Team performance in resuscitation teams: Comparison and critique of two recently developed scoring tools ^☆

Abstract

Background and aim

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:

• 1.

  To determine the inter-rater reliability of the tools in assessing performance within the context of resuscitation.

• 2.

  To correlate scores of the same resuscitation teams episodes using both tools, thereby determining their concurrent validity within the context of resuscitation.

• 3.

  To carry out a critique of both tools and establish how best each one may be utilised.

Methods

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.

Results

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.

Conclusion

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.