Journal of Interprofessional Care, 2011, 25: 189–195
Ó 2011 Informa UK, Ltd.
ISSN 1356-1820 print/1469-9567 online
DOI: 10.3109/13561820.2010.532620
Development and pilot testing of the collaborative practice
assessment tool
Corinne Schroder, Jennifer Medves, Margo Paterson, Vaughan Byrnes, Christine Chapman,
Anne O’Riordan, Deborah Pichora and Carly Kelly
Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada K7L 3N6
Collaborative practice is receiving increased attention as a
model of healthcare delivery that positively influences the
effectiveness and efficiency of patient care while improving
the work environment of healthcare providers. The
collaborative practice assessment tool (CPAT) was developed
from the literature to enable interprofessional teams to assess
their collaborative practice. The CPAT survey included 56 items
across nine domains including: mission and goals;
relationships; leadership; role responsibilities and autonomy;
communication; decision-making and conflict management;
community linkages and coordination; perceived effectiveness
and patient involvement; in addition to three open-ended
questions. The tool was developed for use in a variety of
settings involving a diversity of healthcare providers with the
aim of helping teams to identify professional development
needs and corresponding educational interventions. The
results of two pilot tests indicated that the CPAT is a valid and
reliable tool for assessing levels of collaborative practice within
teams. This article describes the development of the tool, the
pilot testing and validation process, as well as limitations of
the tool.
Keywords: Collaborative practice; assessment tool;
interprofessional; teamwork
INTRODUCTION
Assessing the collaborative function of an interprofessional
team is difficult because there are few instruments
specifically designed to measure the effectiveness of team
collaboration in healthcare settings. This article outlines the
process involved in developing and pilot testing a new
instrument designed specifically to measure healthcare team
members’ perceptions of working collaboratively. It is
important to understand the perceptions of the people in
the team. From an outside view it may seem that a team is
Correspondence: Anne O’Riordan, School of Rehabilitation Therapy and Office of Interprofessional Education and Practice, Queen’s University,
Kingston, Ontario, Canada K7L 3N6. Tel: þ613-533-3345. E-mail: ao3@queensu.ca
189
functioning well, but the perceptions of the team members
may be that the team is not as effective. The CPAT was
developed so that individuals could provide their views and
then the team as a whole could analyze the results and learn
where and why there were discrepancies in the items. The
tool does not provide an absolute score, but is a diagnostic
tool which highlights the relative strengths and weaknesses
of individual teams in various domains of collaborative
practice.
Interprofessional collaborative practice is an enabler
for improving patient care and meeting the current
demands placed on the healthcare system (Canadian
Health Services Research Foundation, 2006; Lemieux-
Charles & McGuire, 2006). This approach to healthcare
has been found to reduce errors, improve quality of care
and patient outcomes, reduce healthcare workloads and
cost, and increase job satisfaction and retention (Boult
et al., 2001; Langhorne & Duncan, 2001; Rogowski et al.,
2001; Buist et al., 2002; Morey et al., 2002; Saltvedt et al.,
2002; Litaker et al., 2003; Charles et al., 2006). In Canada,
Federal and Provincial government funders have targeted
a transition to this model of care through the develop-
ment of strategic reports (Commission of the Future of
Health Care in Canada, 2002; Standing Committee on
Social Affairs, Science and Technology, 2002; Health
Canada, 2003, 2004; Oandasan et al., 2005; HealthFor-
ceOntario, 2007) and substantial funding for research and
initiatives (Health Canada; Health Force Ontario), which
have been paralleled internationally in the United King-
dom, the USA, and Australia (Department of Health,
1999; O’Neil & Pew Health Professions Commission,
1998).
‘‘Collaborative Practice is an inter-professional process
for communication and decision-making that enables the
separate and shared knowledge and skills of care providers
to synergistically influence the client/patient care provided.’’
(Way et al., 2000, p. 3). It is this interprofessional process of
collaboration that is most often discussed when talking
about teamwork in healthcare; when healthcare providers
190 C. SCHRODER ET AL.
from diverse backgrounds actively work together while
retaining the integrity of each profession (Way et al., 2000)
For this, continuous communication among care providers
and participation in clinical decision-making (within and
across disciplines), is required to ensure that patients
receive care from the right person at the right time, and to
avoid duplication and gaps in care (Health Force Ontario,
2007). Respect and trust between team members are
enhanced when healthcare providers develop a deeper
understanding of each other’s roles and responsibilities,
with benefits to workplace cultures and morale (Suter et al.,
2009). The culmination of these factors leads to improved
clinical efficiencies and patient/client outcomes, as well as
greater levels of workplace satisfaction and higher rates of
staff recruitment and retention (Health Force Ontario,
