Variability and gaps in teamwork assessment tools for health care teams in health professions education: A scoping review

Abstract

Purpose: Teamwork is an essential component of health care and health professions education (HPE). The assessment of teamwork remains a significant challenge, and little is known about teamwork assessment tools (i.e. structured instruments or methods) used to examine the performance of health care teams within HPE. In this scoping review, the authors aimed to map and synthesize recent empirical studies of teamwork assessment tools in HPE. Method: Arksey and O'Malley's framework was used to identify and select relevant studies, extract data, and examine the extent, range and nature of research activity across studies. The authors searched MEDLINE, Embase, CINAHL, ERIC and Web of Science for original research studies from January 2015 to March 2024. Studies were included if they (i) used quantitative, qualitative or mixed methods to develop and/or use an assessment tool for the performance of health care teams within HPE; (ii) focused on team-level assessments; and (iii) provided sufficient details on the teams and teamwork competencies being studied. Results: Twelve studies were included. All studies used direct observations of health care teams to assess teamwork. The authors identified over 20 teamwork assessment tools developed and/or used—seven studies used previously published teamwork assessment tools; five studies developed new tools. Variability and ambiguity in definitions and conceptualizations of teamwork and its competencies was common; few were based on theoretical frameworks of teamwork. Gaps included a lack of attention to external factors that influence teamwork (e.g. workload and interruptions), limited exploration of team dynamics (e.g. hierarchy and power) and minimal consideration of patient roles. Conclusions: This scoping review found significant variability and highlighted gaps in current approaches to the assessment of health care teams within HPE. Future work should improve clarity in definitions and conceptualizations of teamwork, conduct theory-building and theory-guided studies of teamwork assessment tools and perform rigorous evaluations of teamwork assessment tools that account for external factors, team dynamics and the role of patients.