title: Adapting the McMaster-Ottawa scale and developing behavioral anchors for assessing performance in an interprofessional Team Observed Structured Clinical Encounter.
abstract: BACKGROUND
  Current scales for interprofessional team performance do not provide adequate behavioral anchors for performance evaluation. The Team Observed Structured Clinical Encounter (TOSCE) provides an opportunity to adapt and develop an existing scale for this purpose. We aimed to test the feasibility of using a retooled scale to rate performance in a standardized patient encounter and to assess faculty ability to accurately rate both individual students and teams.
  
  
  METHODS
  The 9-point McMaster-Ottawa Scale developed for a TOSCE was converted to a 3-point scale with behavioral anchors. Students from four professions were trained a priori to perform in teams of four at three different levels as individuals and teams. Blinded faculty raters were trained to use the scale to evaluate individual and team performances. G-theory was used to analyze ability of faculty to accurately rate individual students and teams using the retooled scale.
  
  
  RESULTS
  Sixteen faculty, in groups of four, rated four student teams, each participating in the same TOSCE station. Faculty expressed comfort rating up to four students in a team within a 35-min timeframe. Accuracy of faculty raters varied (38-81% individuals, 50-100% teams), with errors in the direction of over-rating individual, but not team performance. There was no consistent pattern of error for raters.
  
  
  CONCLUSIONS
  The TOSCE can be administered as an evaluation method for interprofessional teams. However, faculty demonstrate a 'leniency error' in rating students, even with prior training using behavioral anchors. To improve consistency, we recommend two trained faculty raters per station.
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; dlie@usc.edu.
authors.forename: Désirée
authors.initials: D
authors.lastname: Lie
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Win
authors.initials: W
authors.lastname: May
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Regina
authors.initials: R
authors.lastname: Richter-Lagha
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Forest
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Banzali
authors.affiliation: Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Lohenry
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D004521:Educational Measurement / Q000379:methods*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007400:Interprofessional Relations; D017008:Negotiating; D015588:Observer Variation; D010348:Patient Care Team / Q000458:organization & administration*; D016544:Patient Simulation; D024382:Professional Role
keywords: assessment; interprofessional education; observed structured clinical encounter; standard-setting