Development of the “Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills” (TEAM-ENTS) behavioral marker system

Abstract

Background and study aims Non-technical skills (NTS) are integral to team performance and subsequent quality and safety of care. Behavioural marker systems (BMS) are now increasingly used in healthcare to support training and assessment of team NTS. Within gastrointestinal endoscopy, this is an area of novel research. The aims of this study were to define the core relevant NTS for endoscopy teams and develop a preliminary framework for a team-based BMS known as TEAM-ENTS (Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills). Methods This study was conducted in two phases. In phase 1, a literature review of team-based BMS was performed to inform an interview study of core endoscopy team members. Cognitive task analysis was used to breakdown the NTS relevant to endoscopy teams. Framework analysis generated the structure for the preliminary TEAM-ENTS framework. In phase 2, a modified Delphi process was undertaken to refine items of the framework. Results Seven consultant endoscopists and six nurses were interviewed. The final coding framework consisted of 88 codes grouped into 5 overarching categories. In total, 58 participants were recruited to the Delphi panel. In the first round, 9 elements and 37 behavioural descriptors did not meet consensus. Following item adjustment, merging and deletion, all remaining items met consensus thresholds after the second round. The refined TEAM-ENTS BMS consists of 5 categories, 16 elements and 47 behavioural descriptors. Conclusions The refined TEAM-ENTS behavioural marker system was developed to reflect the core non-technical skills relevant to endoscopy teams. Future studies will aim to fully validate this tool.

Importance of non-technical skills: SACRED in advanced endoscopy

“…Recent work has gone further to draw out the core NTS relevant to team functioning across all forms of endoscopy. The ‘Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills’ framework outlines five key NTS domains for endoscopy teams: communication, decision-making, planning and problem-solving, leadership and coordination, situation awareness and, teamwork, cooperation and support 7. This framework provides a template for team training and assessment in endoscopy, which addresses the non-technical and behavioural skills that are vital to team performance.…”

Creating and improving highly effective endoscopic teams

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In this issue of Endoscopy, Ravindran and colleagues from the TEAM-ENTS working group present a framework for core relevant non-technical skills (NTS) for endoscopy teams, derived from a two-phase qualitative mixed-method process involving the development of an NTS taxonomy for endoscopy teams, and refinement into a behavioral marker system (BMS) using Delphi methodology [1]. The authors' approach in this paper is robustbeginning with a systematic review, which included 14 team-based BMSs from other health disciplinesand has resulted in the creation of an endoscopy-specific team BMS that is applicable in numerous circumstances, ranging from generic everyday diagnostic endoscopy to emergency lifesaving procedures."The TEAM-ENTS BMS is an especially valuable resource in two areas: team-based endoscopy training and assessment of endoscopy teams.

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