title: The Teamwork Assessment Scale: A Novel Instrument to Assess Quality of Undergraduate Medical Students' Teamwork Using the Example of Simulation-based Ward-Rounds.
abstract: BACKGROUND
  Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine.
  
  
  OBJECTIVE
  The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance.
  
  
  METHODS
  Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components (Team Coordination, Team Cooperation, Information Exchange, Team Adjustment Behaviours) were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters.
  
  
  RESULTS
  In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach's α=.75). In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64) and the sufficient psychometric properties were replicated (Cronbach's α=.78).
  
  
  CONCLUSIONS
  The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure teamwork by physicians. Further studies are needed to verify the applicability of the instrument.
authors.affiliation: Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany ; Ludwig-Maximilians-Universtiy Munich, Munich Center of the Learning Sciences (MCLS), Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kiesewetter
authors.affiliation: Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Fischer
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003299:Cooperative Behavior; D003479:Curriculum / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000592:standards*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D015588:Observer Variation; D010348:Patient Care Team / Q000592:standards*; D011594:Psychometrics / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000592:standards*; D015203:Reproducibility of Results; D056164:Teaching Rounds / Q000592:standards*; D055815:Young Adult
keywords: medical education; simulation-based training; teaching and learning; team performance measurement; team training