View
0
Download
0
Category
Preview:
Citation preview
1
Making & Executing Decisionsfor Safe and Independent Living
MED-SAIL
MED-SAIL Scenarios
and
Scoring Guide
Date of Administration:
Respondent ID:
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 1
Table of Contents
MED-SAIL scoring summary.................................................................................................................. 2
General scoring guide.......................................................................................................................... 3
Respondent Instructions and Optional Clinician Script.................................................................... 4
Scenarios ................................................................................................................................................. 5
1. The door to your home is locked and you do not have a key.................................. 5
2. You run out of a medication that you take regularly................................................. 7
3. Imagine you are at home and suddenly there is a fire in your kitchen .................. 9
4. You notice that the cut on your foot is not healing and hasbecome infected................................................................................................................ 11
5. Someone calls you saying you’ve won $100,000 and all they needfrom you is your social security number to verify your identity ............................... 13
6. You are driving to the grocery store and you get a flat tire................................... 15
7. Your heating/air conditioning system breaks down and it is verycold/hot outside ................................................................................................................ 17
Appendix ................................................................................................................................................ 19
Overview of MED-SAIL objective and purpose.................................................................. 20
Instructions for probing............................................................................................................ 21
Domains tested ......................................................................................................................... 22
References ................................................................................................................................. 23
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 2
MED-SAIL Scoring Summary
Check completed scenarios below:
1. The door to your home is locked and you do not have a key
2. You run out of a medication that you take regularly
3. Imagine you are at home and suddenly there is a fire in your kitchen
4. You notice that the cut on your foot is not healing and has become infected
5. Someone calls you saying you’ve won $100,000 and all they need fromyou is your social security number to verify your identity
6. You are driving to the grocery store and get a flat tire
7. Your heating unit (air conditioning system) breaks down and it is very cold(hot outside)
Use the score boxes below to record scores for each scenario
In the star-shaped box, record the overall score:
(total points for all scenarios) / (# of scenarios competed x10)
Scenario 1
Total Score: _____ /10
Scenario 2
Total Score: _____ /10
Scenario 3
Total Score: _____ /10
Overall Score
_________ /_________
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
MED
1. Please tell me in your own words what I just said.This question is not included in overall score
(Yes) Respondent paraphrases statement, repeats statement, or(No) cannot do either.
2. Would this scenario be a problem for you? Why or why no
(2) Patient answers Yes or No, and explains why or why not(1) Patient answers Yes or(0) No answer; illogical answer
3. What would you do in this scenario?
(2) Respondent suggests remedy(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
4. What would you do if [respondent’s answerSolving/Consequential Reasoning
(2) Respondent names at least 1 specific consequence that makes sense.(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the ques
5. So you’ve told me that [respondent’s answer to #3] or that [respondent’s answer to #4].Explain what is good and bad about each of these options.
(2) Respondent names at least 1(1) Respondent’s response may make sense, but is vague; names 1 disadvantage/advantage.(0) Respondent avoids answering the question, even after probing; answer makes no sense
6. A) What could you do to prevent this scenario from happening? OR B) What could you doto prepare for this scenario in case it really happened?Consequences
(2) Respondent names at least 1 specificmakes sense.
(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
Example respondent answers for each scenario are
provided on the page immediately
score sheet.
Probing does not lower the respondent’s score
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
MED-SAIL Scoring Guide
Please tell me in your own words what I just said. UnderstandingThis question is not included in overall score
(Yes) Respondent paraphrases statement, repeats statement, or
Would this scenario be a problem for you? Why or why not? Appreciation
(2) Patient answers Yes or No, and explains why or why notes or No, but has no explanation
(0) No answer; illogical answer
What would you do in this scenario? Expressing a choice
(2) Respondent suggests remedy that makes sense and is specific to respondent’s life.(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
What would you do if [respondent’s answer to question #3] didn’t work?Solving/Consequential Reasoning
(2) Respondent names at least 1 specific consequence that makes sense.(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
So you’ve told me that [respondent’s answer to #3] or that [respondent’s answer to #4].Explain what is good and bad about each of these options. Comparative Reasoning
(2) Respondent names at least 1 disadvantage or advantage to each answer (3 and 4).(1) Respondent’s response may make sense, but is vague; names 1 disadvantage/advantage.(0) Respondent avoids answering the question, even after probing; answer makes no sense
A) What could you do to prevent this scenario from happening? OR B) What could you doto prepare for this scenario in case it really happened? Reasoning
(2) Respondent names at least 1 specific A) preventative or B) preparatory mea
(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
Example respondent answers for each scenario are
immediately following each
score sheet.
Probing does not lower the respondent’s score.
3
Appreciation
that makes sense and is specific to respondent’s life.
