Francophone obstetric simulation team-performance tool developed through Delphi consensus, with preliminary rater evaluation

A prospective mixed-methods study reported in the abstract of BMC Medical Education developed a 16-item French-language adaptation of the TeamSTEPPS Team Performance Observation Tool for obstetric simulation. The resulting simulation-adapted tool, called saT-TPOT, showed preliminary evidence of an ability to distinguish between two recorded postpartum-haemorrhage simulations, but its inter-rater reliability and convergent validity have not been established.

The study proceeded in two phases. Sixteen experts from six Francophone countries—Belgium, Cameroon, Canada, France, Senegal and Switzerland—were invited to a Delphi process based on a 33-item French-language adaptation of the original tool. Thirteen panellists responded in Round 1, an 81% response rate, and 12 responded in Round 2, a 92% response rate. Three consensus rounds examined cross-context comprehension of the French wording, the necessity of each item and its direct observability in a recorded obstetric simulation. An item was considered absolutely necessary when at least 50% of respondents selected that option, while direct observability required at least 60% agreement among the 12 Round 2 respondents.

Nine of the 33 items were reworded during the phrasing round, and none were deleted. The necessity round excluded 15 items, merged three into one leadership item and retained 15 unchanged, producing a 16-item grid across the original tool’s five sections. All items met the direct-observability threshold except the Two-Challenge Rule, which was retained by a documented coordination-team decision. The investigators therefore described the saT-TPOT as a consensus-based Francophone obstetric adaptation whose items were filtered for direct observability in simulation.

In the preliminary evaluation, seven simulation experts independently rated recordings of two postpartum-haemorrhage simulations. They were blinded to instructors’ classifications of the recordings as below expectations or at or above expectations. Ratings used a five-point scale ranging from 1, “far below,” to 5, “far above” expectations, with 0 indicating that an item was not applicable. Rating distributions differed between the two recordings for 11 of the 16 items, in the expected direction for 10, while five items had identical distributions. These findings provide preliminary evidence of discriminant capacity, but the abstract states that the study established content validity only; formal inter-rater reliability estimation and convergent validity against an established obstetric instrument remain necessary next steps.

Subject of Research: Development and preliminary evaluation of a Francophone obstetric simulation team-performance observation tool

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

Article References: Desseauve, D., Daelemans, C., Farin, A., & Ceccaldi, P.-F. (2026). Obstetric, Francophone adaptation of the TeamSTEPPS team performance observation tool for simulation (saT-TPOT): a Delphi consensus study with a preliminary rater-based evaluation. BMC Medical Education. https://doi.org/10.1186/s12909-026-10466-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10466-6

Keywords: Francophone obstetric simulation, TeamSTEPPS, saT-TPOT, Delphi consensus, content validity, discriminant capacity, inter-rater reliability, postpartum haemorrhage, simulation assessment, Obstetric, Francophone, adaptation