title: Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.
abstract: BACKGROUND
  Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies.
  
  
  METHODS
  We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data.
  
  
  RESULTS
  Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity.
  
  
  CONCLUSIONS
  More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.
authors.affiliation: From the Department of Anesthesia (D.O., M.B.) and Pain Management, Mount Sinai Hospital; and Department of Anesthesia (S.H.), Sunnybrook Health Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Desire N
authors.initials: DN
authors.lastname: Onwochei
authors.forename: Stephen
authors.initials: S
authors.lastname: Halpern
authors.forename: Mrinalini
authors.initials: M
authors.lastname: Balki
mesh_terms: D000072080:Anesthesiologists / Q000458:organization & administration; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D036861:Delivery, Obstetric / Q000379:methods*; D004630:Emergencies; D005260:Female; D006126:Group Processes; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D011446:Prospective Studies; D015203:Reproducibility of Results; D000066908:Simulation Training