(0) Respondent avoids answering the question, even after probing; answer makes no sense
to question #3] didn’t work? Problem
(2) Respondent names at least 1 specific consequence that makes sense.
tion, even after probing; answer makes no sense
So you’ve told me that [respondent’s answer to #3] or that [respondent’s answer to #4].Comparative Reasoning
disadvantage or advantage to each answer (3 and 4).(1) Respondent’s response may make sense, but is vague; names 1 disadvantage/advantage.(0) Respondent avoids answering the question, even after probing; answer makes no sense
A) What could you do to prevent this scenario from happening? OR B) What could you doReasoning – Generate
preparatory measure that
(1) Respondent’s response may make sense, but is vague or incomplete(0) Respondent avoids answering the question, even after probing; answer makes no sense
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 4
Respondent Instructions and Optional Clinician Script
Optional Clinician Scripts
Introductory script:
Questions to determine appropriate scenarios:
1. Do you use a key to get into your home (Scenario #1)
2. Do you drive a car (Scenario #6)
3. Are you able to manage your meals, medications, and phone? (Scenarios #2, 3, 5)
4. Do you take multiple medications on a regular basis? (Scenario #2)
5. Are you diabetic? (Scenarios #2, 4)
Instructions for the Respondent
Select 2-3 of the following scenarios based on what is most appropriate for your respondent:
1. The door to your home is locked and you do not have a key
2. You run out of a medication that you take regularly
3. Imagine you are at home and suddenly there is a fire in your kitchen
4. You notice that the cut on your foot is not healing and has become infected
5. Someone calls you saying you’ve won $100,000 and all they need from you is your socialsecurity number to verify your identity
6. Select scenario if the individual drives – You are driving to the grocery store and you geta flat tire
7. Select scenario depending on whether the individual is more likely to be cold (or hot) –Your heating unit (air conditioning system) breaks down and it is very cold (hot) outside.
Hi, my name is ______, how are you feeling today? I would like to ask you a few questions
about how you do things in your daily life, would that be OK?
I will tell you about a situation. Pretend this is happening to you. Please respond with answersthat are as detailed and specific to you/your life as possible.
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg. 6) for
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would getting locked out of your home be a problem for you? Why or why not?
2
1
0
Further probing: What might happen if you didn’t take any action?
3. What would you do if the door to your home was locked and you didn’t have a key?
2
1
0
Further probing: How might you
4. What would you do if [respondent’s answer to question #3] didn’t work?
2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
2
1
0
Further probing: Is one optionCan you think of one good or bad outcome of each option and compare them?
6. What could you do to prevent yourself from getting locked out of your home?
2
1
0
Further probing: How might this happen in real life?
#1. The door to your home is locked and you do not have a key
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 6) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
Would getting locked out of your home be a problem for you? Why or why not?What might happen if you didn’t take any action?
What would you do if the door to your home was locked and you didn’t have a key?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
What could you do to prevent yourself from getting locked out of your home?How might this happen in real life?
#1. The door to your home is locked and you do not have a key
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
5
example scored respondent answers
Would getting locked out of your home be a problem for you? Why or why not?
What would you do if the door to your home was locked and you didn’t have a key?go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
Can you think of one good or bad outcome of each option and compare them?
What could you do to prevent yourself from getting locked out of your home?
#1. The door to your home is locked and you do not have a key
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) My door is locked and I don’t have a key
(no) I don’t know; (avoids question, incompliant
2. Would getting locked out of your home be a problem for you? Why or why not?
(2)Yes, this would be a problem for me because I wouldNo, it would not be a problem because my daughter lives next door and she could give me a spare key
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if the door to your home was locked and you didn’t have a key?
(2)I would call my daughter who could come and let me in; I would call my neighbor who has a spare key; Iwould go get my spare key that I hid under
(1) I would call my daughter
(0) I don’t know; that would never happen to me; (avoids question, incompliant
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2)I would go to my neighbor’swindow so I could get into my house and then I would call someone to fix my window
(1) I would call a locksmith
(0) I don’t know; that would never happen to me; (avoids question,
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
(2)Going to my neighbor’s house would be easy and quickfree; I might get hurt breaking open a window and it would be expensive to fix, so calling a neighbor orlocksmith would be better
(1) Breaking a window would be bad because it would be expensive to fix
(0) I don’t know; (avoids question, incompliant
6. What could you do to prevent yourself from getting locked out of your home?
(2) I could keep a spare key with my neighbor/daughter and keep their phone number in my wallet/purse
(1) Get a spare key
(0) I don’t know; that would never happen to me; (avoids question, incompliant
#1. The door to your home is locked and you do not have a key
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
My door is locked and I don’t have a key
(avoids question, incompliant – even after probing)
Would getting locked out of your home be a problem for you? Why or why not?
Yes, this would be a problem for me because I would need to get into my houseNo, it would not be a problem because my daughter lives next door and she could give me a spare key
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
What would you do if the door to your home was locked and you didn’t have a key?
I would call my daughter who could come and let me in; I would call my neighbor who has a spare key; Iwould go get my spare key that I hid under the front doormat
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would go to my neighbor’s house and look up a locksmith’s number and call him; I would break open awindow so I could get into my house and then I would call someone to fix my window
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
Going to my neighbor’s house would be easy and quick compared to calling a locksmith, plus it would befree; I might get hurt breaking open a window and it would be expensive to fix, so calling a neighbor or
Breaking a window would be bad because it would be expensive to fix
(avoids question, incompliant – even after probing)
What could you do to prevent yourself from getting locked out of your home?
I could keep a spare key with my neighbor/daughter and keep their phone number in my wallet/purse
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
#1. The door to your home is locked and you do not have a key
6
Would getting locked out of your home be a problem for you? Why or why not?
No, it would not be a problem because my daughter lives next door and she could give me a spare key
– even after probing)
What would you do if the door to your home was locked and you didn’t have a key?
