formative feedback to support team development. Further research to establish its suitability for self-rating of team performance in the clinical environment, or amongst smaller teams is warranted. References Siassakos D, Bristowe K, Draycott TJ, Angouri J, Hambly H, Winter C, et al. Clinical efficiency in a simulated emergency and relationship to team behaviours: A multisite cross-sectional study. BJOG: An International Journal of Obstetrics and Gynaecology 2011;118(5):pp. 596–607. doi: 10.1111/j.1471-0528.2010.02843.x. Cooper S, Cant R, Connell C, Sims L, Porter JE, Symmons M, et al. Measuring teamwork performance: validity testing of the team emergency assessment measure (TEAM) with clinical resuscitation teams. Resuscitation 2016;101: pp. 97–101. doi: 10.1016/j.resuscitation.2016.01.026. Wooding EL, Gale TC, Maynard V. Evaluation of teamwork assessment tools for interprofessional simulation: a systematic literature review. Journal of Interprofessional Care 2019;34:pp.162–172. doi: 10.1080/13561820.2019.1650730