Update, validation and cultural adaptation of the Spanish version of the TEAM questionnaire for emergency teams

Abstract

Background The Team Emergency Assessment Measure (TEAM) questionnaire is widely used to assess non-technical skills (NTS) in emergency care. An updated and culturally adapted version is needed to ensure continued relevance, particularly for Spanish-speaking professionals working in emergency care settings. Aim To translate, culturally adapt, and validate the TEAM questionnaire for Spanish-speaking emergency teams in a high-fidelity simulated environment. Methods A back-translation and cross-cultural adaptation process was conducted. Twelve Emergency Medical Services (EMS) professionals (nurses, physicians, and Emergency Medical Technicians (EMT)) participated in high-fidelity simulation scenarios. Two evaluators used the translated tool to assess team performance, generating 700 ratings. Psychometric analyses included internal consistency, exploratory factor analysis, inter-rater reliability, and Bland-Altman plots. Results The Spanish TEAM (s-TEAM) questionnaire showed acceptable psychometric performance in this pilot sample. Four factors explained 80.8% of the variance. Internal consistency was high (α and ω > 0.90). Item 6 showed poor performance; its removal improved reliability. Inter-rater agreement exceeded 80%, though some items had lower ICC and kappa values. Conclusions The updated s-TEAM shows promising preliminary validity and reliability for assessing NTS in Spanish-speaking emergency teams under simulated conditions. Removing items 6 and 12 and using a standardised 1–10 scale may enhance precision and usability. However, these findings should be interpreted as preliminary pilot evidence, and further validation in real-world emergency settings is required before broader clinical implementation.