2007). More recent literature expands the definition and
explains that: ‘‘Interprofessional collaboration is the process
of developing and maintaining effective interprofessional
working relationships with learners, practitioners, patients/
clients/families and communities to enable optimal health
outcomes. Elements of collaboration include respect, trust,
shared decision-making, and partnerships.’’ (Canadian
Interprofessional Health Collaborative, 2010)
However, simply placing healthcare professions from
different backgrounds into a team does not mean that
they will have the knowledge, skills or attitude necessary
to work together collaboratively to enhance patient care
(Miller et al., 1999). Professionals from university and
practice settings modeled on traditional siloed approaches
require education on how to work together collaboratively
(Miller et al., 1999; Ferlie & Shortell, 2001; Werrett et al.,
2001; Canadian Health Services Research Foundation,
2006). To provide effective education, team members need
to recognize their current strengths and weaknesses as
they pertain to collaborative practice, and decide collec-
tively on priorities for learning. Therefore, the purpose of
developing and validating the CPAT survey instrument
was to assist teams in identifying specific educational
needs through assessment of their perceived degree of
collaboration.
DEVELOPMENT OF THE COLLABORATIVE PRACTICE
ASSESSMENT TOOL
The CPAT was first developed through the Queen’s
University Inter-Professional Patient-Centred Education
Direction project (QUIPPED), an action research project
funded by Health Canada (Paterson et al., 2007; Medves
et al., 2008). The initial development process began in the
summer of 2007 and was completed by December of that
year. When the QUIPPED project ended in March 2008, the
Office of Interprofessional Education and Practice (OIPEP)
at Queen’s University assumed the piloting and further
development of the CPAT.
The objective was to develop a valid and reliable
instrument for healthcare practitioners to assess the degree
to which they collaborate with one another to provide
comprehensive, timely and appropriate patient care. The
tool needed to assist clinical teams, in a variety of practice
settings, to appropriately pin-point key areas of collabora-
tive practice that could be enhanced by education. To
identify pertinent topics a review of literature on teamwork,
collaboration and existing instruments was carried out.
Expert opinion was incorporated into the content, overall
structure and design of the CPAT, including that of patients
and practitioners in medicine, nursing, occupational
therapy and hospital administration.
Within the literature examined, a range of concepts
were found that related to successful interprofessional
collaborative practice in healthcare. Effective communica-
tion between professional groups and a strong focus on
role awareness appeared to be most fundamental and
highly reported for optimal integrated care (Norsen et al.,
1995; Millward & Jeffries, 2001; Temkin-Greener et al.,
2004; Howarth et al., 2006; Suter et al., 2009).
Responsibility/accountability, coordination, cooperation,
autonomy, and mutual trust and respect (Weiss & Davis,
1985; Baggs, 1994; Norsen et al. 1995) were also reported
as essential for collaborative practice. Other sources
identified shared decision-making and conflict manage-
ment as critical for effective team work (Gibb et al., 2002;
Weiss & Davis, 1985), which was described as a balance
between the ability to be assertive and cooperative (Baggs,
1994). Further conditions deemed necessary for effective
interprofessional collaboration were shared goals and
professional distinctiveness (Oaker & Brown, 1986;
Katzenbach & Smith, 2005), and team identity and team
potency (Millward & Jeffries, 2001). Although interpro-
fessional collaboration was increasingly linked to patient-
centred care, the role of patients in the collaborative
process was not always made clear (D’Amour &
Oandasan, 2005; Sumsion & Law, 2006).
A few validated tools were available to measure
interprofessional collaboration in healthcare settings.
Although most of the existing team development tools
were designed for industry use and had little relevance to
healthcare, several were developed specifically for the
healthcare environment, including the Collaboration and
Satisfaction with Care Decisions (CSACD) (Baggs, 1994),
the Jefferson Survey (Hojat et. al., 1999) the Team Survey
(Millward & Jeffries, 2001), and the Program of All
Inclusive Care for the Elderly (Pace) (Temkin-Greener
et al., 2004). However, a tool to meet all the needs identified
by the QUIPPED team could not be found. Some tools
focused on very specific settings or diagnoses (Shortell et al.,
1991; Baggs, 1994; Millward & Jeffries, 2001) or related to
specific healthcare professions (Weiss & Davis, 1985;
Shortell et al., 1991; Baggs, 1994). Others did not include
concepts identified in the literature, and by the project team,
as critical to collaborative practice such as the role(s) of the
client/patient/family.
Thus from the literature review, together with the expert
opinions, discussion and debate within the QUIPPED
interprofessional team to build consensus on key items for
inclusion, the first version of CPAT was constructed. It had
Journal of Interprofessional Care
 COLLABORATIVE PRACTICE ASSESSMENT TOOL 191

