Table 1 Team Reflection Behavioral Observation (TuRBO) system adapted from Schmutz et al. [20] with direct quote examples from the study

Seeking Information

Actively inviting input

All statements that request information from the team about the current event and invite team members to provide information and share ideas

“What type of abx did this patient get? Do we need a repeat dose? Can you add abx? (Trainee; Video MH 9–11)

Expressing uncertainty

Expressions of uncertainty with an implicit invitation to share information

“Is there anything we are missing? Is there anything else we should be doing” (Trainee; Video MH 10-R)

Evaluating Information

Stating a working hypothesis

Clear formulation of a working hypothesis or diagnosis about the current situation

“Patient is becoming more tachycardic, do you think there is a lot of bleeding?” (Trainee; Video MH 3–10)

Recapping

Various pieces of information are brought together and a summary is provided

“The patient is in mid thirties. She's scheduled for lap chole. She started to develop tachycardia and hyperthermia at an undisclosed rate shortly we have given an antibiotic and contacted MH hotline.” (Trainee; Video MH 7–10)

Explicitly assessing the situation

Providing an explicit judgment for something, give value to a certain process, information or strategy; this can be the process of evaluation information that has been gained through seeking information

“Paralysis: Patient seems “tight”, make sure she is paralyzed. (Trainee; Video MH 5–4)

Reasoning

Explaining why something is more important than something else or why a specific behavior needs to be done

“Elevated CO2: this could be due to difficulty ventilating or drug reaction” (Trainee; Video MH 11–4)

Planning

Stating plans and priorities

Laying out the course of action for the next few minutes. Needs to contain at least 2 actions to show a sequence of actions

“Going to stop the agent and go up on flows” (Trainee; Video MH 6–11)

Implementation

States they are doing the task or delegates a task to another team member

“Administer dantrolene now” (Trainee; Video MH 5–11)