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{
    "pk": 18012,
    "title": "Assessing Team Performance: A Mixed-Methods Analysis Using Interprofessional in situ Simulation",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> Optimizing the performance of emergency department (ED) teams impacts patient care, but the utility of current, team-based performance assessment tools to comprehensively measure this impact is underexplored. In this study we aimed to 1) evaluate ED team performance using current team-based assessment tools during an interprofessional <em>in situ</em> simulation and 2) identify characteristics of effective ED teams.</p>\n<p><strong>Methods:</strong> This mixed-methods study employed case study methodology based on a constructivist paradigm. Sixty-three eligible nurses, technicians, pharmacists, and postgraduate year 2–4 emergency medicine residents at a tertiary academic ED participated in a 10-minute <em>in situ</em> simulation of a critically ill patient. Participants self-rated performance using the Team Performance Observation Tool (TPOT) 2.0 and completed a brief demographic form. Two raters independently reviewed simulation videos and rated performance using the TPOT 2.0, Team Emergency Assessment Measure (TEAM), and Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). Following simulations, we conducted semi-structured interviews and focus groups with <em>in situ</em> participants. Transcripts were analyzed using thematic analysis.</p>\n<p><strong>Results:</strong> Eighteen team-based simulations took place between January–April 2021. Raters’ scores were on the upper end of the tools for the TPOT 2.0 (R1 4.90, SD 0.17; R2 4.53, SD 0.27, IRR [inter-rater reliability] 0.47), TEAM (R1 3.89, SD 0.19; R2 3.58, SD 0.39, IRR 0.73), and Ottawa GRS (R1 6.6, SD 0.56; R2 6.2, SD 0.54, IRR 0.68). We identified six themes from our interview data: team member entrustment; interdependent energy; leadership tone; optimal communication; strategic staffing; and simulation empowering team performance.</p>\n<p><strong>Conclusion:</strong> Current team performance assessment tools insufficiently discriminate among high performing teams in the ED. Emergency department-specific assessments that capture features of entrustability, interdependent energy, and leadership tone may offer a more comprehensive way to assess an individual’s contribution to a team’s performance.</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "team performance"
        },
        {
            "word": "leadership"
        },
        {
            "word": "Simulation"
        },
        {
            "word": "Interprofessional"
        },
        {
            "word": "interdependence"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8j52388r",
    "frozenauthors": [
        {
            "first_name": "Ashley",
            "middle_name": "C.",
            "last_name": "Rider",
            "name_suffix": "",
            "institution": "Stanford University, Department of Emergency Medicine, Palo Alto, California",
            "department": "None"
        },
        {
            "first_name": "Sarah",
            "middle_name": "R.",
            "last_name": "Williams",
            "name_suffix": "",
            "institution": "Stanford University, Department of Emergency Medicine, Palo Alto, California",
            "department": ""
        },
        {
            "first_name": "Vivien",
            "middle_name": "",
            "last_name": "Jones",
            "name_suffix": "",
            "institution": "Royal College of Surgeons, Dublin, Ireland",
            "department": "None"
        },
        {
            "first_name": "Daniel",
            "middle_name": "",
            "last_name": "Rebagliati",
            "name_suffix": "",
            "institution": "Albany Medical College, Albany, New York",
            "department": "None"
        },
        {
            "first_name": "Kimberly",
            "middle_name": "",
            "last_name": "Schertzer",
            "name_suffix": "",
            "institution": "Stanford University, Department of Emergency Medicine, Palo Alto, California",
            "department": ""
        },
        {
            "first_name": "Michael",
            "middle_name": "A.",
            "last_name": "Gisondi",
            "name_suffix": "",
            "institution": "Stanford University, Department of Emergency Medicine, Palo Alto, California",
            "department": "None"
        },
        {
            "first_name": "Stefanie",
            "middle_name": "S.",
            "last_name": "Sebok-Syer",
            "name_suffix": "",
            "institution": "Stanford University, Department of Emergency Medicine, Palo Alto, California",
            "department": "None"
        }
    ],
    "date_submitted": "2023-04-01T01:52:19+03:00",
    "date_accepted": "2024-02-07T00:14:35+03:00",
    "date_published": "2024-06-11T16:00:00+03:00",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/18012/galley/14442/download/"
    },
    "galleys": [
        {
            "label": "Layout",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18012/galley/10651/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18012/galley/14442/download/"
        }
    ]
}