Introducing the TDM-20: A Validated 20-Item Instrument to Measure Team Development.

Background and objectives: Research has shown that effective team functioning increases patient satisfaction and reduces medical errors and burnout. The Team Development Measure (TDM), a 31-item instrument, was validated to assess four areas of team development: cohesion, communication, roles and goals, and team priorities. Despite its high reliability and psychometric validity, the large number of items in the TDM may be a barrier to its use in busy health care settings.

Methods: Using the original dataset of 1,194 participants from 120 primary care teams, we conducted an exploratory factor analysis. We used principal component analysis with varimax rotation and Kaiser normalization to validate a 20-item shortened version (TDM-20). We also performed a scree test as a parallel analysis.

Results: Our exploratory factor analysis identified two domains in the TDM-20. The first was communication and engagement, which we defined as team members' ability to respectfully interact toward accomplishing goals. The second domain was shared values and cohesion, which we defined as core beliefs that guide the behaviors of a group from an empathetic and psychologically safe position. Each domain comprised 10 items. The eigenvalues for the two domains were 10.9 and 1.10, accounting for 54.5% and 5.5% of the variance, respectively. Both domains demonstrated high internal consistency (Cronbach's α were 0.92 and 0.93, respectively).

Conclusions: The TDM-20 demonstrated high validity and is suitable for measuring team development in primary care medical settings. Further research is needed to examine whether the pandemic affected the results of the instrument in various cultural backgrounds and current medical environments.