Results .

1. English version OTAS tool: • 3 teams: surgeons, anesthesiologists, nurses • 114 Exemplar behaviors • OTAS was presented to experts (surgeons, nurses, scrub technicians and anesthesiologists) • Rate: the behavioral construct - communication, coordination, leadership, situational awareness and cooperation • Rate: team to evaluate • Rate: sufficiency, clarity, relevance and wording - each exemplary behavior Psychometric properties of Observational Teamwork Assessment for Surgery (OTAS) for observational assess teamwork in Colombian surgical teams.Amaya Arias, AC¹; Eslava-Schmalbach, JH ¹; Barajas Sierra, R ¹; Gaitán Duarte ¹, H; Hull, L²; Wheelock, AC²; Sevdalis, N².¹ ClinicalResearchInstitute, SCHOOL OF Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.² Department of Surgery and Cancer and the Centre for Patient Safety and Service Quality, Imperial College London, London, United Kingdom. Exemplars removed: 6 Slightly Modified: 48 Added: 47 No modified: 60 Duplicates: 13 Separate nurses in two teams: Surgical nurses Scrub technicians. 168 Content valid behavioral exemplars Introduction. There is ample research stressing the importance of paying attention to human factors and integrating knowledge of areas such as engineering, social and behavioural sciences as part of the assessment of surgical team performance, in order to better understand patient safety in the operating room. Teamwork and nontechnical skills are increasingly recognized as important contributing factors to errors and adverse events in surgery. Researchers have stressed the importance of promoting optimal performance of the work teams in the operating room, and of adapting evaluation and intervention programs aimed at improving inter-personal skills. Currently there are no tools available tools to assess these critical safety skills in Latin America. Objective. To adapt and validate the Observational Teamwork Assessment for Surgery (OTAS) tool for use in Colombian operating theatres. Methodology. Design. Cross-sectional study, assessing the psychometric properties of OTAS. Sample: n=40 surgical teams, assuming: Kappa= 0,4; confidence level: 95%, accuracy:0,3. Inclusion Criteria: General surgery teams, from a third level private health institution, who accepted their participation in this study. Procedure. 1. OTAS tool translation and back-translation 2. Content Validity was assessed through expert opinion: OTAS was presented to experts with a format in order to rate the behavioral construct of teamwork captured by OTAS: communication, coordination, leadership, situational awareness and cooperation), exemplar behaviors and rating scale. The experts were: surgeons, nurses, scrub technicians and anesthesiologists. 3. The concordance was determined with weighted Kappa coefficient calculated between the scores given by two blinded trained psychologists in the OTAS. The weighting for the scores was defined by agreement for experts (Table 1). Figure 1. Flow diagram of exemplar content validation • Results. • One of the most important changes in the content validation was to distinguish between the surgical nurses and scrub technicians (both OR team members are captured in the nursing sub-team described in the original OTAS) as in Latin America these are different professions (Figure 1). This change involved a review of exemplar behaviors of both teams. Inter-observer agreement was moderated (Weighted Kappa: 0.5130; CI: 0.504 - 0.536; z: 18.61; p: 0.0000). The calculated Weighted Kappa by phase, behaviors and teams were between 0.37 and 0.56 (Table 2). • Conclusion. • The study provides a tool validated for use within the Colombian and potentially wider South American context. The tool can be used to assess quality of team performance in ORs, debrief teams and hence improve safety and reduce teamrelated errors. • References • Arora S, Hull L, Sevdalis N, Tierney T, Nestel D, Woloshynowych M, et al. Factors compromising safety in surgery: stressful events in the operating room. Am J Surg. 2010 Jan;199(1):60-5. • Cohen J. Weighted Kappa: Nominal Scale Agreement With Provision for Scaled Disagreement of Partial Credit. PsychologicalBulletin. 1968;70(4):8. • Hull L, Arora S, Kassab E, Kneebone R, Sevdalis N. Observationalteamworkassessmentforsurgery: contentvalidation and toolrefinement. J Am CollSurg. 2011 Feb;212(2):234-43 e1-5. • Viera AJ, Garrett JM. Understanding Interobserver Agreement: The Kappa Statistic. Family Medicine. 2005;37(5):4. • Vincent C, Moorthy K, Sarker SK, Chang A, Darzi AW. Systems Approaches to Surgical Quality and Safety: From Concept to Measurement. Annals of Surgery. 2004;239(4):475-82