Standardized assessment for evaluation of team skills: validity and feasibility

Abstract

Introduction: The authors developed a Standardized Assessment for Evaluation of Team Skills (SAFE-TeamS) in which actors portray health care team members in simulated challenging teamwork scenarios. Participants are scored on scenario-specific ideal behaviors associated with assistance, conflict resolution, communication, assertion, and situation assessment. This research sought to provide evidence of the validity and feasibility of SAFE-TeamS as a tool to support the advancement of science related to team skills training.

Methods: Thirty-eight medical and nursing students were assessed using SAFE-TeamS before and after team skills training. The SAFE-TeamS pretraining and posttraining scores were compared, and participants were surveyed. Generalizability analysis was used to estimate the variance in scores associated with the following: examinee, scenario, rater, pretraining/posttraining, examinee type, rater type (actor-live vs. external rater-videotape), actor team, and scenario order.

Results: The SAFE-TeamS scores reflected improvement after training and were sensitive to individual differences. Score variance due to rater was low. Variance due to scenario was moderate. Estimates of relative reliability for 2 raters and 8 scenarios ranged from 0.6 to 0.7. With fixed scenarios and raters, 2 raters and 2 scenarios, reliability is greater than 0.8. Raters believed SAFE-TeamS assessed relevant team skills. Examinees' responses were mixed.

Conclusions: The SAFE-TeamS was sensitive to individual differences and team skill training, providing evidence for validity. It is not clear whether different scenarios measure different skills and whether the scenarios cover the necessary breadth of skills. Use of multiple scenarios will support assessment across a broader range of skills. Future research is required to determine whether assessments using SAFE-TeamS will translate to performance in clinical practice.

FIGURE 1.

Scores of 27 participants scored by the same 2 external raters pretraining and posttraining. The black line represents the mean score pretraining, and the gray line represents the mean score posttraining.

FIGURE 2.

Estimates of generalizability coefficient for 1 to 4 raters across number of scenarios for external raters using the pretraining data set. Relative reliability assumes scenarios, and raters are selected at random. Fixed reliability assumes that the raters and scenarios are fixed (eg, all participants receive the same scenarios and are rated by the same raters).

FIGURE 3.

Estimates of generalizability coefficient assuming 2 raters for4 different samples of data (rated by actors before and after training and rated by external raters before and after training). Relative reliability assumes scenarios, and raters are selected at random. Fixed reliability assumes that the raters and scenarios are fixed (eg, all participants receive the same scenarios and are rated by the same raters).