Midwest Modified Index Collaboration Pre-test and Follow

Fetal Alcohol Spectrum Disorders Regional Training Centers

F7a_screenshots Midwest FASD RTC Modified Index of Interdisciplinary Collab, 3 mo Follow-up - online survey

Midwest Modified Index Collaboration Pre-test and Follow-up

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Attachment F7a

MRFASTC - Index of Interdisciplinary Collaboration (Follow-up, 3 month)
1. MRFASTC ­ Index of Interdisciplinary Collaborations

 

Approximately 3 months ago, you completed an Interdisciplinary Collaborative Practice Module for FASDs. The purpose 
of this follow­up is to evaluate your perceptions of an interprofessional team approach to healthcare. 
Please take about 10 minutes to answer the following questions.  

1. With regard to your current primary work setting/organization, please indicate the extent
to which you agree or disagree with each of the following statements by circling the
appropriate number beside each statement.
Rate from "Strongly Agree" to "Strongly Disagree".

1. I utilize other professionals in different disciplines for 

Strongly 

Strongly Agree

Agree

Neutral

Disagree

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Disagree

their particular expertise.
2. I consistently give feedback to other professionals in 
my setting.
3. Professionals in different disciplines in my setting 
utilize me for a range of tasks.
*4. Teamwork with professionals from other disciplines is 
not important in my ability to help clients.
*5. The colleagues from other professional disciplines 
and I rarely communicate.
6. The colleagues from other disciplines with whom I 
work have a good understanding of the distinction 
between my role and their role(s).
*7. My colleagues from other disciplines make 
inappropriate referrals to me.
8. I can define those areas that are distinct in my 
professional role from that of professionals from other 
disciplines with whom I work.
9. I view part of my professional role as supporting the 
role of others with whom I work.
10. My colleagues from other disciplines refer to me 
often.
*11. Cooperative work with colleagues from other 
disciplines is not a part of my job description.
*12. My colleagues from other professional disciplines do 
not treat me as an equal.
13. My colleagues from other disciplines believe that 
they could not do their jobs as well without my 
professional discipline.
14. Distinct new programs emerge from the collective 
work of colleagues from different disciplines.
15. Organizational protocols reflect the existence of 

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MRFASTC - Index of Interdisciplinary Collaboration (Follow-up, 3 month)
cooperation between professionals from different 
disciplines.
16. Formal procedures/mechanisms exist for facilitating 

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dialogue between professionals from different disciplines 
(i.e., at staffing, in­service, rounds, etc)
*17. I am not aware of situations in my agency in which a 
coalition, task force, or committee has developed out of 
interdisciplinary efforts.
18. Working with colleagues from other disciplines leads 
to outcomes that we could not achieve alone.
19. Creative outcomes emerge from my work with 
colleagues from other professions that I could not have 
predicted.
20. I am willing to take on tasks outside of my job 
description when that seems important.
*21. I am not willing to sacrifice a degree of autonomy to 
support cooperative problem solving.
22. I utilize formal and informal procedures for problem­
solving with my colleagues from other disciplines.
*23. The professional colleagues from other disciplines 
with whom I work stick rigidly to their job descriptions.
24. Colleagues from other disciplines and I work together 
in many different ways.
25. Professionals from other disciplines with whom I work 
encourage family members’ participation in the 
treatment process.
*26. My colleagues from other disciplines are not 
committed to working together.
27. My colleagues from other disciplines work through 
conflicts with me in efforts to resolve them.
28. When colleagues from different disciplines make 
decisions together they go through a process of 
examining alternatives.
29. My interactions with colleagues from other disciplines 
occurs in a climate where there is freedom to be different 
and to disagree.
30. Clients/patients/students participate in 
interdisciplinary planning that concerns them.
31. Colleagues from all professional disciplines take 
responsibility for developing treatment plans.
*32. Colleagues from all professional disciplines do not 
participate in implementing treatment plans.
33. Professionals from different disciplines are 
straightforward when sharing information with 
clients/patients/students.
34. My colleagues from other disciplines and I often 
discuss different strategies to improve our working 
relationships.

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MRFASTC - Index of Interdisciplinary Collaboration (Follow-up, 3 month)
35. My colleagues from other professions and I talk about 

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ways to involve other professionals in our work together.
*36. Colleagues from other disciplines do not attempt to 
create a positive climate in our organization.
37. I am optimistic about the ability of my colleagues 
from other disciplines to work with me to resolve 
problems.
38. I help my colleagues to address conflict with other 
professionals directly.
39. Colleagues from other disciplines are as likely as I 
am to address obstacles to our successful collaboration.
40. My colleagues from other disciplines and I talk 
together about our professional similarities and 
differences including role, competencies, and 
stereotypes.
*41. My colleagues from other professions and I do not 
evaluate our work together.
42. I discuss with professionals from other disciplines the 
degree to which each of us should be involved in a 
particular case.

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