NICU/PICU Children's Hospital Lucerne, CH-6000, Lucerne 16, Switzerland.
BMC Emerg Med. 2013 Dec 1;13:22. doi: 10.1186/1471-227X-13-22.
Teamwork is a critical component during critical events. Assessment is mandatory for remediation and to target training programmes for observed performance gaps.
The primary purpose was to test the feasibility of team-based self-monitoring of crisis resource management with a validated teamwork assessment tool. A secondary purpose was to assess item-specific reliability and content validity in order to develop a modified context-optimised assessment tool.We conducted a prospective, single-centre study to assess team-based self-monitoring of teamwork after in-situ inter-professional simulated critical events by comparison with an assessment by observers. The Mayo High Performance Teamwork Scale (MHPTS) was used as the assessment tool with evaluation of internal consistency, item-specific consensus estimates for agreement between participating teams and observers, and content validity.
105 participants and 58 observers completed the MHPTS after a total of 16 simulated critical events over 8 months. Summative internal consistency of the MHPTS calculated as Cronbach's alpha was acceptable with 0.712 for observers and 0.710 for participants. Overall consensus estimates for dichotomous data (agreement/non-agreement) was 0.62 (Cohen's kappa; IQ-range 0.31-0.87). 6/16 items had excellent (kappa > 0.8) and 3/16 good reliability (kappa > 0.6). Short questions concerning easy to observe behaviours were more likely to be reliable. The MHPTS was modified using a threshold for good reliability of kappa > 0.6. The result is a 9 item self-assessment tool (TeamMonitor) with a calculated median kappa of 0.86 (IQ-range: 0.67-1.0) and good content validity.
Team-based self-monitoring with the MHPTS to assess team performance during simulated critical events is feasible. A context-based modification of the tool is achievable with good internal consistency and content validity. Further studies are needed to investigate if team-based self-monitoring may be used as part of a programme of assessment to target training programmes for observed performance gaps.
团队合作是关键时刻的关键组成部分。评估对于补救和针对观察到的绩效差距的培训计划至关重要。
主要目的是测试使用经过验证的团队合作评估工具进行基于团队的危机资源管理自我监测的可行性。次要目的是评估特定项目的可靠性和内容有效性，以便开发经过修改的上下文优化评估工具。我们进行了一项前瞻性、单中心研究，通过与观察者评估相比，评估现场跨专业模拟危急事件后基于团队的危机资源管理自我监测。使用 Mayo 高绩效团队合作量表（MHPTS）作为评估工具，评估内部一致性、参与团队和观察者之间的特定项目共识估计、以及内容有效性。
在 8 个月内进行了总共 16 次模拟危急事件后，有 105 名参与者和 58 名观察者完成了 MHPTS。观察者计算的 MHPTS 总评分的内部一致性可接受，为 0.712，参与者为 0.710。二项数据（一致/不一致）的总体一致性估计为 0.62（Cohen's kappa；智商范围 0.31-0.87）。6/16 个项目具有极好的可靠性（kappa>0.8），3/16 个项目具有良好的可靠性（kappa>0.6）。关于易于观察行为的简短问题更有可能具有可靠性。使用 kappa>0.6 的良好可靠性阈值修改了 MHPTS。结果是一个 9 项自我评估工具（TeamMonitor），其计算的中位数 kappa 为 0.86（智商范围：0.67-1.0），具有良好的内容有效性。
使用 MHPTS 进行基于团队的自我监测来评估模拟危急事件期间的团队绩效是可行的。该工具可以基于上下文进行修改，具有良好的内部一致性和内容有效性。需要进一步研究以确定基于团队的自我监测是否可作为评估计划的一部分，以针对观察到的绩效差距的培训计划。
