Teamwork Assessment Scale (TAS)

National Center for Interprofessional Practice and Education's picture
Submitted by National Center... on Sep 6, 2016 - 11:12am CDT

Instrument
Authors: 
Kiesewetter J.
Fischer M.R.
Overview: 

The purpose of the TAS is two-fold: to train and to assess undergraduate medical students' ability to work in teams during ward rounds.  Based on a theoretical model of teamwork, it measures team functioning using a 14-item observational tool applied in a simulation lab. In the validation studies, small teams of 3-4 medical students and chiefs of medicine participated in three different simulated scenarios that were designed to assess team coordination, cooperation, information exchange, and ability to adjust to unexpected patient difficulties.  Both attending physicians and students observed and rated team performance. The validity studies collected evidence of good factor structure and good internal consistency for the instrument.  They also revealed high correlation between the team scores and individual medical students' clinical performance, but only when scored by a trained physician.

Link to Resources
Descriptive Elements
Who is Being Assessed or Evaluated?: 
Teams
Instrument Type: 
Observer-based (e.g., rubric, rating tool, 360 degree feedback)
Source of Data: 
Health care trainees
Health care providers, staff
Notes for Data Sources: 

In terms of the simulation, medical students role played the parts of nurse and medicine resident.  In addition to 3-4 students in these roles, each team had a chief of medicine who was trained to serve in this role.  In study 1 (to assess the tool's internal structure), four trained physician observers were used as raters.  In study 2 (to assess the relationship between TAS scores and clinical performance), two physicians and two medical students were used as raters.

Instrument Content: 
Behaviors / skills
Notes for Content: 

1. Task-related Collaborative Behaviors

  • Coordination
  • Cooperation
  • Information exchange

As a result of factor analysis, the latter two components were combined and the instrument was reduced from 17 to 14 items.

2. Team Adjustment Behaviors had no sub-components.

The three simulation scenarios involved varying degrees of complexity in terms of the amount of information that had to be handled before or within the scenario.

  • Scenario 1: unexpected clinical finding (T-wave negativations on ECG) just prior to patient discharge, requiring team meeting and patient discussion
  • Scenario 2: patient on fasting restrictions ate breakfast, creating a problem for a scheduled gastrointestinal tract ultrasound, conflict and team problem solving
  • Scenario 3: a non-compliant diabetic patient refuses to take medication, requiring team intervention and patient education
Instrument Length: 

14 items; each of the simulation scenarios lasts 5-7 minutes.

Item Format: 
Likert-type, 5-point scales with "completely disagree" (1) and "completely agree" (5) as polar anchors.
Administration: 
Simulations were conducted in a university-based simulation center. In study 1, authors described dividing up the class so half of the students performed the simulated role plays while the other half watched. In the Discussion, the authors state that a short, video-based training session can be used to prepare raters to use the TAS.
Scoring: 
Item scores and overall average scores can be computed from the TAS. Several items are reverse scored.
Language: 
English and German
Norms: 
None described
Access: 
Open access (available on this website)
Notes on Access: 

Contact the author to confirm permission to use.
 

Psychometric Elements: Evidence of Validity
Content: 
The authors reviewed existing literature on teamwork and adapted a framework described by Rousseau, Aube, and Savoie, which itself was derived from an analysis of 29 teamwork models. Authors also reviewed existing instruments, and drew upon those that seemed applicable for "diverse disciplines" (e.g., nurses and doctors). Their initial instrument included 26 items measuring coordination, cooperation, information exchange, and team adjustment behaviors. An interdisciplinary team (medical professionals, educators, psychologists) reviewed the items to ascertain whether they were "representative" (i.e., no obvious part of teamwork behaviors were left out); for the extent the behaviors could be "observed" in teams that possessed teamwork competency and not in teams lacking teamwork competency; and "comprehensibility" (i.e., someone with teamwork knowledge could understand the items and distinguish between scales in the instrument).
Response Process: 
No information
Internal Structure: 
Preliminary psychometric analysis involving 69 students and 4 physician raters suggested the factor structure resembled the theoretical structure, but did not differentiate between 2 of the 4 components of the model: "information exchange" and "team cooperation." In study one (n=69 students, 4 physician raters), the overall internal consistency coefficient (Cronbach's alpha) for 17 items was 0.75, and the coefficients for the sub-scales were as follows: Team Coordination = 0.81; Cooperation and Information Exchange = 0.76; and Team Adjustment Behaviors = 0.67. In study 2 (n=100 medical students, 2 physician and 2 medical student raters), internal consistency for the 14-item tool was 0.78 for the physician raters and 0.69 for the student raters.
Relation to Other Variables: 
In a second study involving 100 medical students, 2 physician raters, and 2 medical student raters, authors reported that physicians' TAS scores were correlated with students' individual clinical performance, as measured by a "collaboration script" (a university-based set of standardardized procedures for ward-rounds). Fulfillment of the script can be analyzed using a coding structure and scored. The correlation between TAS scores and clinical performance was analyzed separately by rater type (physicians vs. medical student raters). The correlation between physician-assigned TAS total score and clinical performance was r = 0.64, with correlations for sub-scales as follows: Team Coordination r = 0.60; Cooperation and Information Exchange r = 0.59; and Team Adjustment Behavior r = 0.52. Medical student-assigned ratings were extremely low.
Consequential: 
No information
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