title: Content Validation and Evaluation of an Endovascular Teamwork Assessment Tool.
abstract: To modify, content validate, and evaluate a teamwork assessment tool for use in endovascular surgery.
  
  
  
  A multistage, multimethod study was conducted. Stage 1 included expert review and modification of the existing Observational Teamwork Assessment for Surgery (OTAS) tool. Stage 2 included identification of additional exemplar behaviours contributing to effective teamwork and enhanced patient safety in endovascular surgery (using real-time observation, focus groups, and semistructured interviews of multidisciplinary teams). Stage 3 included content validation of exemplar behaviours using expert consensus according to established psychometric recommendations and evaluation of structure, content, feasibility, and usability of the Endovascular Observational Teamwork Assessment Tool (Endo-OTAS) by an expert multidisciplinary panel. Stage 4 included final team expert review of exemplars.
  
  
  
  OTAS core team behaviours were maintained (communication, coordination, cooperation, leadership team monitoring). Of the 114 OTAS behavioural exemplars, 19 were modified, four removed, and 39 additional endovascular-specific behaviours identified. Content validation of these 153 exemplar behaviours showed that 113/153 (73.9%) reached the predetermined Item-Content Validity Index rating for teamwork and/or patient safety. After expert team review, 140/153 (91.5%) exemplars were deemed to warrant inclusion in the tool. More than 90% of the expert panel agreed that Endo-OTAS is an appropriate teamwork assessment tool with observable behaviours. Some concerns were noted about the time required to conduct observations and provide performance feedback.
  
  
  
  Endo-OTAS is a novel teamwork assessment tool, with evidence for content validity and relevance to endovascular teams. Endo-OTAS enables systematic objective assessment of the quality of team performance during endovascular procedures.
authors.affiliation: Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK. Electronic address: louise.hull@klc.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Hull
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK; Vascular Unit, Imperial Healthcare NHS Trust, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Bicknell
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Vyas
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Van Herzeele
authors.affiliation: Centre for Implementation Science, Health Services and Population Research Department, King's College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Sevdalis
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK; Vascular Unit, Imperial Healthcare NHS Trust, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Rudarakanchana
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D057510:Endovascular Procedures / Q000592:standards*; D006801:Humans; D010348:Patient Care Team / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods; D015203:Reproducibility of Results
keywords: Assessment; Endovascular surgery; Evaluation; Team performance; Teamwork