Assessment for Collaborative Environments (ACE-15)

National Center for Interprofessional Practice and Education's picture
Submitted by National Center... on Sep 28, 2016 - 12:03pm CDT

Tilden, V.P.
Eckstrom, E.
Dieckmann, N.F.

The ACE-15 was designed to help faculty and administrators conduct a rapid assessment of the quality of interprofessional teamwork in clinical sites.  Results can be used as a guide for placing learners (students, residents) in positive teaching environments in which interprofessional collaboration is being modeled.  This 15-item, self-report survey is appropriate for a broad array of health professionals working in a variety of clinical sites. A validity study including 192 healthcare professionals from 17 clinical professions demonstrated good factor structure and internal reliability. ACE-15 scores significantly related to a separate measure of team cohesion. 

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Descriptive Elements
Who is Being Assessed or Evaluated?: 
Instrument Type: 
Self-report (e.g., survey, questionnaire, self-rating)
Source of Data: 
Health care providers, staff
Notes for Data Sources: 

Members of fairly stable clinical teams working in a variety of clinical training sites (e.g., inpatient, outpatient, urban, rural).  Predominant professionals in the sample were physicians (17%), nurse practitioners (16%), dentists (12%) resident physicians (12%), and nurses (8%).  The broad sample also included smaller percentages of dental assistants and hygienists, pharmacists, occupational and physical therapy, social work, psychologists, dieticians and office staff.

Instrument Content: 
Reported perceptions, experiences of working relationships, teamwork
Notes for Content: 

The tool measures a single factor of clinical teamwork, or “teamness”. The tool is based on the qualities identified in Core Principles & Values of Effective Team-Based Health Care:

  1. Shared goals
  2. Clear roles
  3. Mutual trust
  4. Effective communication
  5. Measurable processes and outcomes
  6. Organizational support
Instrument Length: 

15 items; under 5 minutes

Item Format: 
4-point likert-type scale ranging from strongly disagree (1) to strongly agree (4). Three of the 15 items are reverse scored.
Paper surveys or electronic secure, web-based system (i.e., LimeSurvey).
Item scores are summed to create a total score for each member; these member scores are then averaged to form a team score.
None described.
Subscription (can be viewed in journal article)
Notes on Access: 

Items can be viewed in the journal article, but contact the author to confirm permission to use.

Psychometric Elements: Evidence of Validity
Items developed from Institute of Medicine’s decade of quality chasm report and Interprofessional Education Collaborative Expert Panel report. Items reviews by eight IPE, collaborative practice, or measurement science experts from the US, the UK, and Canada. All experts felt the items strongly linked to the literature.
Response Process: 
The original survey of 30 items was completed and reviewed by a sample of clinicians. Sixteen items were eliminated due to low score variance, signaling lack of discrimination, possible confusion or redundancy among respondents. One double-barreled item was split into two separate items, creating the final version of 15 items.
Internal Structure: 
Factor analysis of 15 items supported a single factor with 45% of variance explained. Factor loadings for 14 of the 15 items ranged from 0.58 - 0.76. Cronbach’s alpha reliability was high (alpha = 0.91).
Relation to Other Variables: 
The ACE-15 total scores significantly related to scores from a separate measure of team cohesion: r = 0.81 p < 0.001. This measure consisted of 4, globally-oriented items proposed by Graetz, et al. (2014).
None described.