Evaluation All participants completed pre- and post-training questionnaires that included a 15-item section with Likert-type questions measuring perceived self-efficacy for targeted team-based competencies in an actual OR environment (1 ¼ not confident at all, to 6 ¼ completely confident). Responses were collated; descriptive statistics were calculated for pre- and post-session responses; and paired t-test with Bonferroni adjustment was performed. Trained observers evaluated team-based performance for each scenario using the Operating Room Teamwork Assessment Scales (ORTAS).37-39 Two scales were used: a 5-item multisource evaluation individual performance scale focusing on team-based behaviors (TBB) of the individual and a 6-item overall teamwork scale that contained a 3-item shared mental model subscale and a 3-item adaptive communication and response (ACR) subscale. Each item contained behavioral anchors for a 6-point Likert-type scale (1 ¼ definitely no, to 6 ¼ definitely yes). The multisource evaluations were conducted based on the role of the participants: surgeon, nurse anesthetist, circulating nurse, and scrub nurse. Participants evaluated self-, peer-, and overall team performance after completion of the second scenario using the ORTAS. Mean item and subscale scores were calculated for observer and participant ratings. Differences between mean calculated observed performances after each scenario were evaluated using a one-way ANOVA. Differences between mean calculated observer and participant ratings were evaluated using paired samples t-test. For missing data, an ad hoc method was used in which any incomplete paired dataset was discarded before comparison.