Obstetric, Francophone adaptation of the TeamSTEPPS team performance observation tool for simulation (saT-TPOT): a Delphi consensus study with a preliminary rater-based evaluation

Abstract Background Team performance is critical in obstetric emergencies. The TeamSTEPPS™ Team Performance Observation Tool (T-TPOT) is widely used to assess team dynamics, but no version had been customised for obstetric simulation in Francophone settings. We aimed to adapt a French-language T-TPOT for obstetric simulation, establish its content validity, and conduct a preliminary rater-based evaluation of the resulting grid. Methods A prospective mixed-methods study was conducted in two phases. In Phase 1, a Delphi process was applied to a 33-item French-language adaptation of the T-TPOT by 16 invited experts from six Francophone countries (Belgium, Cameroon, Canada, France, Senegal and Switzerland). Three consensus rounds addressed the cross-context comprehension of the French phrasing, the necessity of each item (“absolutely necessary” for at least 50% of respondents), and its direct observability in a recorded obstetric simulation (at least 60% agreement among the twelve Round 2 respondents). In Phase 2, seven simulation experts, blinded to the instructors’ classification of two recorded postpartum-haemorrhage simulations (below versus at/above expectations), rated each independently using the final grid (1 = far below to 5 = far above expectations; 0 = not applicable); per-item rating distributions and discriminant capacity were analysed. Results Thirteen of the 16 invited panellists responded in Round 1 (81%) and 12 in Round 2 (92%). In the phrasing round, nine of the 33 items were reworded and none deleted. The necessity round excluded 15 items, merged three into a single leadership item, and retained 15 unchanged, yielding a 16-item grid spanning the five sections of the original T-TPOT: the simulation-adapted T-TPOT (saT-TPOT). All items met the observability threshold except the Two-Challenge Rule, retained by a documented coordination-team decision. In Phase 2, rating distributions differed between the two recordings for 11 of the 16 items — in the expected direction for 10 — while five showed identical distributions. Conclusions The saT-TPOT is a consensus-based, Francophone obstetric adaptation of the T-TPOT whose items were filtered for direct observability in simulation, with preliminary evidence of discriminant capacity. Because this study establishes content validity only, formal inter-rater reliability estimation and convergent validity against an established obstetric instrument are the necessary next steps.