title: Measuring teamwork in health care settings: a review of survey instruments.
abstract: BACKGROUND
  Teamwork in health care settings is widely recognized as an important factor in providing high-quality patient care. However, the behaviors that comprise effective teamwork, the organizational factors that support teamwork, and the relationship between teamwork and patient outcomes remain empirical questions in need of rigorous study.
  
  
  OBJECTIVE
  To identify and review survey instruments used to assess dimensions of teamwork so as to facilitate high-quality research on this topic.
  
  
  METHODS
  We conducted a systematic review of articles published before September 2012 to identify survey instruments used to measure teamwork and to assess their conceptual content, psychometric validity, and relationships to outcomes of interest. We searched the ISI Web of Knowledge database, and identified relevant articles using the search terms team, teamwork, or collaboration in combination with survey, scale, measure, or questionnaire.
  
  
  RESULTS
  We found 39 surveys that measured teamwork. Surveys assessed different dimensions of teamwork. The most commonly assessed dimensions were communication, coordination, and respect. Of the 39 surveys, 10 met all of the criteria for psychometric validity, and 14 showed significant relationships to nonself-report outcomes.
  
  
  CONCLUSIONS
  Evidence of psychometric validity is lacking for many teamwork survey instruments. However, several psychometrically valid instruments are available. Researchers aiming to advance research on teamwork in health care should consider using or adapting one of these instruments before creating a new one. Because instruments vary considerably in the behavioral processes and emergent states of teamwork that they capture, researchers must carefully evaluate the conceptual consistency between instrument, research question, and context.
authors.affiliation: *Harvard Business School, Boston, MA †Yale University School of Public Health and School of Management, New Haven, CT.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Valentine
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Nembhard
authors.forename: Amy C
authors.initials: AC
authors.lastname: Edmondson
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D006126:Group Processes; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D011594:Psychometrics; D011787:Quality of Health Care / Q000458:organization & administration*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires