Reliability of the assessment of non-technical skills by using video-recorded trauma resuscitations

Maarseveen, Oscar E. C. van; Ham, Wietske H. W.; Huijsmans, Roel L. N.; Dolmans, Rianne G F; Leenen, Luke P. H.

doi:10.1007/s00068-020-01401-5

Cited by 14 publications

(28 citation statements)

References 37 publications

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“…The ability to replay cases further highlights the advantages of the Trauma Team Video Review Program, as it limited the possibility of recall bias and allowed for details related to case specifics to be reviewed and accurately collected [ 14 ]. In addition, we used two reviewers, corroborating with the study performed by Maarseveen et al [ 24 ] which suggested that video analysis of trauma team performance by multiple raters using T-NOTECHS leads to a higher ICC compared to resuscitations observed by live raters, suggesting greater reliability. As such, from a methodological perspective, having two reviewers collect data using video review technology allowed for more robust data collection in our study.…”

Section: Discussionsupporting

confidence: 81%

Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis

et al. 2022

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Objectives Communication among trauma team members in the trauma bay is vulnerable to errors, which may impact patient outcomes. We used the previously validated trauma-non-technical skills (T-NOTECHS) tool to identify communication gaps during patient management in the trauma bay and to inform development strategies to improve team performance. Methods Two reviewers independently assessed non-technical skills of team members through video footage at Sunnybrook Health Sciences Centre. Team performance was measured using T-NOTECHS across five domains using a five-point Likert scale (lower score indicating worse performance): (1) leadership; (2) cooperation and resource management; (3) communication and interaction; (4) assessment and decision making; (5) situation awareness/coping with stress. Secondary outcomes assessed the number of callouts, closed loop communications and parallel conversations. Results The study included 55 trauma activations. Injury severity score (ISS) was used as a measure of trauma severity. A case with an ISS score ≥ 16 was considered severe. ISS was ≥ 16 in 37% of cases. Communication and interaction scored significantly lower compared to all other domains ( p < 0.0001). There were significantly more callouts and completed closed loop communications in more severe cases compared to less severe cases ( p = 0.017 for both). Incomplete closed loop communications and parallel conversations were identified, irrespective of case severity. Conclusion A lower communication score was identified using T-NOTECHS, attributed to incomplete closed loop communications and parallel conversations. Through video review of trauma team activations, opportunities for improvement in communication can be identified by the T-NOTECHS tool, as well as specifically identifying callouts and closed loop communication. This process may be useful for trauma programs as part of a quality improvement program on communication skills and team performance. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00295-z.

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Section: Discussionsupporting

confidence: 81%

Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis

et al. 2022

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“…Trauma Nontechnical Skills Scale has widely been used in a trauma setting for teaching purposes and to assess the learning outcomes and teamwork skills of multidisciplinary trauma teams 45 . Trauma Nontechnical Skills Scale is a simple and validated instrument in assessing the nontechnical skills of trauma teams, which may be rapidly adopted by raters of varying expertise (medical students to experienced clinicians) after minimal training 46 . However, studies such as conducted by Wieck et al 43 suggest that T-NOTECHS may still benefit from further refinement, such as increasing the accuracy of the scoring system through mixing expert and self-reported assessments for different domains.…”

Section: Discussionmentioning

confidence: 99%

“…45 Trauma Nontechnical Skills Scale is a simple and validated instrument in assessing the nontechnical skills of trauma teams, which may be rapidly adopted by raters of varying expertise (medical students to experienced clinicians) after minimal training. 46 However, studies such as conducted by Wieck et al 43 suggest that T-NOTECHS may still benefit from further refinement, such as increasing the accuracy of the scoring system through mixing expert and self-reported assessments for different domains. On the other hand, TEAM is an instrument that was designed to assess nontechnical skills more broadly during resuscitation events (extending beyond trauma teams, such as cardiac resuscitation teams), which may be applied for quality improvement research or teaching purposes.…”

Section: Practical Application Of Team Assessment Toolsmentioning

confidence: 99%

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

Bhangu

Stevenson

Szulewski

et al. 2021

J Trauma Acute Care Surg

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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.

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“…In simplest form, the impact of team variance on teamwork could be assessed during simulation sessions to compare teams with no or little variance to high variance. There are reliable and validated tools available to assess the teamwork, such as the T-NOTECHS tool [22][23][24]. Third, interventions to effectively reduce team variation could be developed, tested and implemented into practice.…”

Section: Further Researchmentioning

confidence: 99%

Variation of in-hospital trauma team staffing: new resuscitation, new team

et al. 2022

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Background Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.

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Reliability of the assessment of non-technical skills by using video-recorded trauma resuscitations

Cited by 14 publications

References 37 publications

Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis

Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis

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

Variation of in-hospital trauma team staffing: new resuscitation, new team

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