Live or video? A prospective comparison of non-technical skills assessment in in-situ resuscitation simulation.
Journal
Medical teacher
ISSN
1466-187X
Date Issued
2026-05-25
Author(s)
Abstract
Non-technical skills (NTS) are central to cardiopulmonary resuscitation, yet real-time assessment during in-situ simulation is challenging. Video review offers a practical alternative, but its comparability with live observation for team-based NTS assessment remains uncertain. This study compared live and video-based Team Emergency Assessment Measure (TEAM) ratings in in-situ CPR simulations. In this prospective observational study, adult in-situ CPR simulations in a tertiary emergency department were rated live by one of three trained raters and later re-rated from video by the same rater after ≥ 30-day washout. Agreement was assessed using intra class correlation coefficients (ICC), Pearson correlations, Bland-Altman analysis, and standard error of measurement. Secondary analyses examined paired score differences, effect sizes, and internal consistency. Of 48 recorded simulations, 37 had complete paired assessments. Differences between modalities were small. No paired comparison reached the Bonferroni-corrected sensitivity threshold of < 0.01; Leadership showed only a small nominal difference under unadjusted exploratory testing. Agreement was moderate to good (ICC 0.59-0.75), Pearson correlations ranged from 0.60 to 0.76, and Bland-Altman analysis showed small mean differences without proportional bias but relatively wide limits of agreement. Video-based TEAM assessment produced broadly similar group-level results to live observation. Video review may support formative feedback, faculty calibration, and programme-level evaluation, but should not be treated as fully interchangeable with live ratings for individual or high-stakes judgments.
Subjects
Non-technical skills
Team Emergency Assessment Measure (TEAM)
in-situ simulation
live observation
video-based assessment
Type
text::journal::journal article