RESEARCH NOTES

Interprofessional Teamwork Skills as Predictors of

Clinical Outcomes in a Simulated Healthcare Setting
Sarah Shrader, PharmD
Donna Kern, MD
James Zoller, PhD
Amy Blue, PhD

PURPOSE: Teaching interprofessional teamwork skills is a TEAMWORK SKILLS are essential components of effective
goal of interprofessional education. The purpose of this interprofessional collaboration. Communication failures
study was to examine the relationship between IP team- and break-downs in team functions have been associated
work skills, attitudes and clinical outcomes in a simulated with medical errors.1–3 The Institute of Medicine endorses
clinical setting. METHODS: One hundred-twenty health
effective communication and teamwork as essential com-
professions students (medicine, pharmacy, physician assis-
ponents for the delivery of high quality and safe patient
tant) worked in interprofessional teams to manage a
“patient” in a health care simulation setting. Students com- care.4 Interprofessional competency frameworks developed
pleted the Interdisciplinary Education Perception Scale in Canada and the United States both include teamwork
(IEPS) attitudinal survey instrument. Students’ responses skills as fundamental competencies for successful interpro-
were averaged by team to create an IEPS attitudes score. fessional collaboration.5 Six national associations of schools
Teamwork skills for each team were rated by trained of the health professions formed a collaborative promoting
observers using a checklist to calculate a teamwork score interprofessional education, the Interprofessional Educa-
(TWS). Clinical outcome scores (COS) were determined tion Collaborative (IPEC).6
by summation of completed clinical tasks performed by the Health professions students need opportunities to
team based on an expert developed checklist. Regression acquire and apply teamwork skills suitable for interprofes-
analyses were conducted to determine the relationship of
sional collaborative practice, particularly within patient
IEPS and TWS with COS. RESULTS: IEPS score was not a
care contexts. High-fidelity simulators offer a unique learn-
significant predictor of COS (p=0.054), but TWS was a sig-
nificant predictor (p< 0.001) of COS. Results suggest that ing experience for health professions students. A human
in a simulated clinical setting, students’ interprofessional patient simulator is a mannequin interfaced with a com-
teamwork skills are significant predictors of positive clinical puter program that can produce physiologic responses to
outcomes. CONCLUSION: Interprofessional curricular student actions including changes in the mannequin’s sim-
models that produce effective teamwork skills can improve ulated heart rhythm, blood pressure, respiratory rate, pulse
student performance in clinical environments and likely and heart sounds. Human patient simulators provide a con-
improve teamwork practice to positively affect patient care text for students to assume the responsibility for patient
outcomes. J Allied Health 2013; 42(1):e1–e6. care without compromising the safety of the patient, and to
practice the role of a specific health profession in a patient
care team.7 Furthermore, the simulators present a rich
learning environment for the application of teamwork skills
Dr. Shrader at the time of this project was Associate Professor, South in an interprofessional context. Few interprofessional simu-
Carolina College of Pharmacy, at Medical University of South Carolina, lations that include health professions students are reported
Charleston, and she currently is Associate Professor, University of Kansas in the literature and the majority of results are limited to
School of Pharmacy, Lawrence, Kansas. Dr. Kern is from the Department
of Family Medicine, Dr. Zoller is Professor, College of Health Profes-
pilot data. Reports suggest that health professions students
sions, and Dr. Blue is from the Office of the Provost and Department of learning in interprofessional simulated environments has
Family Medicine, Medical University of South Carolina, Charleston, positive outcomes in that students enjoy the experience,
South Carolina. their attitudes toward interprofessional collaboration
improve, and team communication skills improve.8–12
This study was supported by an AAMC Southern Group on Educational
Affairs (SGEA) Research in Medical Education (RIME) grant.
Team training, including the use of simulations, for
licensed healthcare professionals has been associated with
RN1201—Received Jun 21, 2012; accepted Sept 18, 2012. improvements in patient outcomes and a decrease in
adverse events.13–16 Compared to the data for practicing
Address correspondence to: Sarah Shrader, University of Kansas, KU healthcare teams, student outcomes related to evaluation of
Medical Center, 3901 Rainbow Blvd, MS 4047, Kansas City, KS 66160,
USA. Tel 913-588-9829, fax 913-588-2355. Sshrader2@kumc.edu.
teamwork and clinical outcomes using simulations is lim-
ited. A study of medical students used a simulated health-
© 2013 Association of Schools of Allied Health Professions, Wash., DC. care environment and determined an association between