57 items for questioning respondents about various Respondents were then asked to complete 10 additional
domains of collaborative care as outlined in Table I below: questions to assess the clarity of the statements, time and
Respondents were asked to rate their level of agreement effort to complete, instructions provided, item content,
with each of the 57 statements along a seven-point scale adequacy of scale, and appropriateness to their practice
ranging from the lowest value of ‘Strongly Disagree’ to the setting.
highest value of ‘Strongly Agree’. Three additional open- Respondents positively rated all dimensions of the tool
ended questions were included that asked respondents to and identified, through open-ended comments, their main
comment on their team’s strengths in collaborative practice, areas of concern. The items most frequently cited were:
challenges, and what help they would need to improve their clarifying who was a member of ‘the team’ prior to
levels of collaborative practice. Table II lists the attributes administration of the tool, as some participants worked
for collaborative practice and teamwork identified in the on multiple services within one institution; separating
healthcare literature and how they were incorporated into statements that referred to a team’s mission or goals from
the domains of the CPAT. those that referred a team’s process for peer review or team
meetings; and specific criticism of the phrasing of an item.
First pilot test Further analysis of the CPAT through exploratory factor
Ethical approval was obtained from the Research Ethics analysis (Bartholomew et al., 2002) helped to confirm the
Board, Queen’s University and in the spring of 2008, the concerns mentioned by pilot respondents, and served to
CPAT was pilot tested with a palliative care team, a geriatric identify other problems including statements that required
assessment team, and two family practice teams, all based in rephrasing, statements that needed to be removed, and
south-eastern Ontario. Forty-two practitioners responded statements that would fit better under a different domain.
from a variety of backgrounds including administration, The results from eight exploratory factor analyses using the
medicine, nursing, nutrition services, occupational therapy, maximum likelihood method of extraction, one for each
physical therapy, social work, spiritual care, and volunteer domain, further suggested that the various sections of the
services. CPAT satisfactorily measured the domains of collaborative
practice for which they were developed1. One exception was
Table I. First version of CPAT. the three statements intended to measure a team’s perceived
effectiveness, which, when taken together did not tie into
CPAT domains No. of items
one single factor and were thus cut from the survey.
Mission, meaningful purpose, and goals 8 Excluding statements that were then removed or changed,
General relationships 6 separate factor analyses of the remaining 42 survey items for
Team leadership 9
General role responsibilities and autonomy 10
each of the seven factors for domains of collaborative
Communication and information exchange 9 practice were performed. Each domain has an eigenvalue of
Community linkages and coordination of care 4 around 3.0 that explained roughly 50% of the variation in
Decision-making and conflict management 8 respondents’ answers, and Cronbach’s a’s were between
Perceived effectiveness 3 0.70 and 0.90. Table III shows the summary statistics
Total number of items 57
for each of the seven remaining domains of collaborative
care.
Table II. Mapping collaborative practice and teamwork attributes
onto CPAT domains. Second pilot test
Based on these exploratory analyses, a second version of the
Collaborative practice and tool was developed. This version included the 42 items
CPAT domains teamwork attributes
covering seven domains of collaborative practice identified
Mission, meaningful purpose, Shared goals, team in the first pilot test as well as 14 additional questions for a
goals identity total of 56 items. The 14 additional questions included five
General relationships Mutual trust/respect
from the original pilot version which had been modified
Team leadership –
General role responsibilities Responsibility, role awareness, slightly based on feedback and EFA results, four entirely
and autonomy autonomy new questions, one question from the first pilot which had
Communication and Communication been moved into another domain/section of the survey, as
information exchange well as five new items designed to assess an eighth aspect of
Decision-making and conflict Shared decision-making,
collaborative care, the level of patient involvement. The new
management conflict management
Community linkages and Coordination or modified questions were added with the hope of
coordination of care strengthening the existing factors, knowing that if they
Perceived effectiveness* Team potency did not the 42 core items should still produce strong enough
Patient involvement{ – factors. The five items that measured the level of patient
involvement in a team’s practice were specifically added so
Baggs, 1994; Way et al. 2000; Millward & Jeffries, 2001; Temkin-
Greener et al., 2004; Lemieux & McGuire, 2006; Suter et al., 2009. that this version of the CPAT would assess not only
*Only appeared in first pilot version then cut. collaborative practice between team members, but also with
{Added in to final version. patients or clients.

