Team behavior during trauma resuscitation: a simulation-based performance assessment.

Area of Science:

• Medical simulation
• Team performance assessment
• Trauma care quality improvement

Background:

• Trauma resuscitation demands coordinated multidisciplinary team response.
• Current methods for assessing team effectiveness in trauma resuscitation are lacking.
• Clinical simulation offers a viable approach to evaluate team dynamics and performance.

Purpose of the Study:

• To develop and validate a specialized assessment instrument for evaluating team effectiveness during trauma resuscitation using a simulation setting.
• To create a tool that can objectively measure team performance in high-stakes clinical scenarios.

Main Methods:

• Developed a prototype assessment tool based on the Mayo High Performance Teamwork Scale.
• Utilized four teams of surgical trainees and scripted confederates in six simulated trauma resuscitation scenarios.
• Videotaped 10 scenarios representing a range of team behaviors and scored them using the prototype tool by eight experienced clinicians.

Main Results:

• The prototype trauma team assessment tool comprises seven binary-scored attributes (present/absent).
• Significant variation in attribute presence (52.5%–93.8%) and median scores was observed across scenarios (P < .001).
• The tool effectively differentiated between high- and low-performing teams, with significant differences in median scores (P < .001).

Conclusions:

• The developed prototype instrument shows potential for effectively assessing team effectiveness in trauma resuscitation.
• This tool can aid in evaluating team competency, providing feedback, and studying the link between teamwork and patient outcomes.
• The assessment instrument may be adaptable for other high-acuity, time-sensitive clinical environments.