Table 1.

Modified McMaster-Ottawa scale for rating individual students, with instructions for 3-point scoring, Keck School of Medicine of the University of Southern California, 2014

	Individual rating
Competencies	Below Expected	At Expected	Above Expected
Communication  Assertive communication  Respectful communication  Effective communication	1	2	3
Collaboration  Establishes collaborative relationships  Integration of perspectives  Ensures shared information	1	2	3
Roles and responsibilities  Describes roles and responsibilities  Shares knowledge with others; accepts accountability	1	2	3
Collaborative patient–family centered approach  Seeks input from patient and family  Shares with patients and family  Advocates for patient and family	1	2	3
Conflict management/resolution  Demonstrates active listening  Respectful of different perspectives  Works with others to prevent conflict	1	2	3
Team functioning  Evaluates team function and dynamics  Contributes effectively  Demonstrates shared leadership	1	2	3
Global rating score	1	2	3

Instruction to rater: Observe students during the huddles and patient encounter. Using the 3-point scale, assess each student's demonstration of the six competencies; provide an overall global score based on all the competencies. Please score all behaviors. Do not leave any item blank.

Detailed explanation of performance behaviors for each category:

Communication: Above expected: (The student) expresses opinions in an objective, confident manner; speaks calmly in disagreements; shows deference; listens carefully; asks clarifying questions; responsive to non-verbal clues. At expected: speaks politely; able to comfortably express disagreement and share opinions; does not talk down to others; fully attentive to others’ non-verbal clues. Below expected: expresses opinions in a hostile manner; talks down to others; does not make good eye contact or adopt a listening posture.

Collaboration: Above expected: (The student) incorporates information provided by others; ensures information is disseminated to the entire team. At expected: uses information provided by team members. Below expected: does not use information provided by members.

Roles/responsibilities: Above expected: (The student) shows initiative in describing own role/scope; explicitly asks for and clarifies members’ roles/responsibilities; describes contributions of other professions’ to the team's task; uses evidence-based practice to inform actions; clearly describes the rationale and takes responsibility for own challenging/blameworthy actions. At expected: articulates own role and work when asked; inquires about team members’ roles/responsibilities; shares evidence-based practice; describes actions. Below expected: does not ask for roles/responsibilities of others; does not take ownership of decisions; if challenged, is vague in description of actions.

Collaborative patient-family centered approach: Above expected: (The student) provides patient/family with options for care and reviews including pros/cons; actively summarizes and attempts to incorporate family members’ views in care plans. At expected: listens/solicits family members’ views; provides patient/family with options for care; articulates these needs to the team. Below expected: ignores the family's views/needs, fails to provide options for care.

Conflict management resolution: Above expected: (The student) seeks harmony by listening respectfully to all; acknowledges and processes conflict; initiates resolution, seeks consensus, respects differing opinions; develops common agreement. At expected: listens to team members, asks for feedback, recognizes conflict but does not develop common agreement. Below expected: ignores and interrupts team members, avoids acknowledging conflict.

Team functioning: Above expected: (The student) discusses how the team can be more effective; keeps the climate for team functioning constructive; contributes to discussion; encourages others to contribute; takes a leadership role; allows others to lead when appropriate. At expected: observes team dynamics and determines the climate for the team's functioning; contributes to the discussion. Below expected: does not determine the team climate; fails to contribute to the discussion; states views but does not engage in dialog.

Global rating score: Provide a single rating of the student's performance based on all the ratings above.