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Measuring the teamwork performance of teams in crisis situations: a systematic review of assessment tools and their measurement properties
  1. Sylvain Boet1,
  2. Cole Etherington2,
  3. Sarah Larrigan3,
  4. Li Yin3,
  5. Hira Khan4,
  6. Katrina Sullivan2,
  7. James J Jung5,
  8. Teodor P Grantcharov6
  1. 1Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  2. 2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  3. 3University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
  4. 4Department of Health Sciences, Faculty of Science, Carleton University, Ottawa, Ontario, Canada
  5. 5Division of General Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
  6. 6Division of General Surgery, St Michael’s Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Sylvain Boet, Anesthesiology and Pain Medicine, Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Canada; sboet{at}


Background Educational interventions to improve teamwork in crisis situations have proliferated in recent years with substantial variation in teamwork measurement. This systematic review aimed to synthesise available tools and their measurement properties in order to identify the most robust tool for measuring the teamwork performance of teams in crisis situations.

Methods Searches were conducted in Embase (via OVID), PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, Medline and Medline In-Process (via OVID) (through 12 January 2017). Studies evaluating the measurement properties of teamwork assessment tools for teams in clinical or simulated crisis situations were included. Two independent reviewers screened studies based on predetermined criteria and completed data extraction. Risk of bias was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

Results The search yielded 1822 references. Twenty studies were included, representing 13 assessment tools. Tools were primarily assessed in simulated resuscitation scenarios for emergency department teams. The Team Emergency Assessment Measure (TEAM) had the most validation studies (n=5), which demonstrated three sources of validity (content, construct and concurrent) and three sources of reliability (internal consistency, inter-rater reliability and test–retest reliability). Most studies of TEAM’s measurement properties were at no risk of bias.

Conclusions A number of tools are available for assessing teamwork performance of teams in crisis situations. Although selection will ultimately depend on the user’s context, TEAM may be the most promising tool given its measurement evidence. Currently, there is a lack of tools to assess teamwork performance during intraoperative crisis situations. Additional research is needed in this regard.

  • teamwork
  • crisis management
  • Performance measures

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  • Contributors All authors meet the ICMJE criteria for authorship.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests TPG is the founder and equity holder of Surgical Safety Technologies, Toronto, Ontario, Canada.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.