e1
positive teamwork skills and positive clinical perform- what each profession may contribute to patient care). After
ance.17 Within an interprofessional education context, the orientation, the interprofessional teams were directed to
what might be the clinical performance of students from the patient room where each was provided with the patient’s
different professions working together as a team in a simu- medical record and given 10 minutes to review and begin
lated environment? The purpose of this study was to deter- team discussions. After 10 minutes, the simulation com-
mine if interprofessional teamwork skills, including atti- menced and the team cared for the simulated patient just as
tudes, predict clinical outcomes for the simulated patient they would for an actual patient during hospital rounds.
being cared for by the student interprofessional healthcare They conducted a patient interview and physical examina-
team. The specific hypotheses were: tion, ordered laboratory and diagnostic tests, observed vital
signs on the patient monitor, and ordered medications.
1) Interprofessional teamwork by students will positively Teams were instructed to use a whiteboard serving as the
influence clinical outcomes as measured by team scores on official patient order sheet to record team treatment deci-
observational checklists. sions. Each team encounter was video-recorded. The inter-
2) Positive attitudes toward working with students from differ- professional team was allotted 20 minutes to stabilize and
ent professions will positively influence interprofessional
treat the patient; then course instructors debriefed the team.
teamwork by students as measured by surveys and checklists.
Instructors were guided to debrief the team on both inter-
professional/team communication and clinical skills. The
Methods simulated interprofessional rounding experience was devel-
oped around a case in the medical safety literature where the
The study took place on an academic health science
patient was unstable due to a gastrointestinal bleed caused
campus that is implementing a major interprofessional edu-
by a medical error and medicine interaction.20,21 The patient
cation initiative across its six colleges.18 Students in this
scenario was complex and required expertise from multiple
particular interprofessional activity had participated in the
health professions for the best outcomes.
university’s Interprofessional Day (IP Day) as first and
where applicable, second year students (medical and phar- As part of the study, students were asked at the time of
macy students).19 During first year and second-year student the activity orientation, to individually complete the Inter-
IP Day, students learn more about each other’s profession disciplinary Education Perception Scale (IEPS).22 In addi-
and the importance of interprofessional collaboration in tion to the IEPS items, this instrument also contained items
healthcare; students do not engage in specific teamwork to collect demographic information about the student: age,
activities as part of the event. None had experienced inter- race, and gender. The IEPS instrument was used as a meas-
professional teamwork in a purposeful manner during clini- ure of students’ attitudes toward collaboration since it has
cal rotations, as this requirement similarly was not in place been widely used in the literature to assess learners atti-
during their education. tudes.23,24 It consists of 18 items and measures students’ pro-
One hundred and twenty health professions students fessional perceptions (scale used 1=strongly disagree;
including fourth-year medical students (n=25), third-year 5=strongly agreed)25 relative to their own profession and
pharmacy students (n=76), and first-year physician assis- other health professions through four scales: 1) competence
tant (PA) students (n=19) participated in a high-fidelity and autonomy, 2) perceived need for cooperation, 3) per-
simulation, caring for a patient like they were attending ception of actual cooperation, and 4) understanding others’
hospital rounds. All of the pharmacy students were required values. Since our unit of analysis was the team and the
to participate as part of a required clinical assessment team’s performance, students’ individual responses to items
course; the fourth-year medical students and first-year were grouped by student interprofessional team and then
physician assistant students were required to participate averaged to determine a team IEPS score (IEPS).
depending on what experiential rotation they were com- A clinical outcomes checklist was developed by the
pleting. All students involved were provided with forma- investigators to determine the effectiveness of each team’s
tive evaluations of their performance; no students were for- decision making in the patient care process. The checklist
mally graded on the simulation. The students were divided was validated by interprofessional faculty experts in the
randomly into twenty-four teams consisting of five mem- fields of primary care, cardiology, and emergency medicine
bers (one medicine, one PA, three pharmacy students). using a modified Delphi technique. The patient scenario
Each team was newly formed and members did not have was provided to the faculty experts along with potential
experience working together prior to the simulation. The clinical steps and each expert was asked to rate the impor-
study was approved by the institutional review board. tance of each clinical step for stabilizing the patient. The
The interprofessional teams participated in a 15-minute checklist consisted of 20 items and corresponded to clinical
orientation in which a course instructor explained the steps, including medication administration that would pro-
objectives of the experience and the function of the simula- vide an optimal patient outcome. The clinical items were
tor mannequins. The students also conducted team intro- weighted depending on how critical they were for patient
ductions and discussed potential interprofessional team roles care to acutely stabilize the patient. For example, ordering
(e.g., establish a team leader, recorder for medical orders, intravenous fluids and Vitamin K were weighted more

