Tool # 1- Key Elements of Collaboration Checklist
Complete this checklist at team meetings during your time at Bruyère Continuing Care.
o Did you see the elements being demonstrated by your peers and other team
colleagues? In the column provided, indicate () if you observed a positive
element, (X) if you observed a negative element or (0) if an element was not
observed. Please comment in the column provided about positive or negative
examples of elements you observed.
o Did you demonstrate the elements yourself? In the column provided, indicate ()
if you practiced the element in a positive way, (X) if you practiced the element in
a negative way and (0) if you did not practice the element.
Date:___________________
Elements of collaboration
1. Cooperation:

Acknowledging & respecting
other opinions & view points

Examining & changing own
beliefs & perspectives willingly
2. Assertiveness:
 Supporting own viewpoint with
confidence
3. Responsibility:
 Accepting & sharing
responsibilities
 Participating in group decisionmaking & planning
4. Communication:
 Sharing important information
effectively
This week I
This week I
observed
did …
() (x) (0)
() (x) (0)
Comments
Date:___________________
Elements of collaboration
This week I
This week I
observed
did …
() (x) (0)
() (x) (0)
Comments
 Exchanging ideas & discussing
things effectively
5. Autonomy:

Performing your professional
responsibilities independently
6. Coordination:
 Organizing group tasks &
assignments efficiently
7. Trust & Respect
 Respecting other’s knowledge
and skills
*Share your observations with at least one other learner or team member
Adapted from Jones & Way (2001), Norsen et al. (2005)
Tool #2 Family Meeting Checklist
The following checklist is a useful tool to monitor collaboration within the family meeting.
If you participate in a family meeting during your time at SCOHS, review the meeting
using this checklist. Check whether or not you observed these skills demonstrated.
Observation
Context: Ensures privacy in a quiet room, no distractions
Ensures everyone is seated with no physical barriers
Ensures relatives sit next to person in care
Demonstrates a relaxed and unhurried approach
Maintains eye contact throughout
Initiating the Meeting: Greets person in care and family
Introduces self and identifies role
Introduces reason for family meeting
Establishes facilitator for meeting
Communication Skills: Time constraints explained at beginning of
meeting
Uses open-ended questions
Listens attentively, allowing members to express concerns
Facilitates responses verbally and non-verbally
Clarifies issues which are ambiguous or awkward
Summarizes periodically
Uses language which is concise, easily understood and jargon-free
Presents information in a clear, simple format
Acknowledgment of Emotions: Identifies emotions experienced
by person in care and family
Identifies cause or source of emotion
Supportive during emotional episodes and avoids defensiveness
and inappropriate closure of issues
Information Exchange, Decision-Making & Care Planning:
Yes
No
Observation
Yes
No
Issues and concerns clearly identified
Aids care planning according to issues and concerns discussed
Plan clearly outlined to family
Assesses family’s response to plan
Ensures team and family agree on plan
Summary: Summarizes main issues and outcomes
Asks if there are other issues to be discussed
Establishes clear contract for next contact and follow-up
Comments:
*Share your observations with at least one other learner or team member
Adapted from S. Dojeiji, P. Hall, E. Keely, University of Ottawa