Observational Skill-based Clinical Assessment tool for Resuscitation (OSCAR): Development and validation

Abstract

AimThe aim of the study reported here was to address the need to assess and train teamwork and non-technical skills in the context of Resuscitation. Specifically, we sought to develop a tool that is feasible to use and psychometrically sound to assess team behaviours during cardiac arrest resuscitation attempts.MethodsTo ensure validity, reliability, and feasibility, the Observational Skill based Clinical Assessment tool for Resuscitation (OSCAR) was developed in 3 phases. A review of the literature leading to initial tool development was followed by an assessment of face and content validity, and finally a thorough reliability assessment, using Cronbach's α to assess internal consistency and intraclass correlation to assess inter-rater reliability.ResultsOSCAR was developed methodically, and tested for face and content validity. Cronbach's α results ranged from 0.736 to 0.965 demonstrating high internal consistency, and intraclass correlation results ranged from 0.652 to 0.911, all of which are strongly significant and indicate good inter-rater reliability.ConclusionOn the basis of our results, we conclude that OSCAR is psychometrically robust, scientifically sound, and clinically relevant. We have developed the Observational Skill-based Clinical Assessment tool for Resuscitation (OSCAR) for the assessment of non-technical skills in Resuscitation teams. We propose the use of this tool in simulation and real Cardiac Arrest Resuscitation attempts to assess, guide and train non-technical skills to team members, to improve patient safety and maximise the chances of successful resuscitation.

Major Incident Preparation for Acute Hospitals: Current State-of-the-Art, Training Needs Analysis, and the Role of Novel Virtual Worlds Simulation Technologies

“…Process metrics are likely to be required -given that the positive impact of training on the management of a major incident when it happens is very hard to gauge and entirely unpredictable. Systematic, transparent, scientific skill assessment and feedback is a key aspect of the training that could benefit from recent developments in the domain of non-technical skills training and assessment within the health care literature (37)(38)(39)(40)(41). Training packages that involve simulation and validated performance and skill assessment tools have been developed, validated, and evaluated in other health care fields -these could inform a similar approach to major incident training (42)(43)(44)(45).…”

Development of a behaviour rating system for rural/remote pre-hospital settings

“…Outside the surgical context, an observational skill-based assessment tool for resuscitation (OSCAR) was developed for use within cardiac arrest teams, outlining behaviours specific to anaesthetists, physicians and nurses, incorporating communication, co-operation, co-ordination, monitoring/situation awareness, leadership and decision-making (13). A similar system, the Team Emergency Assessment Measure (TEAM), was developed for emergency resuscitation, featuring teamwork, leadership and task management (14).…”

Implementing an Undergraduate, Team-Based, First Aid Education Course

“…Tool for Resuscitation (OSCAR) were used (Cooper, et al, 2010;Walker et al, 2011 (Cooper et al, 2010). It is for these reasons we used TEAM as one of our assessment tools.…”

“…This tool has been found to be valid and reliable tool when assessing teamwork and non-technical skills in resuscitation contexts in a simulated environment (Walker et al, 2011). OSCAR also allows for detailed breakdown of the assessment of teamwork and non-technical skill as well as identification of areas of weakness in sub-teams and individuals facilitating constructive feedback to all team-members (Walker et al, 2011). It is for these reasons we decided to use OSCAR.…”