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Ann Surg. 2012 Apr;255(4):804-9. doi: 10.1097/SLA.0b013e31824a9a02.

Observational teamwork assessment for surgery: feasibility of clinical and nonclinical assessor calibration with short-term training.

Author information

1
Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College, London, UK. s.russ@imperial.ac.uk

Abstract

OBJECTIVES:

To assess the feasibility of training clinical and nonclinical novice assessors to rate teamwork behavior in the operating room with short-term structured training using the observational teamwork assessment for surgery (OTAS) tool.

BACKGROUND:

Effective teamwork is fundamental to the delivery of optimal patient care in the operating room (OR). OTAS provides a comprehensive and robust measure of teamwork in surgery. To date, assessors with a background in psychology/human factors have been shown to be able to use OTAS reliably after training. However, the feasibility of observer training over a short timescale and accessibility to the wider clinical community (ie, OTAS use by clinicians) are yet to be empirically demonstrated.

METHODS:

Ten general surgery cases were observed and assessed using OTAS in real-time by an expert in rating OTAS behaviors (100+ cases rated) and 4 novices: 2 psychologists and 2 surgeons. Assessors were blinded to each other's scores during observations. After each observation, scores were compared and discussed between expert and novice assessors in a debriefing session.

RESULTS:

All novices were reliable with the expert to a acceptable degree at rating all OTAS behaviors by the end of training (intraclass correlation coefficients ≥0.68). For 3 of the 5 behaviors (communication, cooperation, and leadership), calibration improved most rapidly across the first 7 observed cases. For monitoring/situational awareness, calibration improved steadily across the 10 observed cases. For coordination, no significant improvement in calibration over time was observed because of high interrater reliability from the outset (ie, a ceiling effect). There was no significant difference between surgeons and psychologists in their calibration with the expert.

CONCLUSIONS:

It is feasible to train both clinicians and nonclinicians to use OTAS to assess teamwork behaviors in ORs over a short structured training period. OTAS is an accessible tool that can be used robustly (ie, reliably) by assessors from both clinical and nonclinical backgrounds.

PMID:
22367446
DOI:
10.1097/SLA.0b013e31824a9a02
[Indexed for MEDLINE]

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