Abstract

Background: Effective teamwork is essential for preventing adverse events during surgery. Over the past two decades, various teamwork assessment tools have been developed to evaluate the non-technical performance of surgical teams. The purpose of this literature review is to present a summary of tools including the validity and reliability of each tool.

Methods: To identify teamwork assessment tools, a literature search was performed through the Medline and Embase databases, along with forward citation tracking across Scopus and Web of Science.

Results: Forty-nine articles were selected for review. Sixteen original team assessment tools identified have been employed in various surgical procedures. Fourteen out of sixteen tools were designed by point scale and two were event coding of surgical videos. The Non-Technical Skills for Surgeons (NOTSS) assessment was found to possess the highest level of validity. The Oxford Non-technical Skills System (NOTECHS) was the most validated tool on content, concurrent, predictive, and convergent validation evidence.

Conclusions: Several teamwork assessment tools such as ANTS, NOTECHS, NOTSS, OTAS and SPLINTS demonstrated good validity and reliability. However, tools developed more recently tend to show less validity and reliability evidence, possibly due to a lack of research to date. Deficits in the current integration of teamwork training and assessment into surgical training are observed. The incorporation of non-technical skill training and formal training of assessors are recommended in surgical programs.