Safer Surgery part 12. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 84 Safer Surgery entire operating theatre team in real time. OTAS aims to be such a comprehensive and robust measure of teamwork in surgery. We report in detail the conceptual background initial development and empirical application revision and further testing of the OTAS . We conclude with an outline of ongoing empirical work and future directions in OTAS -related research. Conceptual Background Components of Teamwork Systematic study of teamworking started in the 1950s and 1960s with an emphasis on military teams. The focus of this work was military teams functioning in demanding stressful conditions and the ultimate aim was to understand the constituents of an effective team and to feed this understanding into team training Paris et al. 2000 . Subsequently empirical study of teamwork extended to high risk industries outside the military . commercial aviation nuclear industry and soon the conclusion was reached that effective teamwork is fundamental to safety and efficiency in high-risk environments Helmreich and Foushee 1993 . Team communication emerged as a particularly critical aspect of teamwork which allows the fulfilment of other dimensions of teamwork such as team coordination. Numerous studies on teamwork were eventually reviewed and organized in a conceptual framework or model of teamwork by Dickinson and McIntyre 1997 . These authors proposed that from the existing literature seven components of teamwork can be identified team orientation team leadership communication monitoring feedback backup behaviour and coordination. Dickinson and McIntyre s 1997 model of teamwork and its components was an important step in conceptually clarifying what teamwork consist of . the sampling domain of the construct . The logical next step is how to best measure and assess the components of teamwork in real-world teams. Measuring Teamwork in Real-World Teams Since historically the study of teamwork started from teams of experts carrying out complex tasks in .