Ó 2011 Informa UK, Ltd.

192 C. SCHRODER ET AL.

The second version of the CPAT was tested in 2008–
2009 as part of a research project led by OIPEP and funded
by the Ministry of Health and Long-term Care and the
Ministry of Training, Colleges and Universities. The goal of
this South Eastern Interprofessional Collaborative Learning
Environment (SEIPCLE) project was to develop a colla-
borative learning environment to support interprofessional
education and care. As part of the SEIPCLE project, the
CPAT was administered to members of six participating
healthcare units from different clinical practice settings and
a total of 111 respondents completed the CPAT including
those shown below in Figure 1.
Based upon this larger sample of respondents, the CPAT
was evaluated a second time using confirmatory factor
analysis (Long, 1983) with the AMOS software (Arbuckle,
2005) and the maximum likelihood method of estimation.
The results of eight separate CFAs confirmed that the 56
items in the CPAT, including modifications made based upon
the results of the first pilot test, were valid and reliable
measures of collaborative practice and their respective
underlying domains, as included in Table IV below. The 56
items included in the final CPAT can be viewed at: http://
meds.queensu.ca/oipep/assets/CPAT_Statistical_Analysis.pdf
Table V reports the results of the w2 tests for the eight
CFAs as well for several indices of fit that provide a means
for judging a model’s fit (Gerbing & Anderson, 1992),
including the Normed Fit Index (NFI), the Comparative Fit
Index (CFI), and the Tucker Lewis Index (TLI), which are
incremental fit indexes that judge model fit relative to a
baseline null model. For all three, a statistic of 1.0 represents
a perfect fit of the model to the data, and normally a statistic
of 0.90 represents an acceptable fit and 0.95 or above a good
fit. In addition, the table presents the RMSEA, an absolute
fit index that estimates the difference between observed and
predicted model covariance matrices and for which values
should ideally fall below 0.05. While some of the factors
display some questionable fit statistics in regards to w2, TLI
or RMSEA, most notably the factors for communication
and patient involvement, all eight of the factors show very
strong NFI and CFI statistics, and in general strong statistics
across the range of goodness-of-fit measures presented.
Thus, overall we find that our models are a good fit to our
sample and the observed data, and that the CPAT provides
a good measure of collaborative practice.
While there remains some room for improvement
amongst some of the aspects of collaborative care as

