Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT)

Int J Qual Health Care. 2016 Jun;28(3):332-8. doi: 10.1093/intqhc/mzw030. Epub 2016 Apr 15.


Objective: To develop a tool for independent observational assessment of cancer multidisciplinary team meetings (MDMs), and test criterion validity, inter-rater reliability/agreement and describe performance.

Design: Clinicians and experts in teamwork used a mixed-methods approach to develop and refine the tool. Study 1 observers rated pre-determined optimal/sub-optimal MDM film excerpts and Study 2 observers independently rated video-recordings of 10 MDMs.

Setting: Study 2 included 10 cancer MDMs in England.

Participants: Testing was undertaken by 13 health service staff and a clinical and non-clinical observer.

Intervention: None.

Main outcome measures: Tool development, validity, reliability/agreement and variability in MDT performance.

Results: Study 1: Observers were able to discriminate between optimal and sub-optimal MDM performance (P ≤ 0.05). Study 2: Inter-rater reliability was good for 3/10 domains. Percentage of absolute agreement was high (≥80%) for 4/10 domains and percentage agreement within 1 point was high for 9/10 domains. Four MDTs performed well (scored 3+ in at least 8/10 domains), 5 MDTs performed well in 6-7 domains and 1 MDT performed well in only 4 domains. Leadership and chairing of the meeting, the organization and administration of the meeting, and clinical decision-making processes all varied significantly between MDMs (P ≤ 0.01).

Conclusions: MDT-MOT demonstrated good criterion validity. Agreement between clinical and non-clinical observers (within one point on the scale) was high but this was inconsistent with reliability coefficients and warrants further investigation. If further validated MDT-MOT might provide a useful mechanism for the routine assessment of MDMs by the local workforce to drive improvements in MDT performance.

Keywords: cancer; multidisciplinary team; observation; patient care team; quality assessment; teamwork.

MeSH terms

  • Clinical Decision-Making
  • England
  • Environment
  • Group Processes*
  • Humans
  • Leadership
  • Medical Oncology
  • Neoplasms / therapy*
  • Observer Variation
  • Organizational Culture
  • Patient Care Team / organization & administration*
  • Patient Care Team / standards
  • Patient-Centered Care / organization & administration
  • Reproducibility of Results
  • Surveys and Questionnaires / standards*