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  • Title: Assessing teamwork in the trauma bay: introduction of a modified "NOTECHS" scale for trauma.
    Author: Steinemann S, Berg B, DiTullio A, Skinner A, Terada K, Anzelon K, Ho HC.
    Journal: Am J Surg; 2012 Jan; 203(1):69-75. PubMed ID: 22172484.
    Abstract:
    BACKGROUND: A modified nontechnical skills (NOTECHS) scale for trauma (T-NOTECHS) was developed to teach and assess teamwork skills of multidisciplinary trauma resuscitation teams. In this study, T-NOTECHS was evaluated for reliability and correlation with clinical performance. METHODS: Interrater reliability (intraclass correlation coefficient) and correlation with the speed and completeness of resuscitation tasks were assessed during simulation-based teamwork training and during actual trauma resuscitations. RESULTS: For T-NOTECHS ratings done in real time, intraclass correlation coefficients were .44 for simulated and .48 for actual resuscitations. Reliability was higher (intraclass correlation coefficient = .71) for video review of resuscitations. Better T-NOTECHS scores were correlated with better performance during simulations, evidenced by a greater number of completed resuscitation tasks (r = .50, P < .01) and faster time to completion (r = -.38, P < .05) In actual resuscitations, T-NOTECHS ratings improved after teamwork training (P < .001). Higher T-NOTECHS scores were correlated with better clinical performance, evidenced by faster resuscitation (r = -.13, P < .05) and fewer unreported resuscitation tasks (r = -.16, P < .05). CONCLUSIONS: Improvement in T-NOTECHS scores after teamwork training, and correlation with clinical parameters in simulated and actual trauma resuscitations, suggest its clinical relevance. Further evaluation, aiming to improve reliability, may be warranted.
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