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Standardized Assessment for Evaluation of Team Skills: Validity and Feasibility

Wright, Melanie C. PhD; Segall, Noa PhD; Hobbs, Gene CHT; Phillips-Bute, Barbara PhD; Maynard, Laura MDiv; Taekman, Jeffrey M. MD

doi: 10.1097/SIH.0b013e318290a022
Empirical Investigations

Introduction The authors developed a Standardized Assessment for Evaluation of Team Skills (SAFE-TeamS) in which actors portray health care team members in simulated challenging teamwork scenarios. Participants are scored on scenario-specific ideal behaviors associated with assistance, conflict resolution, communication, assertion, and situation assessment. This research sought to provide evidence of the validity and feasibility of SAFE-TeamS as a tool to support the advancement of science related to team skills training.

Methods Thirty-eight medical and nursing students were assessed using SAFE-TeamS before and after team skills training. The SAFE-TeamS pretraining and posttraining scores were compared, and participants were surveyed. Generalizability analysis was used to estimate the variance in scores associated with the following: examinee, scenario, rater, pretraining/posttraining, examinee type, rater type (actor-live vs. external rater–videotape), actor team, and scenario order.

Results The SAFE-TeamS scores reflected improvement after training and were sensitive to individual differences. Score variance due to rater was low. Variance due to scenario was moderate. Estimates of relative reliability for 2 raters and 8 scenarios ranged from 0.6 to 0.7. With fixed scenarios and raters, 2 raters and 2 scenarios, reliability is greater than 0.8. Raters believed SAFE-TeamS assessed relevant team skills. Examinees’ responses were mixed.

Conclusions The SAFE-TeamS was sensitive to individual differences and team skill training, providing evidence for validity. It is not clear whether different scenarios measure different skills and whether the scenarios cover the necessary breadth of skills. Use of multiple scenarios will support assessment across a broader range of skills. Future research is required to determine whether assessments using SAFE-TeamS will translate to performance in clinical practice.

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From the Research Institute (M.C.W.), Saint Alphonsus Health System, Boise, ID; Trinity Institute for Health and Community Benefit (M.C.W.), Trinity Health, Livonia, MI; Department of Anesthesiology (J.M.T., N.S., G.H.,B.P.-B.) and Human Simulation and Patient Safety Center (J.M.T., N.S., G.H.), School of Medicine, Duke University, Durham, NC; NC Center for Hospital Quality and Patient Safety (L.M.), North Carolina Hospital Association, Cary, NC.

Reprints: Melanie C. Wright, PhD, Saint Alphonsus Regional Medical Center, 1055 N Curtis Rd, Boise ID 83706 (e-mail:

Supported by grants from the Edward J. Stemmler, MD, Medical Education Research Fund at the National Board of Medical Examiners (0708-086) and the Agency for Healthcare Research and Quality (U18 HS01653-01). Also partially supported by the Agency for Healthcare Research and Quality (K02 HS015704-01) (to M.C.W).

The authors declare no conflict of interest.

The study sponsors had no role in any aspect of study design, data collection and analysis, or manuscript preparation.

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© 2013 Society for Simulation in Healthcare