I would call my daughter who could come and let me in; I would call my neighbor who has a spare key; I
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
house and look up a locksmith’s number and call him; I would break open awindow so I could get into my house and then I would call someone to fix my window
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
compared to calling a locksmith, plus it would befree; I might get hurt breaking open a window and it would be expensive to fix, so calling a neighbor or
What could you do to prevent yourself from getting locked out of your home?
I could keep a spare key with my neighbor/daughter and keep their phone number in my wallet/purse
even after probing)
#1. The door to your home is locked and you do not have a key
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would running out of a medication you take regularly
2
1
0
Further probing: What might happen if you didn’t take any action?
3. What would you do if you ran out of a
2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?
2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’sanswer to #4]. Explain what is good and bad about each of these options.
2
1
0
Further probing: Is one optionCan you think of one good or bad outcome of each option and compare them?
6. What could you do to prevent yourself from running out of a medication you take regularly
2
1
0
Further probing: How might this happen in real life?
#2. You run out of a medication that you take regularly
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 8) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
running out of a medication you take regularly be a problem for you? Why or why not?What might happen if you didn’t take any action?
you ran out of a medication that you take regularlyHow might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
[respondent’s answer to question #3] or that [respondent’sanswer to #4]. Explain what is good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
prevent yourself from running out of a medication you take regularlyHow might this happen in real life?
#2. You run out of a medication that you take regularly
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
7
) for example scored respondent answers
be a problem for you? Why or why not?
medication that you take regularly?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
[respondent’s answer to question #3] or that [respondent’sanswer to #4]. Explain what is good and bad about each of these options.
Can you think of one good or bad outcome of each option and compare them?
prevent yourself from running out of a medication you take regularly?
#2. You run out of a medication that you take regularly
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored
1. Please tell me in your own words what I just said
(yes)I’ve run out of my heart medication; I’ve run out of my blue pills that I take every day; I’ve run out of amedication; I’ve run out of a medication that I take regularly
(no) I don’t know; (avoids question, incompliant
2. Would running out of a medication you take regularlywhy not?
(2)Yes, this would be a problem for me because I need my heart medication to keep myself fromheart attack; I need my insulin to keep my blood sugar low so I don’t pass out or get sick
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if you ran out of a medication you take regularly
(2)Call my doctor who would then give me a refill; call in my refill at the pharmacy and go pick it up; ask mydaughter (caregiver) who would refill my medication
(1) I would call my doctor; I would call my daughter
(0) I don’t know; that would never happen to me; (avoids question, incompliant
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2)I would go to urgent care to get another prescription and fill it at a 24daughter and tell her I needed help getting my medicine right away
(1) I would call my doctor; I would call my daughter; I would go get my
(0) I don’t know; that would never happen to me; (avoids question, incompliant
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’sanswer to #4]. Explain what is good and bad about each of
(2)Going to urgent care would be bad because it would require a long wait compared to having my doctor callin a refill which would be faster; having my daughter take care of it would be the fastest and easiest way forme to take care of things
(1) I would wait a long time at urgent care
(0) I don’t know; (avoids question, incompliant
6. What could you do to prevent yourself fromregularly?
(2)I could keep track of when my pillsnotice my pills are almost gone; I could ask my daughter (caregiver) to keep track of my medication
(1) I could keep track of my pills; I could talk to my doctor
(0) I don’t know; that would never happen to me; (avoids question, incompliant
#2. You run out of a medication that you take regularly
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just saidI’ve run out of my heart medication; I’ve run out of my blue pills that I take every day; I’ve run out of amedication; I’ve run out of a medication that I take regularly
(avoids question, incompliant – even after probing)
running out of a medication you take regularly be a problem for you? Why or
Yes, this would be a problem for me because I need my heart medication to keep myself fromheart attack; I need my insulin to keep my blood sugar low so I don’t pass out or get sick
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
do if you ran out of a medication you take regularly
Call my doctor who would then give me a refill; call in my refill at the pharmacy and go pick it up; ask mydaughter (caregiver) who would refill my medication
I would call my daughter; I would go get my medication
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would go to urgent care to get another prescription and fill it at a 24-hour pharmacy; I would call mydaughter and tell her I needed help getting my medicine right away
I would call my doctor; I would call my daughter; I would go get my medication
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’sanswer to #4]. Explain what is good and bad about each of these options.
Going to urgent care would be bad because it would require a long wait compared to having my doctor callin a refill which would be faster; having my daughter take care of it would be the fastest and easiest way for
I would wait a long time at urgent care
(avoids question, incompliant – even after probing)
What could you do to prevent yourself from running out of a medication you take
I could keep track of when my pills will run out so I’ll know when to get a refill; I could call my doctor when Inotice my pills are almost gone; I could ask my daughter (caregiver) to keep track of my medication
I could keep track of my pills; I could talk to my doctor
know; that would never happen to me; (avoids question, incompliant – even after probing)
#2. You run out of a medication that you take regularly
8
I’ve run out of my heart medication; I’ve run out of my blue pills that I take every day; I’ve run out of a
be a problem for you? Why or
Yes, this would be a problem for me because I need my heart medication to keep myself from having aheart attack; I need my insulin to keep my blood sugar low so I don’t pass out or get sick
– even after probing)
do if you ran out of a medication you take regularly?
