VALIDATION OF THE TEAM-ENTS (TEAMWORK IN ENDOSCOPY ASSESSMENT MODULE FOR ENDOSCOPIC NON-TECHNICAL SKILLS) FRAMEWORK

Aims We previously developed a novel team-based non-technical skills framework in endoscopy known as TEAM-ENTS (Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills). The aim of this study was to establish face and content validity of the tool.

Methods A multidisciplinary group of endoscopists, nurses, screening practitioners and trainees were recruited to refine items of the framework in a modified Delphi process. Items from the framework were presented as elements (subsets of overriding categories) and behavioural descriptors. Panel members rated items against a 4-point Likert Scale and were able to leave free text comments. The content validity index (I-CVI) was calculated for each item and a result of>0.79 indicated acceptance. Two rounds were conducted.

Results In total, 58 participants from the UK and Ireland were recruited. There were 24 consultant endoscopists (41%), 14 clinical/nurse endoscopists (24%), 11 nurses (19%; including manager and screening practitioner roles) and 9 trainee endoscopists (16%). Median duration of experience in role was 14 years (IQR 7.75 – 20). There was a 5% attrition rate between rounds. In the first round, 9 elements and 37 behavioural descriptors did not meet consensus (I-CVI<0.79). In total, 36 items were adjusted, 7 items were merged and 3 items were deleted. Remaining items met consensus thresholds after the second round (I-CVI>0.79). The refined TEAM-ENTS BMS now consists of 5 categories, 16 elements and 47 behavioural descriptors.

Table 1

COMMUNICATION	Information exchange Maintaining open dialogue Patient communication	Effective information exchange between team members Maintaining open lines of communication between team members Communicating with the patient (if able to do so)
PLANNING, DECISION-MAKING & PROBLEM-SOLVING	Preparation Shared decision-making Reviewing outcomes	Preparing team members for events and actions. Ensuring everyone is ready Collaborative decision-making between relevant team members, adaptable to the situation Debriefing procedure(s) to review outcomes and promote learning
LEADERSHIP & COORDINATION	Control and responsibility Role delegation Team adaptability	Maintaining control and responsibility over a situation Team members aware of roles and skill mix Adapting the team to the situation or task and recognising when help is required
SITUATION AWARENESS	Problem recognition and focus Shared understanding Anticipating events	Detection of issues, having a wider awareness of the environment and maintaining focus Ensuring the team have a shared understanding of events throughout the procedure Anticipating future outcomes and reacting appropriately
TEAMWORK, COOPERATION & SUPPORT	Teambuilding and mutual respect Cohesion Support Empowerment	Building the team to be a functioning unit, developing mutual respect between team members Team members working together, valuing each other and conflict resolution Team members helping each other and seeking support if necessary Appropriate expression of opinion and receptiveness to feedback or opinion, empowering team members to contribute

Conclusions The TEAM-ENTS framework has been validated by a multidisciplinary group to reflect the core non-technical skills and behaviours relevant to endoscopy teams.

Publication History

Article published online:
14 April 2022