Table III. Results of exploratory factor analysis.

No of questions % of variation Questions excluded

Domain included Cronbach’s a Eigenvalue explained from EFA

Mission, meaningful purpose, goals 7 0.78 3.2 45 One changed

General relationships 5 0.81 3.1 62 One changed, two new
Team leadership 9 0.84 4.3 47 none
General role responsibilities, autonomy 8 0.73 3.1 39 One changed, one new,
one dropped
Communication and information exchange 5 0.74 2.5 50 One changed, three dropped
Community linkages and coordination of care 3 0.73 1.6 53 One new
Decision-making and conflict management 5 0.74 2.7 53 One changed, one dropped,
one moved

Figure 1. Professional backgrounds of respondents.

Journal of Interprofessional Care

 COLLABORATIVE PRACTICE ASSESSMENT TOOL 193

measured by the CPAT, the instrument successfully fills a included in their work. In these situations, the response
gap for practitioners across all healthcare fields. As pattern was affected, although this could be seen as an
collaborative care develops both as a model of care opportunity for teams to develop mission, goals or policies
provision and in its practical application throughout the for team meetings in order to enhance their collaboration.
healthcare system, the CPAT provides researchers and Questions relating to leadership could also pose difficulty, as
practitioners with a means of assessing levels of collabora- health professionals often experienced leadership at differ-
tive care across diverse healthcare settings in order to target ent levels or worked on multiple services within one
and focus efforts aimed at improving practice and patient institution with more than one leader (i.e. service director
outcomes. Existing instruments have either not focused on leader versus a profession specific leader). This suggests the
collaborative care or not been applicable to diverse settings topic of leadership must be clearly defined prior to
of heath care practices and the CPAT, while new and still administering the instrument within a healthcare team. A
developing, provides a valid and reliable starting point from potential limitation was that participants tended to respond
which practitioners can begin self-assessment and improve- differently to questions that specifically referred to physi-
ment processes. cians as distinguished from other professions. Modifica-
tions, made after the first pilot test, improved the pattern of
Limitations responses to these questions, but the need to address the
The items in the CPAT provided a good measure in each of traditional hierarchical structure of the healthcare system
their respective domains. However, a few items were was underscored by this particular challenge to collabora-
difficult for respondents to rate and some items correlated tive practice (Way et al., 2000). These types of questions
less well to the linked collaborative practice domains, where (related to meetings and leadership) were clear to the vast
the items related to concrete topics such as meetings and majority of respondents. Similarly, while they may have
mission goals, which some groups may not have formally been more weakly related to their respective domains than
other questions, they still contributed valuable information
and strengthened the measurement of the various factors,
Table IV. Comparison of domains and number of items in the CPAT
before and after EFA (first pilot) and in CFA (second pilot).
according to w2 tests and measures for goodness-of-fit.
(Gerbing & Anderson, 1992; Arbuckle, 2005). Also, while
First pilot the results of the CFAs suggest that the CPAT is overall a
good measure of collaborative practice and its various
After Second
CPAT domain Pre-EFA EFA pilot aspects, the two factors for communication and patient
involvement did not meet the standards for all of the
Mission, meaningful purpose, 8 7 8 relevant statistical tests and could be improved with future
goals development.
General relationships 6 5 8
Team leadership 9 9 9 Finally, it would not be appropriate to use the CPAT for
General role responsibilities 10 8 10 addressing the influence of contextual factors outside the
and autonomy team at institutional and systemic levels, such as policies,
Communication and 9 5 6 procedures, differences in rates of pay, staff turn-over,
information exchange schedules and shift work, and adequate resources affecting
Decision-making and 4 3 4
conflict management team collaboration. These factors could limit or reduce the
Community linkages and 8 5 6 extent to which the team-building process may succeed,
coordination of care although the open-ended questions of the CPAT could help
Perceived effectiveness* 3 N/A N/A to identify such systemic roadblocks, and did so in the
Patient involvement{ N/A N/A 5 SEIPCLE project, but these external factors may remain
Total number of items 57 42 56
outside the influence of the teams themselves.