e2 SHRADER ET AL. Interprofessional Teamwork

 TABLE 1. Regression Model of Teamwork Score and IEPS TABLE 2. Respondent Demographic Characteristics
Score Predicting Clinical Outcome Score Age group % Race % Gender %
Model B Std error
p
20–25 55.6 Asian 7.8 Male 28.7
Constant –60.276 25.526 0.028 26–29 32.5 Black or African- Female 71.3
Teamwork score (TWS) 0.440 0.099 0.659 <0.001 30–35 10.3 American 2.9
IEPS score (IEPS) 0.680 0.333 0.303 0.054 36–39 1.7 White 89.2

NOTE: adjusted R2=0.495

Descriptive statistics were conducted on demographic
heavily than ordering a cardiology consult. The clinical variables. Descriptive statistics were calculated for the
outcomes for each team was scored by a member of an inter- IEPS, COS, and TWS. Regression analysis with COS as the
professional faculty pair (PharmD and MD or PharmD and dependent variable and the TWS and IEPS scores as inde-
PA) located in a simulation booth where one person con- pendent variables was conducted. Additionally, regression
trolled the computerized checklist. The clinical outcomes analysis was conducted with each of the IEPS sub-scales
score (COS) was calculated for the teams’ clinical perform- from each of the teams. All data management and statisti-
ance using the weighted clinical outcomes checklist. cal analyses were performed using IBM SPSS Statistics ver-
To assess teamwork performance of the interprofessional sion 19 software.
team of students, a teamwork evaluation instrument was
created by the investigators. We were unable to locate Results
reports of validated interprofessional teamwork ratings
instruments designed for student assessment that evaluated Twenty-four teams of students were included in the analy-
teamwork and communication skills necessary in a clinical sis (see Table 2). A forced entry multivariate regression
environment. Therefore, we modified the TeamSTEPPS model with COS as the dependent variable and TWS and
team performance observation tool to create an assessment IEPS as independent variables was calculated (see Table 3)
for students when they participate in a single interprofes- with an F=12.26 (p<.001). The IEPS was a not a significant
sional exercise in a newly formed team for a patient that predictor of COS (p=.054), however, the TWS was a sig-
was not in critical condition.26 The rating scale used the nificant predictor (p<0.001) of COS, and model R2=.539
same dimensions of TeamSTEPPS including: team struc- (see Table 1). When the IEPS four subscales were used
ture, leadership, situation monitoring, mutual support, and within the model, none of the subscales was a significant
communication. In some of the dimensions, team perform- predictor. Pearson correlation between TWS and IEPS was
ance measures were removed if they were not applicable to 0.032 and not significant. There was evidence of a positive
our clinical scenario. The teamwork evaluation instrument relationship between teamwork scores predicting clinical
is found in Appendix 1. outcomes in a simulated healthcare environment.
Two faculty members (from medicine and pharmacy)
were trained to use the behaviorally anchored interprofes- Discussion
sional teamwork scale and were blinded to the COS for
each team. The trained faculty members independently Development of teamwork skills is an essential foundation
rated the interprofessional teams using the teamwork rating for effective collaborative practice. Health care simulation
scale by observing the recorded videos of the simulated using high-fidelity human patient simulators offers a unique
rounding experience. They then met to discuss their inde- learning environment for health professions students to
pendently rated scores and to reconcile any scores with a practice interprofessional clinical care. Health care simula-
difference greater than 1 point between themselves. For tion has been associated with improving students’ attitudes
five teams (20%), it was necessary to reconcile the scores. toward interprofessional collaboration and teamwork com-
For each team, the scores for each of the dimensions were munication skills.8–12 To our knowledge, there have been
summed to calculate a total score. Each observer rated the no reports in the literature that have demonstrated the rela-
overall team performance using the rating scale and their tionship between interprofessional teamwork, including
scores were averaged to determine a teamwork score attitudes, and clinical outcomes in a simulated clinical
(TWS) for each interprofessional team. environment for health professions students.

