title: Validation of a measurement tool for self-assessment of teamwork in intensive care.
abstract: BACKGROUND
  Teamwork is an important contributor to patient safety and a validated teamwork measurement tool could help healthcare teams identify areas for improvement and measure progress. We explored the psychometric properties of a teamwork measurement tool when used for self-assessment. We hypothesized that the tool had a valid factor structure and that scores from participants and external assessors would correlate.
  
  
  METHODS
  Forty intensive care teams (one doctor, three nurses) participated in four simulated emergencies, and each independently rated their team's performance at the end of each case using the teamwork measurement tool, without prior training in the use of the tool. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and compared factor structure between participants and external assessors (using previously reported data). Scores from participants and external assessors were compared using Pearson's correlation coefficient.
  
  
  RESULTS
  EFA demonstrated items loaded onto three distinct factors which were supported by the CFA. We found significant correlations between external and participant scores for overall teamwork scores and the three factors. Participants agreed with external assessors on the ranking of overall team performance but scored themselves significantly higher than external assessors.
  
  
  CONCLUSIONS
  The teamwork measurement tool has a valid structure when used for self-assessment. Participant and external assessor scores correlated significantly, suggesting that participants could discriminate between different levels of performance, although leniency in self-assessed scores indicated the need for calibration. This tool could help structure reflection on teamwork and potentially facilitate self-directed, workplace-based improvement in teamwork.
authors.affiliation: Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92-019, Auckland 1142, New Zealand. j.weller@auckland.ac.nz
authors.forename: J
authors.initials: J
authors.lastname: Weller
authors.forename: B
authors.initials: B
authors.lastname: Shulruf
authors.forename: J
authors.initials: J
authors.lastname: Torrie
authors.forename: R
authors.initials: R
authors.lastname: Frengley
authors.forename: M
authors.initials: M
authors.lastname: Boyd
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: B
authors.initials: B
authors.lastname: Yee
authors.forename: P
authors.initials: P
authors.lastname: Dzendrowskyj
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003422:Critical Care / Q000592:standards*; D005163:Factor Analysis, Statistical; D006801:Humans; D010348:Patient Care Team / Q000592:standards*; D011594:Psychometrics; D015203:Reproducibility of Results; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D017132:Workplace
keywords: educational; healthcare team; measurement; reliability and validity; self-assessment; simulation; teamwork