Table V. Results of confirmatory factor analysis.

a w2 NFI CFI TLI RMSEA (90% CI)

Mission, meaningful purpose, goals 0.88 0.101 0.941 0.980 0.961 0.063 (0.000–0.114)
General relationships 0.89 0.009* 0.941 0.968 0.928 0.096 (0.047–0.144)
Team leadership 0.80 0.180 0.932 0.984 0.967 0.049 (0.000–0.099)
General role responsibilities, autonomy 0.81 0.268 0.901 0.985 0.973 0.036 (0.000–0.083)
Communication and information exchange 0.84 0.006* 0.917 0.943 0.851 0.124 (0.062–0.188)
Community linkages and coordination of care 0.76 0.145 0.970 0.986 0.952 0.085 (0.000–0.199)
Decision-making and conflict management 0.67 0.053 0.934 0.962 0.866 0.099 (0.000–0.177)
Patient involvement 0.87 0.027* 0.962 0.975 0.905 0.126 (0.038–0.218)

*Statistically significant at the a 5 .05 level.

Ó 2011 Informa UK, Ltd.

194 C. SCHRODER ET AL.
CONCLUSIONS
The CPAT was developed to assist clinical teams in
identifying strengths and weaknesses in their collaborative
practice thereby providing opportunities for focused
educational interventions. The design of the tool was based
on constructs of collaboration identified in the literature
and a review of existing tools to assess perceptions of team
work and collaboration in healthcare. An additional domain
was included prior to the second pilot test to assess the level
of patient involvement in collaborative practice. The tool
was intended to be general in nature in order to allow for
flexibility and application across a wide variety of clinical
practice settings and with a range of healthcare providers.
The overall result from the two pilot tests indicates that the
CPAT is a valid and reliable tool for measuring healthcare
team members’ perceptions of working collaboratively. In
assessing levels of collaborative practice within teams, it
provides a basis upon which teams can begin to explore
domains that would benefit from educational interventions.
Note
1. Although N ¼ 42 is considered low for conducting EFA (N 5 50),
the results of the analyses suggest conditions in which EFA can
work given a small sample size. These include loadings predomi-
nantly between 0.6 and 0.8 combined with the presence of only
factor for each EFA (de Winter & Wieringa, 2009).
REFERENCES
Arbuckle, J. (2005). AMOS 6.0 user’s guide. Chicago: Smallwaters.
Baggs, J. (1994). Development of an instrument to measure
collaboration and satisfaction about care decisions. Journal of
Advanced Nursing, 20, 176–182.
Bartholomew, D., Steele, F., Moustaki, I., & Galbraith, J. (2002). The
analysis and interpretation of multivariate data for social scientists.
USA: Chapman & Hall/CRC.
Boult, C., Boult, L., Morishita, L., Dowd, B., Kane, R., & Urdangarin,
C. (2001). A randomized clinical trial of outpatient geriatric
evaluation and management. Journal of the American Geriatrics
Society, 49, 351–359.
Buist, M., Moore, G., & Bernard, S. (2002). Effects of a medical
emergency team on reduction of incidence of and mortality from
unexpected cardiac arrests in hospital; Preliminary study. British
Medical Journal, 324, 387–390.
Canada. Parliament. Senate. Standing Committee on Social Affairs,
Science and Technology. 2002. The health of Canadians: The federal
role: Final report on the state of the health care system of Canada.
Ottawa: Standing Committee on Social Affairs, Science and
Technology.
Canadian Health Services Research Foundation. (2006). Teamwork
in healthcare: Promoting effective teamwork in healthcare in
Canada. Policy Synthesis and Recommendations. Ottawa, Cana-
dian Health Services Research Foundation.
Canadian Interprofessional Health Collaborative. (2010). A national
interprofessional competency framework. Retrieved from http://
www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Charles, G., Bainbridge, L., Copeman-Stewart, K., Tiffin Art, S., &
Kassam, R. (2006). The interprofessional program of British