Call my doctor who would then give me a refill; call in my refill at the pharmacy and go pick it up; ask my
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
hour pharmacy; I would call my
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’sthese options.
Going to urgent care would be bad because it would require a long wait compared to having my doctor callin a refill which would be faster; having my daughter take care of it would be the fastest and easiest way for
running out of a medication you take
will run out so I’ll know when to get a refill; I could call my doctor when Inotice my pills are almost gone; I could ask my daughter (caregiver) to keep track of my medication
even after probing)
#2. You run out of a medication that you take regularly
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would being at home with a fire in your kitchen
2
1
0
Further probing: What might happen if you didn’t take any action?
3. What would you do if you were at home and
2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?
2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
2
1
0
Further probing: Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
6. What could you do to prepare yourself in case a fire really did start in your kitchen
2
1
0
Further probing: How might this happen in real life?
#3. Imagine you are at home and suddenly there is a fire in your kitchen
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 10) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
being at home with a fire in your kitchen be a problem for you? Why or why not?What might happen if you didn’t take any action?
you were at home and there was a fire in your kitchenHow might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
prepare yourself in case a fire really did start in your kitchenHow might this happen in real life?
Imagine you are at home and suddenly there is a fire in your kitchen
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
9
) for example scored respondent answers
be a problem for you? Why or why not?
there was a fire in your kitchen?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
Can you think of one good or bad outcome of each option and compare them?
prepare yourself in case a fire really did start in your kitchen?
Imagine you are at home and suddenly there is a fire in your kitchen
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) I’m at home and suddenly there’s a fire in my kitchen
(no) I don’t know; (avoids question, incompliant
2. Would being at home with a fire in your kitchen
(2)Yes, this would be a problem for mehome
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if you
(2) I would throw water on the fire and try to put it out; I would get out of the house and call 911
(1) Throw water; put it out; yell for help
(0) I don’t know; that would never happen to me;
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2) I would leave my house immediately and get help from a neighbor; I would leave and call 911
(1) I would call 911
(0) I don’t know; that would never happen to me; (avoids question, incompliant
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
(2)If I just left without trying to put out the fire, my home would probably be destroyed because the fire wouldspread
(1) I would try to put it out so the fire wouldn’t spread
(0) I don’t know; (avoids question, incompliant
6. What could you do to prepare yourself in case a fire really did start in your kitchen
(2) I could keep a fire extinguisher in my house and put 911 on speed dial
(1) Avoid cooking
(0) I don’t know; that would never happen to me; (avoids question,
#3. Imagine you are at home and suddenly there is a fire in your kitchen
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
at home and suddenly there’s a fire in my kitchen
(avoids question, incompliant – even after probing)
being at home with a fire in your kitchen be a problem for you? Why or why not?
Yes, this would be a problem for me because the fire could spread and I could die; the fire could destroy my
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
you were at home and suddenly there was a fire in your kitchen
I would throw water on the fire and try to put it out; I would get out of the house and call 911
Throw water; put it out; yell for help
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would leave my house immediately and get help from a neighbor; I would leave and call 911
know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
just left without trying to put out the fire, my home would probably be destroyed because the fire would
I would try to put it out so the fire wouldn’t spread
(avoids question, incompliant – even after probing)
prepare yourself in case a fire really did start in your kitchen
fire extinguisher in my house and put 911 on speed dial
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
. Imagine you are at home and suddenly there is a fire in your kitchen
10
be a problem for you? Why or why not?
because the fire could spread and I could die; the fire could destroy my
– even after probing)
were at home and suddenly there was a fire in your kitchen?
I would throw water on the fire and try to put it out; I would get out of the house and call 911
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would leave my house immediately and get help from a neighbor; I would leave and call 911
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
just left without trying to put out the fire, my home would probably be destroyed because the fire would
prepare yourself in case a fire really did start in your kitchen?
even after probing)
. Imagine you are at home and suddenly there is a fire in your kitchen
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would having an infected cut on your footor why not?
2
1
0
Further probing: What might
3. What would you do if there was an infected cut on your foot that wasn’t healing
2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?
2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
2
1
0
Further probing: Is one option better than the other? Why?Can you think of
6. What could you do to prevent yourself from getting2
1
0
Further probing: How might this happen in real life?
#4. You notice that the cut on your foot is not healing and has become
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 12) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
having an infected cut on your foot that isn’t healing be a problem for you? Why
What might happen if you didn’t take any action?
there was an infected cut on your foot that wasn’t healingHow might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answeris good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
What could you do to prevent yourself from getting cuts on your footHow might this happen in real life?
#4. You notice that the cut on your foot is not healing and has becomeinfected
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
11
) for example scored respondent answers
be a problem for you? Why
there was an infected cut on your foot that wasn’t healing?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
one good or bad outcome of each option and compare them?
cuts on your foot?
#4. You notice that the cut on your foot is not healing and has become
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) I cut my foot, it isn’t healing, and it has become infected
(no) I don’t know; (avoids question, incompliant
2. Would having an infected cut on your foot that isn’t healingor why not?
(2) Yes this would be a problem because if my foot got infected, I could get very sick, lose my foot, or even die
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if there was an infected cut on your foot that wasn’t healing
(2)I would make an appointment with my doctor so he could help the cut get better; I would call my daughterwho would take me to the doctor
(1) I would call my daughter (caregiver)
(0) I don’t know; that would never happen to me; (avoids question, incompliant
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2) I could look up a number for urgent care and get my daughter to
(1) Go to urgent care
(0) I don’t know; that would never happen to me; (avoids question, incompliant
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
(2)My regular doctor would know me and my history, so that would be better than a random doctor in urgentcare, plus I wouldn’t have to wait as long. The bad thing about seeing my regular doctor is that I wouldprobably have to wait a day or two to get an appointment.
