Observational teamwork assessment for surgery: content validation and tool refinement.

Area of Science:

• Surgical Safety
• Teamwork and Communication in Healthcare
• Medical Education and Training

Background:

• Effective teamwork is critical for safe surgical procedures.
• Failures in nontechnical and teamwork skills are often linked to adverse surgical events.
• The Observational Teamwork Assessment for Surgery (OTAS) tool evaluates operating room team dynamics, but its content validity requires empirical testing.

Purpose of the Study:

• To empirically test the content validity of the Observational Teamwork Assessment for Surgery (OTAS) tool.
• To refine OTAS behavior exemplars based on expert assessment and consensus.
• To establish the psychometric robustness of OTAS for assessing surgical teamwork.

Main Methods:

• A cross-sectional observational study involving 30 surgical procedures.
• Two researchers scored five teamwork behaviors and recorded behavior exemplar completion.
• Expert operating room personnel and a patient-safety expert panel assessed and refined OTAS exemplar behaviors.

Main Results:

• High observer agreement (Cohen's κ ≥ 0.41) was achieved for 83.85% of 130 assessed exemplar behaviors.
• 60.77% of exemplar behaviors were frequently observed with high agreement.
• Expert consensus led to the removal of 21 exemplars and modification of 23 others, with most rated as crucial for teamwork and patient safety.

Conclusions:

• The OTAS tool demonstrates very good content validity.
• Refined OTAS exemplars contribute to its psychometric robustness.
• OTAS is a reliable tool for capturing and assessing operating room teamwork, supporting patient safety initiatives.