Measuring Teamwork and Conflict among Emergency Medical Technician Personnel

Abstract Objective. We sought to develop a reliable and valid tool for measuring teamwork among emergency medical technician (EMT) partnerships. Methods. We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool (EMT-TEAMWORK). We performed a series of exploratory factor analyses (EFAs) and confirmatory factor analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. Results. We received 687 completed surveys. The EFAs identified a nine-factor solution. We labeled these factors 1) Team Orientation, 2) Team Structure & Leadership, 3) Partner Communication, Team Support, & Monitoring, 4) Partner Trust and Shared Mental Models, 5) Partner Adaptability & Back-Up Behavior, 6) Process Conflict, 7) Strong Task Conflict, 8) Mild Task Conflict, and 9) Interpersonal Conflict. We tested a short-form (30-item SF) and long-form (45-item LF) version. The CFAs determined that both the SF and the LF possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties, with a mean Cronbach's alpha coefficient ≥0.70 across all nine factors (mean = 0.84; minimum = 0.78, maximum = 0.94). The mean Cronbach's alpha coefficient for the EMT-TEAMWORK-LF was 0.87 (minimum = 0.79, maximum = 0.94). There was wide variation in weighted scores across all nine factors and the global score for the SF and LF. Mean scores were lowest for the Team Orientation factor (48.1, standard deviation [SD] 21.5, SF; 49.3, SD 19.8, LF) and highest (more positive) for the Interpersonal Conflict factor (87.7, SD 18.1, for both SF and LF). Conclusions: We developed a reliable and valid survey to evaluate teamwork between EMT partners.

[1]  Kaleab Z. Abebe,et al.  Variation in emergency medical technician partner familiarity. , 2011, Health services research.

[2]  Brian Bjørn,et al.  Descriptions of verbal communication errors between staff. An analysis of 84 root cause analysis-reports from Danish hospitals , 2011, Quality and Safety in Health Care.

[3]  Rollin J Fairbanks,et al.  Variation in Emergency Medical Services Workplace Safety Culture , 2010, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[4]  L. Weingart,et al.  Revisiting the Dimensions of Intra-Group Conflict: Theoretical and Psychometric Construct Refinement , 2010 .

[5]  James E. Driskell,et al.  Collective Orientation and Team Performance: Development of an Individual Differences Measure , 2010, Hum. Factors.

[6]  Cheryl B. Jones,et al.  The Longitudinal Study of Turnover and the Cost of Turnover in Emergency Medical Services , 2010, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[7]  B. Suffoletto,et al.  Sleep Quality and Fatigue Among Prehospital Providers , 2010, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[8]  Henry E. Wang,et al.  The Emergency Medical Services Safety Attitudes Questionnaire , 2010, American journal of medical quality : the official journal of the American College of Medical Quality.

[9]  E. Salas,et al.  The Development and Testing of the Nursing Teamwork Survey , 2010, Nursing research.

[10]  Antonio R. Fernandez,et al.  An Assessment of Key Health Indicators among Emergency Medical Services Professionals , 2009, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[11]  R. Fairbanks,et al.  Ambulance stretcher adverse events , 2009, Quality & Safety in Health Care.

[12]  K. T. Fong,et al.  Surgical team behaviors and patient outcomes. , 2009, American journal of surgery.

[13]  V. LeBlanc,et al.  Stressful intensive care unit medical crises: How individual responses impact on team performance* , 2009, Critical care medicine.

[14]  Eduardo Salas,et al.  Do Familiar Teammates Request and Accept More Backup? Transactive Memory in Air Traffic Control , 2009, Hum. Factors.

[15]  David M Williams Jems 2008 200 city survey: the future is your choice. , 2009, JEMS : a journal of emergency medical services.

[16]  Carolyn M Clancy,et al.  TeamSTEPPS: Assuring Optimal Teamwork in Clinical Settings , 2007, American journal of medical quality : the official journal of the American College of Medical Quality.

[17]  D. Davis,et al.  A Descriptive Analysis of Emergency Medical Service Systems Participating in the Resuscitation Outcomes Consortium (ROC) Network , 2007, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[18]  Douglas F Kupas,et al.  Comparison of rural and urban ambulance crashes in Pennsylvania. , 2007, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[19]  Daniel P. Davis,et al.  Paramedic Self-Reported Medication Errors , 2007, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[20]  C. Lance,et al.  The Sources of Four Commonly Reported Cutoff Criteria , 2006 .

[21]  Dana E. Sims,et al.  Is there a “Big Five” in Teamwork? , 2005 .

[22]  Jon C Rittenberger,et al.  ERRORS OF OMISSION IN THE TREATMENT OF PREHOSPITAL CHEST PAIN PATIENTS , 2005, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[23]  R. Reznick,et al.  Communication failures in the operating room: an observational classification of recurrent types and effects , 2004, Quality and Safety in Health Care.

[24]  J. McGrath,et al.  TIME MATTERS IN TEAM PERFORMANCE: EFFECTS OF MEMBER FAMILIARITY, ENTRAINMENT, AND TASK DISCONTINUITY ON SPEED AND QUALITY , 2003 .

[25]  J. May,et al.  Time dependent memory decay. , 2002, American journal of industrial medicine.

[26]  Mark Huisman,et al.  Imputation of Missing Item Responses: Some Simple Techniques , 2000 .

[27]  J E Ware,et al.  Methods for testing data quality, scaling assumptions, and reliability: the IQOLA Project approach. International Quality of Life Assessment. , 1998, Journal of clinical epidemiology.

[28]  John H. Bradley,et al.  The effect of personality type on team performance , 1997 .

[29]  R. Cydulka,et al.  Stress Levels in EMS Personnel: A National Survey , 1997, Prehospital and Disaster Medicine.

[30]  C. Heckler A Step-by-Step Approach to Using the SAS™ System for Factor Analysis and Structural Equation Modeling , 1996 .

[31]  Deborah H. Gruenfeld,et al.  Group Composition and Decision Making: How Member Familiarity and Information Distribution Affect Process and Performance , 1996 .

[32]  D. Revicki,et al.  Work-related stress and psychological distress in emergency medical technicians. , 1996, Journal of occupational health psychology.

[33]  S. Hendricks,et al.  Effect of recall on reporting of at-work injuries. , 1995, Public health reports.

[34]  F. Floyd,et al.  Factor analysis in the development and refinement of clinical assessment instruments. , 1995 .

[35]  R. Peterson A Meta-analysis of Cronbach's Coefficient Alpha , 1994 .

[36]  Robert F. DeVellis,et al.  Scale Development: Theory and Applications. , 1992 .

[37]  M. Appelbaum,et al.  Psychometric methods. , 1989, Annual review of psychology.

[38]  James C. Anderson,et al.  STRUCTURAL EQUATION MODELING IN PRACTICE: A REVIEW AND RECOMMENDED TWO-STEP APPROACH , 1988 .

[39]  R. P. McDonald,et al.  Goodness-of-fit indexes in confirmatory factor analysis : The effect of sample size , 1988 .

[40]  J. Nunnally,et al.  Psychometric Theory: NY. , 1978 .