Role confusion and self-assessment in interprofessional trauma teams

Am J Surg. 2016 Feb;211(2):482-8. doi: 10.1016/j.amjsurg.2015.11.001. Epub 2015 Dec 12.


Background: Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment.

Methods: Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations. After each resuscitation, nurses and teamwork experts independently scored teamwork (T-NOTECHS). After video debriefing, nurses repeated T-NOTECHS self-assessment.

Results: Nurses and surgeons assumed significantly more responsibility by their own profession for 71% of resuscitation tasks. Nurses' overall T-NOTECHS ratings were slightly higher than experts'. This was evident in all T-NOTECHS subdomains except "leadership," but despite statistical significance the difference was small and clinically irrelevant. Video debriefing did not improve the accuracy of self-assessment.

Conclusions: Nurses and physicians demonstrated discordant perceptions of responsibilities. Nurses' self-assessment of teamwork was statistically, but not clinically significantly, higher than experts' in all domains except physician leadership.

Keywords: Interprofessional education; Simulation-based training; T-NOTECHS; Teamwork; Trauma.

Publication types

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

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Female
  • Humans
  • Interprofessional Relations*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Professional Role*
  • Reproducibility of Results
  • Resuscitation*
  • Self-Assessment*
  • Trauma Centers
  • Video Recording