A scoping review of nontechnical skill assessment tools to evaluate trauma team performance

Abstract

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.

Impact of video recordings review with structured debriefings on trauma team performance: a prospective observational cohort study

“…There were no statistically signi cant differences in patient age, gender, injury severity, or EMS prehospital time between the study cohorts (Table 1). There was statistically signi cant improvement in the T-NOTECHS score after the implementation of the SD: 12 [10][11][12][13][14] out of possible 25 points or 48% [40-56%] in the before SD group and 16 [14][15][16][17][18][19] points or 64% [56-75%] in the after SD group (p < 0.001). Comparison of the distribution in ve behavior domains between the study groups are shown in Table 5.…”

“…Non-technical skills were evaluated using T-NOTECHS [12,13] scale. This scale is widely used to evaluate the non-technical skills of trauma teams during simulated or real-life trauma scenarios.…”

Evaluation of video review tools for assessing non-technical skills in emergency department resuscitation teams: a systematic review

“…Bhangu et al [ 37 ] also published a scoping review in 2022 evaluating tools used to assess NTS in both real world and simulated settings. They identified the T-NOTECHS and TEAM tool as the most reliable for use in this context.…”

Reliability and validity testing of team emergency assessment measure in a distributed team context

“…Furthermore, a vital aspect of training effective teamwork is to include the team’s specific challenges and environment ( Manser, 2009 ) when planning the training program since clinical context greatly affects how team members work together ( Schmutz et al, 2019 ). Several instruments for performance evaluation have been developed and validated for teams working in traditional co-located settings, either in clinical or simulation-based environments ( Valentine et al, 2015 ; Boet et al, 2019 ; Bhangu et al, 2022 ). Available instruments range in focus from assessing general teamwork skills (e.g., Healthy Teams Model; Mickan and Rodger, 2005 ) to more context-specific skills such as Non-Technical Skills for Surgeons (NOTSS; Yule et al, 2008 ).…”

“…Even though TEAM is an established measurement of teamwork with good psychometric properties for emergencies ( Valentine et al, 2015 ; Boet et al, 2019 ; Bhangu et al, 2022 ), to the best of our knowledge, its validity and reliability have not been established for the distributed team context. To address this gap, we report on the reliability and validity of TEAM for distributed teams managing acute medical conditions when the physician participates from a remote location via telemedicine.…”