title: Assessing teamwork in the trauma bay: introduction of a modified "NOTECHS" scale for trauma.
abstract: BACKGROUND
  A modified nontechnical skills (NOTECHS) scale for trauma (T-NOTECHS) was developed to teach and assess teamwork skills of multidisciplinary trauma resuscitation teams. In this study, T-NOTECHS was evaluated for reliability and correlation with clinical performance.
  
  
  METHODS
  Interrater reliability (intraclass correlation coefficient) and correlation with the speed and completeness of resuscitation tasks were assessed during simulation-based teamwork training and during actual trauma resuscitations.
  
  
  RESULTS
  For T-NOTECHS ratings done in real time, intraclass correlation coefficients were .44 for simulated and .48 for actual resuscitations. Reliability was higher (intraclass correlation coefficient = .71) for video review of resuscitations. Better T-NOTECHS scores were correlated with better performance during simulations, evidenced by a greater number of completed resuscitation tasks (r = .50, P < .01) and faster time to completion (r = -.38, P < .05) In actual resuscitations, T-NOTECHS ratings improved after teamwork training (P < .001). Higher T-NOTECHS scores were correlated with better clinical performance, evidenced by faster resuscitation (r = -.13, P < .05) and fewer unreported resuscitation tasks (r = -.16, P < .05).
  
  
  CONCLUSIONS
  Improvement in T-NOTECHS scores after teamwork training, and correlation with clinical parameters in simulated and actual trauma resuscitations, suggest its clinical relevance. Further evaluation, aiming to improve reliability, may be warranted.
authors.affiliation: University of Hawaii, Department of Surgery, Honolulu, HI, USA. steine@hawaii.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Steinemann
authors.forename: Benjamin
authors.initials: B
authors.lastname: Berg
authors.forename: Alexandra
authors.initials: A
authors.lastname: DiTullio
authors.forename: Alisha
authors.initials: A
authors.lastname: Skinner
authors.forename: Kara
authors.initials: K
authors.lastname: Terada
authors.forename: Kathleen
authors.initials: K
authors.lastname: Anzelon
authors.forename: Hao Chih
authors.initials: HC
authors.lastname: Ho
mesh_terms: D000223:Adaptation, Psychological; D003142:Communication; D003657:Decision Making; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011361:Professional Competence; D015203:Reproducibility of Results; D012151:Resuscitation / Q000592:standards*; D018709:Statistics, Nonparametric; D014193:Trauma Centers / Q000458:organization & administration*