Translation, cross-cultural adaptation, and psychometric validation of the Team Emergency Assessment Measure (TEAM) into European Spanish: a multi-perspective study including peer-assessment

Abstract Background The Team Emergency Assessment Measure (TEAM) is the most widely used tool for evaluating emergency team performance, with robust psychometric evidence across multiple languages and settings. However, no European Spanish version has been validated, and no previous TEAM study has simultaneously assessed teamwork from four complementary rater perspectives: instructors from the learners’ own specialty, instructors from other specialties, self-assessment by the performing participants, and peer-assessment by observing peers. This study aimed to translate, culturally adapt, and psychometrically validate a European Spanish version of the TEAM (s-TEAM) and to evaluate its reliability and validity across these four perspectives in emergency simulation scenarios, with peer-assessment representing a novel contribution of this work. Methods The TEAM was translated and adapted into European Spanish following internationally recommended guidelines. The s-TEAM was applied across 216 high-fidelity cardiology emergency simulation scenarios within nine editions of a national training programme for second-year cardiology residents organised by the Spanish Society of Cardiology. Ratings were collected simultaneously from all four perspectives. Internal consistency, item analysis, concurrent validity, and factor structure (EFA and CFA on independent subsamples using polychoric correlations) were examined. Results A total of 145 residents were registered across the nine course editions, with 30 participating instructors and 216 scenarios. The final analytical sample comprised 1,414 valid ratings. Internal consistency was excellent overall (Cronbach’s α = 0.921) and across all rater groups (range 0.901–0.938). The total score correlated strongly with the Global Rating Scale ( r = .816). Factor analysis supported a predominantly unidimensional structure with a distinguishable Leadership/Communication facet (interfactor correlation 0.904–0.908). Peer-assessment yielded reliable scores (α = 0.901) comparable to other rater groups. Instructors from the residents’ own specialty (cardiologists) scored significantly lower than all other groups (d = − 0.42). Internal consistency was stable from the first scenario (α = 0.900) despite the absence of formal rater training. Conclusions The s-TEAM is a valid, reliable, and feasible European Spanish adaptation of the TEAM. It produces consistent scores across four rater perspectives, enabling multi-source feedback during debriefing without additional faculty. These findings support its integration as both an assessment and formative tool within iterative simulation curricula.