title: Assessing teamwork in medical education and practice: relating behavioural teamwork ratings and clinical performance.
abstract: BACKGROUND
  Problems with communication and team coordination are frequently linked to adverse events in medicine. However, there is little experimental evidence to support a relationship between observer ratings of teamwork skills and objective measures of clinical performance.
  
  
  OBJECTIVE
  Our main objective was to test the hypothesis that observer ratings of team skill will correlate with objective measures of clinical performance.
  
  
  METHODS
  Nine teams of medical students were videotaped performing two types of teamwork tasks: (1) low fidelity classroom-based patient assessment and (2) high fidelity simulated emergent care. Observers used a behaviourally anchored rating scale to rate each individual on skills representative of assertiveness, decision-making, situation assessment, leadership, and communication. A checklist-based measure was used to assess clinical team performance.
  
  
  RESULTS
  Moderate to high inter-observer correlations and moderate correlations between cases established the validity of a behaviourally anchored team skill rating tool for simulated emergent care. There was moderate to high correlation between observer ratings of team skill and checklist-based measures of team performance for the simulated emergent care cases (r = 0.65, p = 0.06 and r = 0.97, p < 0.0001).
  
  
  CONCLUSIONS
  These results provide prospective evidence of a positive relationship between observer ratings of team skills and clinical team performance in a simulated dynamic health care task.
authors.affiliation: Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. melanie.wright@duke.edu
authors.forename: Melanie C
authors.initials: MC
authors.lastname: Wright
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Phillips-Bute
authors.forename: Emil R
authors.initials: ER
authors.lastname: Petrusa
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Griffin
authors.forename: Gene W
authors.initials: GW
authors.lastname: Hobbs
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Taekman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003299:Cooperative Behavior; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D016544:Patient Simulation; D013647:Task Performance and Analysis; D013997:Time Factors; D014481:United States; D014741:Video Recording; D055815:Young Adult