Passauer-Baierl Stefanie, Hull Louise, Miskovic Danilo, Russ Stephanie, Sevdalis Nick, Weigl Matthias
Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig-Maximilians-University Munich, Ziemssentr. 1, 80336, Munich, Germany,
World J Surg. 2014 Feb;38(2):305-13. doi: 10.1007/s00268-013-2299-8.
The nontechnical and team skills of surgical teams are critical for safety and efficiency in the operating room. Assessment of nontechnical and team skills can facilitate improvement by encouraging both self-reflection and team reflection, identifying training needs, and informing operating room (OR) team training approaches. The observational teamwork assessment for surgery (OTAS) tool is a well-validated and robust tool for capturing teamwork in the operating room. The aims of the present study were to systematically adapt and refine the OTAS for German-speaking OR staff and to test the adapted assessment tool (OTAS-D) for psychometric properties and metric equivalence.
The study was carried out in three stages: at stage 1, OTAS was translated into German. At stage 2, experienced German OR experts (surgeons, OR nurses, anesthetists) were interviewed. At stage 3, two blinded assessors observed 11 general surgical operations (general surgical and vascular procedures) and interrater reliability was tested for refined OTAS-D behavioral exemplars and scorings.
The German OR experts confirmed the applicability and content validity of the vast majority of translated behavioral exemplars. After their evaluation, 32 items were changed slightly, six were changed substantially, and one item was added. During observations, perfect and substantial interobserver agreement was found for 77 behavioral exemplars (67.1 % of the items, kappa coefficient >0.60). Rating at all OTAS behaviors showed acceptable levels of reliability (intraclass correlation coefficients >0.72).
The OTAS-D is a tool for valid and reliable assessment of nontechnical skills that contribute to safe and effective surgical performance in ORs staffed by German-speaking professionals. Furthermore, our study serves as an example for systematically adapting and customizing well-established observational tools across different healthcare environments.
手术团队的非技术技能和团队协作能力对于手术室的安全与效率至关重要。对非技术技能和团队协作能力进行评估，可通过促进自我反思和团队反思、识别培训需求以及为手术室团队培训方法提供信息来推动改进。手术观察性团队协作评估（OTAS）工具是一种经过充分验证且强大的工具，用于捕捉手术室中的团队协作情况。本研究的目的是系统地将OTAS工具改编并完善，以适用于讲德语的手术室工作人员，并测试改编后的评估工具（OTAS-D）的心理测量特性和度量等效性。
该研究分三个阶段进行：在第一阶段，将OTAS翻译成德语。在第二阶段，采访了经验丰富的讲德语的手术室专家（外科医生、手术室护士、麻醉师）。在第三阶段，两名盲法评估者观察了11台普通外科手术（普通外科和血管手术），并对完善后的OTAS-D行为范例和评分进行了评分者间信度测试。
讲德语的手术室专家确认了绝大多数翻译后的行为范例的适用性和内容效度。经过他们的评估，32个项目略有改动，6个项目大幅改动，并增加了1个项目。在观察过程中，77个行为范例（占项目的67.1%，kappa系数>0.60）的观察者间一致性达到了完美和高度一致。所有OTAS行为的评分显示出可接受的信度水平（组内相关系数>0.72）。
OTAS-D是一种用于有效且可靠地评估非技术技能的工具，这些技能有助于在由讲德语的专业人员组成的手术室中实现安全有效的手术操作。此外，我们的研究为在不同医疗环境中系统地改编和定制成熟的观察工具提供了一个范例。
