Endoscopy 2021; 53(S 01): S161-S162
DOI: 10.1055/s-0041-1724693
Abstracts | ESGE Days
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Development of the Team-Ents (Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills) Framework

S Ravindran
1   Joint Advisory Group on Gastrointestinal Endoscopy, London, United Kingdom
,
R Cavilla
2   NHS England and NHS Improvement, London, United Kingdom
,
C Healey
1   Joint Advisory Group on Gastrointestinal Endoscopy, London, United Kingdom
,
M Coleman
1   Joint Advisory Group on Gastrointestinal Endoscopy, London, United Kingdom
,
H Ashrafian
3   Imperial College London, London, United Kingdom
,
A Haycock
4   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
,
S Archer
5   University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
,
A Darzi
3   Imperial College London, London, United Kingdom
,
S Thomas-Gibson
4   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
› Author Affiliations
 
 

    Aims Teamworking is crucial to team performance and has been demonstrated to improve the quality and safety of care. Non-technical Skills (NTS) are integral to teamworking and NTS frameworks have been used to support training and assessment in healthcare. The aim of this study was to develop a novel team-based NTS framework in endoscopy – TEAM-ENTS (Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills).

    Methods A qualitative mixed-methods study was conducted to ascertain the core NTS relevant to endoscopy teams. This was undertaken in two phases: 1) a detailed literature review of team-based NTS frameworks in the literature and, 2) an interview study of endoscopists and endoscopy nurses utilising Cognitive Task Analysis (CTA). Transcribed interviews were analysed by two researchers using framework analysis involving both joint and independent coding. A codebook of relevant skills and behaviours was created which formed the basis for the TEAM-ENTS framework.

    Results After screening of 1162 articles, 36 were reviewed encompassing 14 team-based NTS frameworks across the medical literature. In total, 13 semi-structured interviews were completed involving 7 endoscopists and 6 nurses. The mean number of years in role was 15.2 and mean lifetime procedure count was 9571. Following joint review, 88 codes were identified from transcribed interviews. These fell into 5 major categories: 1) Communication, 2) Planning, decision-making and problem-solving, 3) Leadership and coordination, 4) Situation awareness and 5) Teamwork, cooperation and support. A hierarchical framework was created of overarching categories, split into elements and characterised by behavioural descriptors informed by the literature review (see [Table 1]). The final TEAM-ENTS framework consists of 5 categories, 17 elements and 58 behavioural descriptors.

    Tab. 1

    COMMUNICATION

    1. Information exchange

    2. Maintaining open dialogue

    3. Patient communication

    1. Effective information exchange between team members

    2. Maintaining open lines of communication between team members

    3. Communicating with the patient (if able to do so)

    PLANNING, DECISION-MAKING & PROBLEM-SOLVING

    1. Preparation

    2. Joint decision-making

    3. Reviewing outcomes

    1. Preparing team members for events and actions. Ensuring everyone is ready

    2. Team members making decisions together

    3. Reviewing outcomes of decisions

    LEADERSHIP & COORDINATION

    1. Control and responsibility

    2. Role delegation

    3. Team adaptation

    4. Team diagnosis

    1. Maintaining control and responsibility over a situation

    2. Team members aware of roles and skill mix

    3. Adapting the team to the task or task to the team

    4. Recognising issues or limitations within the team

    SITUATION AWARENESS

    1. Problem recognition and focus

    2. Shared understanding

    3. Anticipating events

    1. Detection of issues, having a wider awareness of the environment and maintaining focus

    2. Ensuring the team have a shared understanding of events

    3. Identifying future problems and thinking ahead

    TEAMWORK, COOPERATION & SUPPORT

    1. Teambuilding and trust

    2. Cohesion

    3. Support

    4. Assertion

    1. Building the team to be a functioning unit, developing trust between team members

    2. Team members working together, valuing each other and conflict resolution

    3. Team members providing and seeking support

    4. Appropriate assertion of opinion to other team members

    Conclusions The TEAM-ENTS framework contains the core NTS relevant to endoscopy teams. Further work is underway to refine the tool through an online Delphi study followed by an observational validation study.

    Citation: Ravindran S, Cavilla R, Healey C et al. eP197 DEVELOPMENT OF THE TEAM-ENTS (TEAMWORK IN ENDOSCOPY ASSESSMENT MODULE FOR ENDOSCOPIC NON-TECHNICAL SKILLS) FRAMEWORK. Endoscopy 2021; 53: S161.


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    Publication History

    Article published online:
    19 March 2021

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