Columbia (IRPbc). Journal of Interprofessional Care, 20(1), 40–50.
Commission of the Future of Health Care in Canada. (2002,
November). Building on values: The future of healthcare in
Canada: Final report. Saskatoon: Commission on the Future of
Health Care in Canada.
D’Amour, D., & Oandasan, I. (2005). Interprofessionality as the field
of interprofessional practice and interprofessional education: An
emerging concept. Journal of Interprofessional Care, 19(1), 8–20.
Department of Health. (1999). Continuing professional development
quality in the new NHS. Retrieved August, 1999, from http://
www.tap.ccta.gov.uk/doh
de Winter, D., & Wieringa (2009). Exploratory factor analysis with
small sample sizes. Multivariate Behavioral Research, 44, 147–
181.
Ferlie, E., & Shortell, S. (2001). Improving the quality of health-care
in the United Kingdom and the United States. A framework for
change. The Millbank Quarterly, 79, 281–315.
Gerbing, D., & Anderson, J. (1992). Monte Carlo evaluations of
goodness-of-fit indices for structural equation models. Sociological
Methods and Research, 21, 132–160.
Gibb, C., Morrow, M., Clarke, C., Cook, G., Gertig, P., & Ramprogus,
V. (2002). Transdisciplinary working: Evaluating the development
of health and social care provision in mental health. Journal of
Mental Health, 11(3), 339–350.
Health Canada. (2003). First ministers’ accord on health care renewal.
Ottawa: Health Canada.
Health Canada. (2004). First Ministers’ meeting on the future of health
care: A 10-year plan to strengthen health care. Ottawa: Health
Canada.
Health Force Ontario. (2007). Interprofessional care: A blueprint for
action. Retrieved from http://www.healthforceontario.ca/upload/
en/whatishfo/ipc%20blueprint%20final.pdf
Hojat, M., Fields, S., Veloski, J., Griffiths, M., Mitchell, J., & Plumb, J.
(1999). Psychometric properties of an attitude scale measuring
physician–nurse collaboration. Evaluation & The Health Profes-
sions, 22(2), 208–220.
Howarth, M., Holland, K., & Grant, M. (2006). Education needs for
integrated care: a literature review. Journal of Advanced Nursing,
56, 144–156.
Katzenbach, J., & Smith, D. (2005). The discipline of teams. Harvard
Business Review, July/August, 162–171.
Langhorne, P., & Duncan, P. (2001). Does the organization of post
acute stroke care really matter? Stroke, 32(1), 268–274.
Lemieux-Charles, L., & McGuire, W. (2006). What do we know about
heath care team effectiveness? A review of the literature. Medical
Care Research and Review, 63(3), 263–300.
Litaker, D., Mion, L., Planavsky, L., Kippes, C., Mehta, N., & Frolkis,
J. (2003). Physician–nurse practitioner teams in chronic disease
management: The impact on costs, clinical effectiveness, and
patients’ perception of care. Journal of Interprofessional Care,
17(3), 223–237.
Long, J.S. (1983). Confirmatory factor analysis. California: Sage
Publications.
Medves, J., Paterson, M., Schroder, C., Verma, S., Broers, T.,
Chapman, C., O’Riordan, A. (2008). The constant cycle: Day to
day critical action of the QUIPPED project. The Qualitative
Report, 13(4), 531–543.Retrieved from http://www.nova.edu/ssss/
QR/QR13-4/medves.pdf
Miller, C., Ross, N., & Freeman, M. (1999). Shared learning and
clinical teamwork: New directions in education for multiprofes-
sional practice. London: English National Board for Nursing,
Midwifery and Health Visiting.
Millward, L., & Jeffries, N. (2001). The team survey: A tool for health
care team development. Journal of Advanced Nursing, 35(2), 276–
287.
Morey, J., Simon, R., & Jay, G. (2002). Error reduction and
performance improvement in the emergency department through
formal teamwork training: Evaluation results of the MedTeams
project. Health Services Research, 37(6), 1553–1581.
Norsen, L., Opladan, J., & Quinn, J. (1995). Practice model:
Collaborative practice. Critical Care Nursing Clinics of North
America, 7(1), 43–52.
Journal of Interprofessional Care

