Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Canada
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
BMJ Qual Saf. 2019 Apr;28(4):327-337. doi: 10.1136/bmjqs-2018-008260. Epub 2018 Oct 11.
Educational interventions to improve teamwork in crisis situations have proliferated in recent years with substantial variation in teamwork measurement. This systematic review aimed to synthesise available tools and their measurement properties in order to identify the most robust tool for measuring the teamwork performance of in crisis situations.
Searches were conducted in Embase (via OVID), PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, Medline and Medline In-Process (via OVID) (through 12 January 2017). Studies evaluating the measurement properties of teamwork assessment tools for in clinical or simulated crisis situations were included. Two independent reviewers screened studies based on predetermined criteria and completed data extraction. Risk of bias was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.
The search yielded 1822 references. Twenty studies were included, representing 13 assessment tools. Tools were primarily assessed in simulated resuscitation scenarios for emergency department teams. The Team Emergency Assessment Measure (TEAM) had the most validation studies (n=5), which demonstrated three sources of validity (content, construct and concurrent) and three sources of reliability (internal consistency, inter-rater reliability and test-retest reliability). Most studies of TEAM's measurement properties were at no risk of bias.
A number of tools are available for assessing teamwork performance of teams in crisis situations. Although selection will ultimately depend on the user's context, TEAM may be the most promising tool given its measurement evidence. Currently, there is a lack of tools to assess teamwork performance during intraoperative crisis situations. Additional research is needed in this regard.
近年来，教育干预措施在危机情况下改善团队合作的措施大量涌现，而团队合作的测量方法也有很大差异。本系统评价旨在综合现有工具及其测量特性，以确定在危机情况下测量团队合作表现的最有效工具。
通过 OVID 对 Embase、PsycINFO、Cumulative Index to Nursing and Allied Health Literature、Education Resources Information Center、Medline 和 Medline In-Process（通过 OVID）（截至 2017 年 1 月 12 日）进行检索。纳入评估临床或模拟危机情况下团队合作评估工具的测量特性的研究。两名独立评审员根据预先确定的标准筛选研究并完成数据提取。使用共识基础的健康测量仪器选择标准（COSMIN）清单评估偏倚风险。
检索结果得到 1822 条参考文献。纳入 20 项研究，代表 13 种评估工具。这些工具主要在急诊科团队的模拟复苏场景中进行评估。团队紧急评估量表（TEAM）有最多的验证研究（n=5），这些研究展示了三种有效性来源（内容、结构和同期）和三种可靠性来源（内部一致性、评价者间可靠性和测试-重测可靠性）。TEAM 测量特性的大多数研究无偏倚风险。
有许多工具可用于评估危机情况下团队的团队合作表现。尽管最终的选择将取决于用户的情况，但鉴于 TEAM 的测量证据，它可能是最有前途的工具。目前，还缺乏评估手术期间危机情况下团队合作表现的工具。在这方面需要进一步研究。