(1)Calling my doctor would be better because he knows me; going to urgent care would be better because Icould go the same day
(0) I don’t know; (avoids question, incompliant
6. What could you do to prevent yourself
(2)I could wear socks and shoes or slippers; I could check myself daily for cuts and put medicine on the cuts Ido have
(1) I could take care of my cuts
(0) I don’t know; that would never happen to me; (avoids question, incompliant
#4. You notice that the cut on your foot is not healing and has become
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
cut my foot, it isn’t healing, and it has become infected
(avoids question, incompliant – even after probing)
having an infected cut on your foot that isn’t healing be a problem for you? Why
problem because if my foot got infected, I could get very sick, lose my foot, or even die
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
if there was an infected cut on your foot that wasn’t healing
I would make an appointment with my doctor so he could help the cut get better; I would call my daughterwho would take me to the doctor
(caregiver)
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I could look up a number for urgent care and get my daughter to take me there
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answergood and bad about each of these options.
My regular doctor would know me and my history, so that would be better than a random doctor in urgentcare, plus I wouldn’t have to wait as long. The bad thing about seeing my regular doctor is that I wouldprobably have to wait a day or two to get an appointment.
Calling my doctor would be better because he knows me; going to urgent care would be better because I
(avoids question, incompliant – even after probing)
What could you do to prevent yourself from getting cuts on your footI could wear socks and shoes or slippers; I could check myself daily for cuts and put medicine on the cuts I
that would never happen to me; (avoids question, incompliant – even after probing)
#4. You notice that the cut on your foot is not healing and has becomeinfected
12
be a problem for you? Why
problem because if my foot got infected, I could get very sick, lose my foot, or even die
– even after probing)
if there was an infected cut on your foot that wasn’t healing?
I would make an appointment with my doctor so he could help the cut get better; I would call my daughter
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
My regular doctor would know me and my history, so that would be better than a random doctor in urgentcare, plus I wouldn’t have to wait as long. The bad thing about seeing my regular doctor is that I would
Calling my doctor would be better because he knows me; going to urgent care would be better because I
from getting cuts on your foot?I could wear socks and shoes or slippers; I could check myself daily for cuts and put medicine on the cuts I
even after probing)
#4. You notice that the cut on your foot is not healing and has become
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would someone asking for your socialproblem for you? Why or why not?2
1
0
Further probing: What might
3. What would you do if someone called saying they needed your social security number foryou to claim prize money2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.2
1
0
Further probing: Is one option better than the other? Why?Can you think of
6. What could you do to prevent2
1
0
Further probing: How might this happen in real life?
#5. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 14) for example scored respondent answers
your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
someone asking for your social security number for you to claim prize moneyproblem for you? Why or why not?
What might happen if you didn’t take any action?
if someone called saying they needed your social security number foryou to claim prize money?
How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answeris good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
What could you do to prevent yourself from getting calls like this in the futureHow might this happen in real life?
. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
13
) for example scored respondent answers
security number for you to claim prize money be a
if someone called saying they needed your social security number for
How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
one good or bad outcome of each option and compare them?
yourself from getting calls like this in the future?
. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) I received a phone call from someone saying I’ve won $100,000 and they want my social security
(no) I don’t know; (avoids question, incompliant
2. Would someone asking for your social security number for you to claim prize moneyproblem for you? Why or why not?
(2) Yes, this would be a problem because it means that a scammer got my phone number
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if someone called saying they needed your social security number foryou to claim prize money
(2) I wouldn’t talk to them because it’s probably a scam
(1) Hang up the phone (without any additional rationale or justification)
(0) I don’t know; that would never happen to me; (avoids question, incompliant
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2)I would write down the number and I would get caller ID so when they called, I wouldn’t answer; try to get aname or information so I could report them to someone
(1) Hang up again (without any rationale or justification)
(0) I don’t know; that would never happen to me;
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
(2)It’s easier to just hang up, and I don’tfind out that information, which could take a while
(1) Hanging up the phone would be easiest
(0) I don’t know; (avoids question, incompliant
6. What could you do to prevent yourself from getting
(2)I could put my name on the “do not call” list; I could be careful about who I give my phone number to; Icould get caller ID and screen my phone calls
(1) Not talk to them
(0) I don’t know; that would never happen to me; (avoids question, incompliant
#5. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
I received a phone call from someone saying I’ve won $100,000 and they want my social security
(avoids question, incompliant – even after probing)
someone asking for your social security number for you to claim prize money? Why or why not?
Yes, this would be a problem because it means that a scammer got my phone number
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
someone called saying they needed your social security number foryou to claim prize money?
