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A scoping review of nontechnical skill assessment tools to evaluate trauma team performance
Avneesh Bhangu1, Christina Stevenson, Adam Szulewski
1From the Faculty of Health Sciences (A.B.), School of Medicine, Queen's University, Kingston, Ontario, Canada; School of Medicine (C.S.), University of Limerick, Limerick, Ireland; Department of Emergency Medicine (A.S.) and Department of Psychology (A.S.), Queen's University, Kingston, Ontario; Department of Biological Sciences (A.M.), Bishop's University, Sherbrooke, Quebec; Division of Emergency Medicine, Department of Medicine (B.N.), University of Toronto; Li Ka Shing Knowledge Institute (B.N.), St. Michael's Hospital; and Department of Emergency Medicine (B.N.), St. Michael's Hospital, Toronto, Ontario, Canada.
Background:
The objective of this scoping review was to identify assessment tools of trauma team performance (outside of technical skills) and assess the validity and reliability of each tool in assessing trauma team performance.
Methods:
We searched Embase, Cochrane Library, Web of Science, Ovid Medline, and Cumulative Index to Nursing and Allied Health Literature from inception to June 1, 2021. English studies that evaluated trauma team performance using nontechnical skill assessment tools in a simulation or real-world setting were included. Studies were assessed by two independent reviewers for meeting inclusion/exclusion criteria. Data regarding team assessment tools were extracted and synthesized into behavior domains. Each tool was then assessed for validity and reliability.
Results:
The literature search returned 4,215 articles with 29 meeting inclusion criteria. Our search identified 12 trauma team performance assessment tools. Most studies were conducted in the United States (n = 20 [69%]). Twenty studies (69%) assessed trauma team performance in a simulation setting; Team Emergency Assessment Measure (TEAM) and Trauma Nontechnical Skills Scale (T-NOTECHS) were the only tools to be applied in a simulation and real-world setting. Most studies assessed trauma team performance using video review technology (n = 17 [59%]). Five overarching themes were designed to encompass behavioral domains captured across the 12 tools: (1) Leadership, (2) Communication, (3) Teamwork, (4) Assessment, and (5) Situation Awareness. The reliability and validity of T-NOTECHS were investigated by the greatest number of studies (n = 13); however, TEAM had the most robust evidence of reliability and validity.
Conclusion:
We identified 12 trauma team performance tools that assessed nontechnical skills to varying degrees. Trauma Nontechnical Skills Scale and TEAM tools had the most evidence to support their reliability and validity. Considering the limited research in the impact of trauma team performance on patient outcomes, future studies could use video review technology in authentic trauma cases to further study this important relationship.
Level Of Evidence:
Systematic reviews and meta-analyses, level IV.
