Team Emergency Assessment Measure (TEAM)


This research developed a valid, reliable, and feasible teamwork assessment measure for emergency resuscitation team performance. Although generic and profession specific team performance assessment measures are available (e.g. anaesthetics) there are no specific measures for the assessment of emergency resuscitation team performance.
METHODS: The instrument was developed and tested with senior nursing and medical students in the stages listed in the section below.
Conclusion: The final 12 item (11 specific and 1 global rating) are rated using a five-point scale and cover three categories leadership, teamwork and task management. In this primary study, TEAM was found to be a valid and reliable instrument and should be a useful addition to clinicians’ tool set for the measurement of teamwork during medical emergencies. Further evaluation of the instrument is warranted to fully determine its psychometric properties.


DEVELOPMENT: (1) An extensive review of the literature for teamwork instruments; (2) development of a draft instrument with an expert clinical team; (3) Review by an international team of seven independent experts for face and content validity; (4) Instrument testing on 56 video-recorded hospital and simulated resuscitation events for construct, consistency, concurrent validity and reliability; and (5) a final set of ratings for feasibility on fifteen simulated ‘real time’ events.
TESTING: Following expert review, selected items were found to have a high total content validity index of 0.96. A single ‘teamwork’ construct was identified with an internal consistency of 0.89. Correlation between the total item score and global rating (rho= 0.95; p < 0.01) indicated concurrent validity. Interrater (k= 0.55) and retest reliability (k= 0.53) were ‘fair’, with positive feasibility ratings following ‘real time’ testing.

Author of Tool:

Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, Nestel D.

Key references:

Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, Nestel D. Rating medical emergency team performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation 2010: 81(4): 446-452.

Primary use / Purpose:

Evaluation of teamwork performance in medical emergencies- e.g., cardiac or other resuscitation teams.

Team Emergency Assessment Measure (TEAM)

This non- technical skills questionnaire has been designed as an observational rating score for valid, reliable and feasible ratings of emergency medical teams (e.g. resuscitation and trauma teams). The questionnaire should be completed by expert clinicians to enable accurate performance rating and feedback of leadership, team work, situation awareness and task management. Rating prompts are included where applicable. The following scale should be used for each rating:

Never/Hardly ever seldom About as often as not Often Always/Nearly always
0 1 2 3 4
Team Identification  

Team Leader:

Time: Place:


Leadership: it is assumed that the leader is either designated, has emerged or

is the most senior – if no leader emerges allocate a ‘0’ to question 1 and 2.

0 1 2 3 4
1.The team leader let the team know what was expected of them through

direction and command

2. The team leader maintained a global perspective

Prompts: Monitoring clinical procedures and the environment? Remaining ‘hands off’ as applicable? Appropriate delegation.

Team Work: ratings should include the team as a whole i.e. the leader and the team as a collective (to a greater or lesser extent). 0 1 2 3 4
3. The team communicated effectively

Prompts: Verbal, non-verbal and written forms of communication?

4. The team worked together to complete the tasks in a timely manner
5. The team acted with composure and control

Prompts: Applicable emotions? Conflict management issues?

6. The team morale was positive

Prompts: Appropriate support, confidence, spirit, optimism, determination?

7. The team adapted to changing situations

Prompts: Adaptation within the roles of their profession? Situation changes: Patient deterioration? Team changes?

8. The team monitored and reassessed the situation
9. The team anticipated potential actions

Prompts: Preparation of defibrillator, drugs, airway equipment?

Task Management: 0 1 2 3 4
10. The team prioritised tasks
11.The team followed approved standards and guidelines

Prompt: Some deviation may be appropriate?

Overall: 1 2 3 4 5 6 7 8 9 10
12. On a scale of 1-10 give your global rating of the team’s

non-technical performance