Oaker, G., & Brown, R. (1986). Intergroup relations in a hospital
setting: A further test of social identity theory. Human Relations,
39(8), 767–778.
Oanadan, I., & Reeves, S. (2005). Key elements for interprofessional
education. Part I. The learner, the educator and the learning
context. Journal of Interprofessional Care, Supplement I, 21–38.
O’Neil, F., & The Pew Health Professions Commission. (1998).
Recreating health professional practice for a new century. San
Francisco: Pew Health Professions Commission.
Paterson, M., Medves, J., Chapman, C., Verma, S., Broers, &
Schroder, C. (2007). Action research as qualitative research
approach in interprofessional education: The QUIPPED ap-
proach. The Qualitative Report, 12(2), 332–344.
Rogowski, J., Horbar, J., Plsek, P., Baker, L., Deterding, J., Edwards,
W., et al. (2001). Economic implications of neonatal intensive care
unit collaborative quality improvement. Pediatrics, 107, 23–29.
Saltvedt, I., Opdahl Mo, E., Fayers, P., Kaasa, S., & Sletvold, O. (2002).
Reduced mortality in treating acutely sick, frail older patients in a
geriatric evaluation and management unit. A prospective randomi-
zed trial. Journal of the American Geriatrics Society, 50(5), 792–798.
Shortell, S., Rousseau, D., Gillies, R., Devers, M., & Simons, T. (1991).
Organizational assessment in intensive care units: Construct
Ó 2011 Informa UK, Ltd.
COLLABORATIVE PRACTICE ASSESSMENT TOOL 195
development, reliability and validity of the ICU nurse physician
questionnaire. Medical Care, 29(8), 709–723.
Sumsion, T., & Law, M. (2006). A review of evidence on the
conceptual elements informing client-centred practice. Canadian
Journal of Occupational Therapy, 73(3), 153–162.
Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., &
Deutschlander, S. (2009). Role understanding and effective
communication as core competencies for collaborative practice.
Journal of Interprofessional Care, 23(1), 41–51.
Temkin-Greener, H., Mukamel, D., Gross, D., & Kunitz, S. (2004).
Measuring interdisciplinary team performance in a long-term care
setting. Medical Care, 42(5), 472–481.
Way, D., Jones, L., & Busing, N. (2000). Implementation strategies:
Collaboration in primary care – Family doctors & nurse
practitioners delivering shared care. Toronto, Ontario: College of
Family Physicians.
Weiss, S., & Davis, H. (1985). Validity and reliability of the
collaborative practice scales. Nurse Research, 34(5), 299–304.
Werrett, J., Helm, R., & Carnwell, R. (2001). The primary and
secondary care interface: The educational needs of nursing staff
for the provision of seamless service. Journal of Advanced Nursing,
34(5), 629–638.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not
be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.