Assessing teamwork in medical education and practice: relating behavioural teamwork ratings and clinical performance

Med Teach. 2009 Jan;31(1):30-8. doi: 10.1080/01421590802070853.


Background: Problems with communication and team coordination are frequently linked to adverse events in medicine. However, there is little experimental evidence to support a relationship between observer ratings of teamwork skills and objective measures of clinical performance.

Aim: Our main objective was to test the hypothesis that observer ratings of team skill will correlate with objective measures of clinical performance.

Methods: Nine teams of medical students were videotaped performing two types of teamwork tasks: (1) low fidelity classroom-based patient assessment and (2) high fidelity simulated emergent care. Observers used a behaviourally anchored rating scale to rate each individual on skills representative of assertiveness, decision-making, situation assessment, leadership, and communication. A checklist-based measure was used to assess clinical team performance.

Results: Moderate to high inter-observer correlations and moderate correlations between cases established the validity of a behaviourally anchored team skill rating tool for simulated emergent care. There was moderate to high correlation between observer ratings of team skill and checklist-based measures of team performance for the simulated emergent care cases (r = 0.65, p = 0.06 and r = 0.97, p < 0.0001).

Conclusions: These results provide prospective evidence of a positive relationship between observer ratings of team skills and clinical team performance in a simulated dynamic health care task.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Clinical Competence / standards*
  • Cooperative Behavior*
  • Education, Medical, Undergraduate / organization & administration*
  • Emergency Medicine / education*
  • Female
  • Group Processes*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Leadership
  • Male
  • Middle Aged
  • Patient Care Team / organization & administration*
  • Patient Simulation*
  • Task Performance and Analysis
  • Time Factors
  • United States
  • Video Recording
  • Young Adult