Table 3. Team Clinical Outcome, Teamwork and IEPS Scores

Measure Mean Range SD

Clinical Outcomes Score (COS) 25.22 (out of 43) 13–37 7.44

Teamwork Score (TWS) 80.75 (out of 110) 61.5–97.5 11.13
IEPS Score (IEPS) 73.42 (out of 82) 68.75–79.0 3.31

Journal of Allied Health, Spring 2013, Vol 42, No 1 e3

 Our results indicate that effective interprofessional been widely used in the literature.23-25, Other instruments
teamwork skills applied in health care simulation are pre- measuring attitudinal aspects of collaboration may find a
dictive of positive clinical outcomes, as measured within stronger relationship than our results indicated. While our
this setting. Work by Wright et al. indicated that medical hypothesis was that positive attitudes toward interprofes-
student teamwork was associated with positive clinical per- sional collaboration would be associated with improved
formance in a simulated setting; however, the teams con- teamwork and positive clinical outcomes, it may be that
sisted of only one health profession.17 Our work provides positive attitudes toward interprofessional collaboration
evidence that effective interprofessional teamwork is asso- facilitate effective teamwork, but are not a necessary com-
ciated with positive clinical outcomes in a health care sim- ponent if team members have the essential teamwork skills
ulation setting in a large cohort of students. The results of to work together. Clearly, the relationship of attitudes
our study go beyond other reports examining student learn- toward collaboration and outcomes needs further research.
ing in interprofessional simulated environments because we While our findings add to the literature, this study is not
evaluated the effects on clinical outcomes and not student without limitations. First, there was an unequal distribution
attitudes and satisfaction. These findings suggest that stu- of students representing different health professions in each
dents were able to transcend their uni-professional training, team and this imbalance may not have authentically repre-
including perhaps their unique professional identities, to sented the interprofessional team dynamic in a real clinical
apply teamwork skills and work collaboratively as effective setting. In addition, nursing students were not represented
interprofessional teams. Student teams that were able to within the team due to scheduling conflicts. The student
draw upon members’ unique professional knowledge and groups also had varying levels of didactic and clinical expe-
skills (i.e., medical student asking pharmacy student for rience. It is unclear if these imbalances influenced clinical
medication-related information) appear to have performed outcomes or teamwork scores. A validated teamwork rating
better than those that were not able to do this. scale would have improved our results; however, for educa-
Professionalization in health care training, with profes- tional purposes of the clinical scenario it was necessary to
sions possessing distinct social identities, roles, and areas of use a modified assessment instrument. The development
expertise, has been cited as a significant barrier to interpro- and testing of teamwork instruments particularly for stu-
fessional education and practice.27–30 Whitehead describes dents to be used in a clinical environment, is an area for
aspects of medical education and socialization that impart the future research. Regarding the examination of student atti-
hierarchical characteristics found in health care, including tudes, teamwork and clinical outcomes, as discussed above,
power differentials between physicians and other health pro- other instruments may have found a stronger relationship
fessionals.28 These aspects hinder interprofessional education, than our results indicated. Due to the regression analysis
and by inference, interprofessional teamwork. While our study design, we were unable to conclude that this inter-
study sought to examine the relationship between interpro- professional simulation produced students with improved
fessional teamwork skills and clinical outcomes in a simulated teamwork skills. Debriefing data were not collected for pur-
environment, theoretical perspectives on professionalization, poses of this study; this information could have been used
social categorization, and social identity, provide some con- as an additional measure of student attitudes regarding
text for possible interpretation of the findings and more interprofessional teamwork and collaboration. Different
importantly, for future work.27, 30 Perhaps the traditional hier- approaches to the study design including pre/post evalua-
archy within health care training may be more permeable in tion of teams undergoing training or randomizing teams
the emerging context of interprofessional education. Maybe a consisting of a single health profession compared to teams
newer generation of practitioners will develop professional consisting of interprofessional members would have
social identities and social categorizations that deconstruct strengthened our results. All of these limitations could be
the traditional hierarchy and permit more easily achieved considered for areas of future research.
interprofessional collaborative relationships. This is clearly
one of the goals of interprofessional education. Conclusion
Interestingly, we found that while students’ attitudes
This study provides evidence that interprofessional team-
toward interprofessional collaboration were closely associ-
work, when used effectively, is associated with positive clin-
ated with positive clinical outcomes, they were not signifi-
ical outcomes in a simulated clinical environment for
cant predictors. Since we examined attitudes by team, it
health professions students, including medical students.
may be that there was an insufficient number of team obser-
Interprofessional curricular models that produce effective
vations (n=24) for sufficient analytical power. Or, examina-
teamwork skills can improve student performance in clini-
tion of students’ attitudes at the individual level, and not
cal environments and likely improve teamwork practice to
team level, may result in different findings. Debate exists in
positively affect patient care outcomes.
the field regarding assessment of student attitudes, including
psychometric properties of the various instruments reported ACKNOWLEDGMENTS: The authors thank all the medical, pharmacy,
in the literature.23 In light of the debate, we chose the IEPS and physician assistant faculty members who served as faculty facilitators
because it has established psychometric properties and has and the simulation center staff for their assistance.