I wouldn’t talk to them because it’s probably a scam
(without any additional rationale or justification)
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
number and I would get caller ID so when they called, I wouldn’t answer; try to get aname or information so I could report them to someone
(without any rationale or justification)
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
It’s easier to just hang up, and I don’t know how to put someone on the “do not call” list, so I would have tofind out that information, which could take a while
Hanging up the phone would be easiest
(avoids question, incompliant – even after probing)
What could you do to prevent yourself from getting calls like this in the futureput my name on the “do not call” list; I could be careful about who I give my phone number to; I
could get caller ID and screen my phone calls
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
14
I received a phone call from someone saying I’ve won $100,000 and they want my social security number
someone asking for your social security number for you to claim prize money be a
Yes, this would be a problem because it means that a scammer got my phone number
– even after probing)
someone called saying they needed your social security number for
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
number and I would get caller ID so when they called, I wouldn’t answer; try to get a
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
know how to put someone on the “do not call” list, so I would have to
calls like this in the future?put my name on the “do not call” list; I could be careful about who I give my phone number to; I
even after probing)
. Someone calls you saying you've won $100,000 and all they needfrom you is your social security number to verify your identity
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would getting a flat tire on the way to the grocery storewhy not?
2
1
0
Further probing: What might happen if you didn’t take any action?
3. What would you do if you got a flat tire2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.2
1
0
Further probing: Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
6. What could you do to prepare yourself in case you did get a flat tire on the way to thegrocery store?2
1
0
Further probing: How might this happen in real life?
#6. You are driving to the grocery store and you get a flat tire
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 16) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
getting a flat tire on the way to the grocery store be a problem for you? Why or
What might happen if you didn’t take any action?
you got a flat tire on the way to the grocery storeHow might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
prepare yourself in case you did get a flat tire on the way to the
How might this happen in real life?
#6. You are driving to the grocery store and you get a flat tire
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
15
respondent answers
be a problem for you? Why or
on the way to the grocery store?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
Can you think of one good or bad outcome of each option and compare them?
prepare yourself in case you did get a flat tire on the way to the
#6. You are driving to the grocery store and you get a flat tire
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) I’m driving to the grocery store and I get a flat tire
(no) I don’t know; (avoids question, incompliant
2. Would getting a flat tire on the way to the grocery store be a problem for youwhy not?
(2)Yes this would be a problem for me because I would be stranded for a while, then I would have to find a wayto fix my tire or get a new one
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do if you got a flat tire on the way to the grocery store
(2) I would call my daughter to come pick me up; I would call AAA so someone could come help me
(1) I would call for help
(0) I don’t know; that would never
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2)I would try to walk somewhere to find help or I would call 411 to see if someone could help me; I wouldchange my flat tire
(1) I would call 911
(0) I don’t know; that would never happen to me; (avoids question, incompliant
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good
(2)I might get hurt changing my flat tire or I might not be able to do it, so calling someone to come help mewould be better; calling someone could take a long time, so I would try to fix the tire first
(1) Calling someone would be easier
(0) I don’t know; (avoids question, incompliant
6. What could you do to prepare yourself in case you did get a flat tire in the future?
(2)I could take the bus so I wouldn’t have to worry about my tires; Iwould need to fix a flat in my car; I could keep a cell phone with AAA’s number in my car so I could call themif I had a flat
(1) I could drive more carefully; I could keep a spare tire
(0) I don’t know; that would never happen to me; (avoids question, incompliant
#6. You are driving to the grocery store and you get a flat tire
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
I’m driving to the grocery store and I get a flat tire
(avoids question, incompliant – even after probing)
a flat tire on the way to the grocery store be a problem for you
problem for me because I would be stranded for a while, then I would have to find a wayto fix my tire or get a new one
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
you got a flat tire on the way to the grocery store
I would call my daughter to come pick me up; I would call AAA so someone could come help me
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would try to walk somewhere to find help or I would call 411 to see if someone could help me; I would
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
I might get hurt changing my flat tire or I might not be able to do it, so calling someone to come help mewould be better; calling someone could take a long time, so I would try to fix the tire first
someone would be easier
(avoids question, incompliant – even after probing)
prepare yourself in case you did get a flat tire in the future?I could take the bus so I wouldn’t have to worry about my tires; I could put a spare tire and all the tools Iwould need to fix a flat in my car; I could keep a cell phone with AAA’s number in my car so I could call them
I could drive more carefully; I could keep a spare tire
would never happen to me; (avoids question, incompliant – even after probing)
#6. You are driving to the grocery store and you get a flat tire
16
a flat tire on the way to the grocery store be a problem for you? Why or
problem for me because I would be stranded for a while, then I would have to find a way
– even after probing)
you got a flat tire on the way to the grocery store?
I would call my daughter to come pick me up; I would call AAA so someone could come help me
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?
I would try to walk somewhere to find help or I would call 411 to see if someone could help me; I would
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
I might get hurt changing my flat tire or I might not be able to do it, so calling someone to come help mewould be better; calling someone could take a long time, so I would try to fix the tire first
prepare yourself in case you did get a flat tire in the future?could put a spare tire and all the tools I
would need to fix a flat in my car; I could keep a cell phone with AAA’s number in my car so I could call them
even after probing)
#6. You are driving to the grocery store and you get a flat tire
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Please see other side of this sheet (pg.
1. Please tell me in your own words what I just said
YesNo
Understands; can repeatCannot repeat statement; does not understand
2. Would having your heater (AC) break downfor you? Why or why not?
2
1
0
Further probing: What might
3. What would you do if your heater (AC) broke down and it was very cold (hot) outside
2
1
0
Further probing: How might you go about doing that? What are the steps you might take?
