Department of Resuscitation and Outreach, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK.
Resuscitation. 2012 Dec;83(12):1478-83. doi: 10.1016/j.resuscitation.2012.04.015. Epub 2012 May 3.
Following high profile errors resulting in patient harm and attracting negative publicity, the healthcare sector has begun to focus on training non-technical teamworking skills as one way of reducing the rate of adverse events. Within the area of resuscitation, two tools have been developed recently aiming to assess these skills - TEAM and OSCAR. The aims of the study reported here were:
The study consisted of two phases - reliability assessment; and content comparison, and correlation. Assessments were made by two resuscitation experts, who watched 24 pre-recorded resuscitation simulations, and independently rated team behaviours using both tools. The tools were critically appraised, and correlation between overall score surrogates was assessed.
Both OSCAR and TEAM achieved high levels of inter-rater reliability (in the form of adequate intra-class coefficients) and minor significant differences between Wilcoxon tests. Comparison of the scores from both tools demonstrated a high degree of correlation (and hence concurrent validity). Finally, critique of each tool highlighted differences in length and complexity.
Both OSCAR and TEAM can be used to assess resuscitation teams in a simulated environment, with the tools correlating well with one another. We envisage a role for both tools - with TEAM giving a quick, global assessment of the team, but OSCAR enabling more detailed breakdown of the assessment, facilitating feedback, and identifying areas of weakness for future training.
在一些导致患者伤害和引起负面宣传的重大错误之后,医疗保健行业已开始专注于培训非技术团队合作技能,以此作为降低不良事件发生率的一种方法。在复苏领域,最近开发了两种旨在评估这些技能的工具——TEAM 和 OSCAR。本研究报告的目的是:
该研究分为两个阶段——可靠性评估和内容比较及相关性评估。两位复苏专家进行评估,观看了 24 个预先录制的复苏模拟,然后使用这两种工具独立评估团队行为。对这两种工具进行了批判性评估,并评估了总体得分替代指标之间的相关性。
OSCAR 和 TEAM 都具有较高的评分者间可靠性(表现为足够的组内相关系数),Wilcoxon 检验之间的差异较小且具有统计学意义。两种工具的评分比较显示出高度的相关性(因此具有同时效度)。最后,对每种工具的批评都强调了长度和复杂性的差异。
OSCAR 和 TEAM 均可用于模拟环境中评估复苏团队,这两种工具彼此之间相关性良好。我们设想这两种工具都有其作用——TEAM 可以快速、全面地评估团队,而 OSCAR 则可以更详细地分解评估结果,提供反馈,并确定未来培训的薄弱环节。