e4 SHRADER ET AL. Interprofessional Teamwork

REFERENCES team performance when added to an existing didactic teamwork cur-
riculum? Qual Saf Health Care. 2004; 13: 417–21.
16. Siassakos D, Fox R, Crofts JF, et al. The management of a simulated
1. Tully MP, Ashcroft DM, Dornan T, Lewis PJ, Taylor D, WassV. The
emergency: better teamwork, better performance. Resuscitation. 2011:
causes of and factors associated with prescribing errors in hospital
82: 203–6.
inpatients: a systematic review. Drug Saf. 2009; 32: 819–36.
17. Wright MC, Phillips-Bute BG, Petrusa ER, et al. Assessing teamwork
2. Freitag M, Carroll VS. Handoff communication: using failure modes
in medical education and practice: relating behavioural teamwork
and effects analysis to improve the transition in care process. Qual
ratings and clinical performance. Med Teach. 2009; 31: 30–8.
Manag Health Care. 2011: 20: 103–9.
18. Blue A, Mitcham M, Smith T, et al. Changing the future of health
3. Woods DM, Holl JL, Angst D. Improving clinical communication
professions by embedding interprofessional education with an aca-
and patient safety: clinician-recommended solutions. In Henriksen,
demic health center. Acad Med. 2010; 85: 1290–95.
et al. (Eds.), Advances in Patient Safety: New Directions and Alterna-
19. Hall PD, Zoller JS, West VT, et al. A novel approach to interprofes-
tive Approaches (Vol. 3: Performance and Tools). Rockville (MD):
sional education: Interprofessional Day, the four-year experience at
Agency for Healthcare Research and Quality; 2008.
the Medical University of South Carolina. J Res Interprof Pract Educ
4. Committee on Quality Health Care in America, Institute of Medi-
2001; 2: 49–62.
cine. Crossing the Quality Chasm: A New Health System for the 21st
20. Institute for Safe Medication Practices [internet]. ISMP Medication
Century. Washington, DC: National Academy Press; 2001.
Safety Alert. Horsham (PA): 2011, Available at: http://www.
5. Interprofessional Education Collaborative Expert Panel. Core compe-
ismp.org/newsletters/acutecare/articles/20080925-1.asp. Accessed:
tencies for interprofessional collaborative practice: Report of an expert
Mar 25, 2012.
panel. Washington, DC: Interprofessional Education Collaborative;
21. Shrader S, McRae L, King W, Kern D. Simulated interprofessional
2011.
rounding experience in a clinical assessment course. Am J Pharm
6. Schmitt M, Blue AV, Aschenbrener CA, Viggiano TR. Core compe-
Educ. 2011; 75: Article 61.
tencies for interprofessional collaborative practice: reforming health
22. Luecht R, Madsen M, Taugher M, Petterson B. Assessing profes-
care by transforming health professionals’ education. Acad Med.
sional perceptions: design and validation of an interdisciplinary edu-
2011; 86: 1351.
cation perception scale. J Allied Health. 1990; Spring: 181–91.
7. Friedrich M. Practice makes perfect: risk-free medical training with
23. Thannhauser J, Russell-Mayhew S, Scott C. Measures of inteprofes-
patient simulators. J Am Med Assoc. 2002; 288: 2808–12.
sional education and collaboration. J Interprof Care. 2010; 24
8. Robins L, Brock DM, Gallagher T, et al. Piloting team simulations to
:336–49.
assess interprofessional skills. J Interprof Care. 2008; 22: 325–8.
24. Baker C, Pulling C, McGraw R, et al. Simulation in inteprofessional
9. Ker J, Mole L, Bradley P. Early introduction to interprofessional
educaton for patient-centred collaborative care. J Adv Nurs. 2008;
learning: a simulated ward environment. Med Educ. 2003; 37:
64:372–9. Epub 2008 Sep 1.
248–55.
25. Becker EA, Godwin EM. Methods to improve teaching interdiscipli-
10. Kyrkjebo J, Brattebo G, Smith-Strom H. Improving patient safety by
nary teamwork through computer conferencing. J Allied Health.
using interprofessional simulation training in health professional
2005;34:169–176.
education. J Interprof Care. 2006; 20: 507–16.
26. Agency for Healthcare Research and Quality [internet]. Team Per-
11. Van Soeren M, Macmillan K, Cop S, et al. Development and evalu-
formance Observation Tool; Rockville (MD): 2011, Available at:
ation of interprofessional care practices through clinical simulation.
http://www.ahrq.gov/teamsteppstools/instructor/reference/tmpot.ht
J Interprof Care. 2009; 23: 304–6.
m. Accessed: Mar 25, 2012
12. Robertson B, Kaplan B, Atallah H, et al. The use of simulation and
27. Friedson E. Professionalism Reborn: Theory, Prophecy, and Policy.
a modified TeamSTEPPS curriculum for medical and nursing student
Chicago, IL: University of Chicago Press, 2001.
team training. Simul Healthc. 2010; 5: 332–7.
28. Whitehead C. The doctor dilemma in interprofessional education
13. Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and
and care: how and why will physicians collaborate? Med Educ. 2007;
error in the operating room: analysis of skills and roles. Ann Surg.
41: 1010–16.
2008; 247: 699–706.
29. Ginsburg L., Tregunno D. New approaches to interprofessional edu-
14. Leonard M, Graham S, Bonacum D. The human factor: the critical
cation and collaborative practice: Lessons from the organizational
importance of effective teamwork and communication in providing
change literature. J Interprof Care. 2005; 19: 177–87.
safe care. Qual Saf Health Care. 2004; 13(Suppl 1): i85–i90.
30. Sargeant J. Theories to aid understanding and implementation of
15. Shapiro MJ, Morey JC, Small SD, et al. Simulation based teamwork
interprofessional education. Journal of Continuing Education in
training for emergency department staff: does it improve clinical
Health Professions. J Contin Educ Health Prof 2009; 29: 178–84.