4. What would you do if [respondent’s answer to question #3] didn’t work?
2
1
0
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
2
1
0
Further probing: Is one option better than the other? Why?Can you think of
6. What could you do to prepare yourself in case your heater (AC) unit did break down2
1
0
Further probing: How might this happen in real life?
#7. Your heating unit (air conditioning system) breaks down and it is very
Total Score
______ / 10
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Please see other side of this sheet (pg. 18) for example scored respondent answers
Please tell me in your own words what I just said
Understands; can repeatCannot repeat statement; does not understand
having your heater (AC) break down during very cold (hot) weatherfor you? Why or why not?
What might happen if you didn’t take any action?
your heater (AC) broke down and it was very cold (hot) outsideHow might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answeris good and bad about each of these options.
Is one option better than the other? Why?Can you think of one good or bad outcome of each option and compare them?
prepare yourself in case your heater (AC) unit did break downHow might this happen in real life?
#7. Your heating unit (air conditioning system) breaks down and it is verycold (hot) outside
Total Score
______ / 10
Scoring System
•Complete and logical2
•Logical, but incomplete1
•No answer, incomplete, illogical0
17
) for example scored respondent answers
during very cold (hot) weather be a problem
your heater (AC) broke down and it was very cold (hot) outside?How might you go about doing that? What are the steps you might take?
What would you do if [respondent’s answer to question #3] didn’t work?
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
one good or bad outcome of each option and compare them?
prepare yourself in case your heater (AC) unit did break down?
#7. Your heating unit (air conditioning system) breaks down and it is very
Scoring System
Complete and logical
Logical, but incomplete
No answer, incomplete, illogical
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Example Scored Respondent Answers
1. Please tell me in your own words what I just said
(yes) My heater (air conditioner) is broken and it’s cold (hot) outside
(no) I don’t know; (avoids question, incompliant
2. Would having your heater (AC) break down during very cold (hot) weatherfor you? Why or why not?
(2)Yes, this would be a problem because I could get really cold (hot) and get sick or freeze to death (have aheat stroke)
(1) Yes/No, this would/wouldn’t be a problem
(0) No, I don’t know; that would never happen to me; (avoids question, incompliant
3. What would you do your heater (AC) broke down and it was very cold (hot) outside
(2) I would call a repair man to come and fix it; I would call my daughter for help
(1) I would call my someone
(0) I don’t know; that would never happen
4. What would you do if [respondent’s answer to question #3] didn’t work?
(2)I would call a different repair man and then see if I could stay at my daughter’s house until it was fixed; Iwould put blankets over the windows and wear lots of clothes (cold); I would turn on a fan and dress in lightclothing (hot)
(1) I would call another repair man
(0) I don’t know; that would never happen to me; (avoids question, incompliant
5. So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
(2)Getting it fixed would be better than using blankets (fans) because it would be a longproblem; asking my daughter to fix it would be the best thing because it would be faster and free comparedto calling a repair man
(1) I would call my daughter because she could get it done
(0) I don’t know; (avoids question, incompliant
6. What could you do to prepare yourself in case your heater (AC) unit did break down
(2) I could get a space heater (fan) and blankets to be prepared if it ever happened
(1) Find a way to stay warm (cool)
(0) I don’t know; that would never
#7. Your heating unit (air conditioning system) breaks down and it is very
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
Example Scored Respondent Answers
Please tell me in your own words what I just said
My heater (air conditioner) is broken and it’s cold (hot) outside
(avoids question, incompliant – even after probing)
having your heater (AC) break down during very cold (hot) weatherfor you? Why or why not?
Yes, this would be a problem because I could get really cold (hot) and get sick or freeze to death (have a
Yes/No, this would/wouldn’t be a problem
No, I don’t know; that would never happen to me; (avoids question, incompliant –
your heater (AC) broke down and it was very cold (hot) outside
I would call a repair man to come and fix it; I would call my daughter for help
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?I would call a different repair man and then see if I could stay at my daughter’s house until it was fixed; I
blankets over the windows and wear lots of clothes (cold); I would turn on a fan and dress in light
I would call another repair man
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answerto #4]. Explain what is good and bad about each of these options.
Getting it fixed would be better than using blankets (fans) because it would be a longproblem; asking my daughter to fix it would be the best thing because it would be faster and free compared
I would call my daughter because she could get it done
(avoids question, incompliant – even after probing)
prepare yourself in case your heater (AC) unit did break down
I could get a space heater (fan) and blankets to be prepared if it ever happened
Find a way to stay warm (cool)
I don’t know; that would never happen to me; (avoids question, incompliant – even after probing)
#7. Your heating unit (air conditioning system) breaks down and it is verycold (hot) outside
18
having your heater (AC) break down during very cold (hot) weather be a problem
Yes, this would be a problem because I could get really cold (hot) and get sick or freeze to death (have a
– even after probing)
your heater (AC) broke down and it was very cold (hot) outside?
even after probing)
What would you do if [respondent’s answer to question #3] didn’t work?I would call a different repair man and then see if I could stay at my daughter’s house until it was fixed; I
blankets over the windows and wear lots of clothes (cold); I would turn on a fan and dress in light
even after probing)
So you’ve told me that [respondent’s answer to question #3] or that [respondent’s answer
Getting it fixed would be better than using blankets (fans) because it would be a long-term fix to theproblem; asking my daughter to fix it would be the best thing because it would be faster and free compared
prepare yourself in case your heater (AC) unit did break down?
