ఆరోగ్య సంరక్షణ : ప్రస్తుత సమీక్షలు

నైరూప్య

Development and Assessment of an Evaluation Tool for Team Clinical Performance: The Team Average Performance Assessment Scale (TAPAS)

Denis Oriot, Armelle Bridier and Daniel Aiham Ghazali

Introduction: Team effectiveness consists in team performance (procedures, algorithms) and team process (Crisis Resource Management - CRM). Although CRM scales and a few team performance checklists exist, to our knowledge, no team performance assessment scale covering all critical conditions in adults and children exists.

Objective: The objective was to develop and assess a clinical team average performance assessment scale (TAPAS) evaluating clinical performance during immersive simulation of critical conditions.

Methods: Three experts selected items from PALS, EPLS, NLS, ACLS, and ATLS courses. The final TAPAS included 129 items, rated 0/1/2, with a total over 100. Items were preselected according to each scenario, making the score a reflection of the percentage of the best performance for a given scenario. The psychometric analysis was tested on 159 simulations. Scenarios were acute life-threatening conditions in neonates, children and adults (medical, trauma) (SimNewB and ALS, Laerdal*). Two independent observers among a group of 8, assessed performance and were surveyed on TAPAS ease of use. The analysis included: comparison between observers of means and SD, linear logistic regression, coefficient correlation, discordance; Cronbach alpha (CA), intra-class coefficient (ICC), and comparison at two training times.

Results: TAPAS score was 46.6 ± 15.5 (18-83.5). Analysis showed: CA=0.745, ICC=0.862. Observers' scores were not different (means and SD), highly correlated (coefficient=0.838, p=0.0011, R2 =0.64), and with a discordance <7%. TAPAS scores increased after training (p<0.0001). TAPAS were found to be easy to use.

Conclusions: TAPAS was a valuable team performance assessment instrument, easy to use in team simulation, in different age groups (neonatal, pediatric, adult) and critical conditions (medical, trauma).