Journal of Allied Health, Spring 2013, Vol 42, No 1 e5

 Appendix 1. Interprofessional Teamwork Evaluation.
Rating Scale:

1=very poor (basically did not occur); 2=poor (occurred minimally); 3=acceptable (occurred throughout but not consistently); 4=good
(occurred majority of time); 5=excellent (occurred consistently).

Team Number: ____________ Rater: _______________________________________

Team Structure 1 2 3 4 5
Team leader established and evident (ok to shift over course of interview, leader still clear)
Roles and responsibilities established (support member roles clear; pharmacists give drug
recommendations, a member transcribes chart orders, etc.)
All clinical roles represented (e.g. patient interview, medication history/review; diagnostic
exam; treatment plan)
Clinical roles shared among members of the team (e.g. more than one person fulfills roles above)
Actively share information among team members (e.g. shares results of EKG or physical
exam with entire team)
Leadership (the team leader) 1 2 3 4 5
Balances workload with team (team leader not dominating entire encounter)
Delegates tasks, unanswered clinical questions as appropriate (e.g. MD/PA seeks drug
information from pharmacy students)
Conducts briefs, huddles and debriefs throughout the patient encounter (summarizes, team
reviews thoroughly/systematically what has happened, what still needs to be addressed, etc)
Empowers team members to speak freely and ask questions (minimal time spent dominating
encounter and providing one-way orders just coming from leader)
Situation Monitoring 1 2 3 4 5
Includes patient in conversation and the encounter (should occur throughout the scenario)
Cross monitors fellow team members (other team members find out information being
exchanged and decisions being made in side conversations)
Update team members on patient status (e.g. blood pressure is dropping)
Team members share focus on patient problem and outcome (e.g. all focused on bleeding
rather than side issues)
Mutual Support 1 2 3 4 5
Members provide task related support (e.g. PA may do diagnostic checks after MD to see if agree
with findings, pharmacy student may help the order transcriber write appropriate med orders
without using unapproved abbreviations)
Advocates for the patient (e.g. “let’s think about what’s in the patient’s best interest”)
Team members are properly assertive (e.g. willing to participate, speak up, acknowledge
disagreement with team members assessment, actively and openly discuss alternatives)
Collaborates with team members (e.g., discuss things among each other in smaller groups first)
Communication 1 2 3 4 5
Introduction of team members to patient
Members provide brief, clear, specific and timely information/recommendations to other members
Members seek information from all available team members (e.g. ask for help; second set of eyes;
solicit opinions)
Verify information that is communicated is accurate (e.g. clarify when there uncertainty or
disagreement, information is verified and confirmed)
Member side conversations are openly communicated with team as a whole
Overall Total Score

e6 SHRADER ET AL. Interprofessional Teamwork