TECHNICAL PERFORMANCE
Assessing Surgical Team Performance in the Management of Hip Fractures
Published on
Oct 3, 2025
Journal of Orthopaedic Trauma
Portia Kalun, PhD; Stanley J. Hamstra, PhD; Cari Whyne, PhD; Normand Robert, PhD; Hans Kreder, MD, FRCSC; Albert Yee, MD, FRCSC; Marvin Tile, MD, FRCSC; and Markku T. Nousiainen, MD, MedFRCSCa
Overview
This study aimed to develop and validate a multidisciplinary assessment framework capable of capturing variation in intraoperative team performance during hip fracture fixation. Recognizing that both technical proficiency and teamwork dynamics significantly influence surgical outcomes, the researchers designed a series of evaluation tools to measure key teamwork dimensions—communication, cooperation, coordination, leadership, and monitoring—across surgeon, anesthesia, nursing, and radiology technologist teams. In parallel, assessment instruments for evaluating surgical trainees’ technical skills during hip fracture fixation procedures were created.
Guided by expert input and intraoperative recordings from an instrumented operating room, the framework was developed to provide objective, fine-grained insights into performance differences that could ultimately inform targeted training and improve patient outcomes.
Results
The finalized assessment framework successfully captured measurable variations in performance across multiple surgical teams and cases, with global and checklist rating data revealing clear patterns of strengths and weaknesses. Coordination and cooperation emerged as the strongest facets across teams, while monitoring and cross-disciplinary cooperation were identified as key areas for improvement—particularly between surgeons and radiology technologists.
Technical skill assessments demonstrated that procedural proficiency generally improved with trainee experience, though specific steps such as fracture reduction and maintenance of leg length and rotation remained challenging.
Feedback sessions highlighted the impact of varying staff experience levels on team performance. Overall, the results validate that the framework effectively distinguishes differences in intraoperative teamwork and technical skill, providing a data-driven foundation for developing targeted interventions to enhance surgical team effectiveness and consistency in hip fracture management.
Peer-reviewed Research