even after probing)
#7. Your heating unit (air conditioning system) breaks down and it is very
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 19
Appendix
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
1. MED-SAIL is used to evaluate decisionthese pertain to situations arising
MED-SAIL offers information that other assessments do not
Most assessments measure cognitive functioning in strict domains
o Short-term memory
o Spatial orientation
MED-SAIL evaluates multiple domains within the context of realo Decision-making capacity
o Problem solving
o Judgment
MED-SAIL provides practical information for clinical tasks
o Identifying specific safety problems in respondent’s life
o Writing guardianship letters
2. Respondents do not lose points for “bad” answers that
Evaluation of capacity to make and modify decisions
Appropriate respondent answers are not necessarily knowledge
Example:o Clinician question: “What would you do if you ran out of medication?”o Respondent answer: “Take my h
o Respondent further explanation: “I always do this with little side effects” or “it’s the exact
same medication, so it doesn’t matter”
o These are appropriate responses because decision
It is within a respondent’s righ
3. MED-SAIL is not a diagnostic tool, but rather a screening tool designed to be used with other
assessments
The purpose of MED-SAIL is to learn about the respondent’s thought processo Further diagnostic
o MED-SAIL is not meant to be used as a tool to diagnose mental health problems, such as
dementia or schizophrenia
MED-SAIL may identify gaps in specific domains of safety
o More assessment is neededo Use MED-SAIL with other assessments to provide more thorough understanding of
respondent’s ability to live safely and independently
MED-SAIL is NOT meant to be used in isolation to determine a respondent’s status or
Objective: Screen for and identify impairments in a respondent’s ability to make andexecute decisions concerning safe and independent living using everyday scenarios
research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
MED-SAIL Overview
SAIL is used to evaluate decision-making capacity, problem solving, and judgment asthese pertain to situations arising in everyday living
SAIL offers information that other assessments do not
Most assessments measure cognitive functioning in strict domains
term memory
Spatial orientation
SAIL evaluates multiple domains within the context of real-life situatiomaking capacity
SAIL provides practical information for clinical tasks
Identifying specific safety problems in respondent’s life
Writing guardianship letters
Respondents do not lose points for “bad” answers that are appropriately explained
Evaluation of capacity to make and modify decisions
Appropriate respondent answers are not necessarily knowledge-based
Clinician question: “What would you do if you ran out of medication?”Respondent answer: “Take my husband’s pills”
Respondent further explanation: “I always do this with little side effects” or “it’s the exact
same medication, so it doesn’t matter”
These are appropriate responses because decision-making ability is intact
It is within a respondent’s rights to make decisions with which you do not agree
SAIL is not a diagnostic tool, but rather a screening tool designed to be used with other
SAIL is to learn about the respondent’s thought processFurther diagnostic evaluation needed for those having trouble making decisions
SAIL is not meant to be used as a tool to diagnose mental health problems, such as
dementia or schizophrenia
SAIL may identify gaps in specific domains of safety
More assessment is needed to determine a proper intervention planSAIL with other assessments to provide more thorough understanding of
respondent’s ability to live safely and independently
SAIL is NOT meant to be used in isolation to determine a respondent’s status or
Screen for and identify impairments in a respondent’s ability to make andexecute decisions concerning safe and independent living using everyday scenarios
20
making capacity, problem solving, and judgment as
life situations
are appropriately explained
Clinician question: “What would you do if you ran out of medication?”
Respondent further explanation: “I always do this with little side effects” or “it’s the exact
making ability is intact
ts to make decisions with which you do not agree
SAIL is not a diagnostic tool, but rather a screening tool designed to be used with other
SAIL is to learn about the respondent’s thought processevaluation needed for those having trouble making decisions
SAIL is not meant to be used as a tool to diagnose mental health problems, such as
to determine a proper intervention planSAIL with other assessments to provide more thorough understanding of
SAIL is NOT meant to be used in isolation to determine a respondent’s status or capacity level
Screen for and identify impairments in a respondent’s ability to make andexecute decisions concerning safe and independent living using everyday scenarios
MED-SAIL was developed by a research team at Baylor College of Medicine (PI
Why Probe?Most assessments have directions that must be followed precisely, which means the administrator cannot
offer further help or clarification to the respondent. MED
be encouraged to give the most complete answ
record the respondent’s thought process. See specific instructions below.
Probing Instructions for the MED
If the respondent gives a vague answer without specific details:o Continue probing (see example phrases below) to encourage further elaboration
Ask another question
Rephrase the same question
o Avoid asking questions that would lead the respondent to a particular answer or to a“yes” or “no” response
If the respondent still does not
o Continue further probing in the same mannero Probing and providing more details to your questions in encouragedo Continue until it is clear that the respondent’s answer will not change significantly
If you find yourself having to probe
score
Probing ExamplesHelpful probes can be found on all scoring sheets below the questions asked for each scenario.
You may think of more probing phrases not found here. Keepin mind that you should encourage the respondent to think
through his/her answer and further elaborate; you should notprobe in any way that "leads" the respondent
Tell me more about that
Can you explain a little more?
SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD)
MED-SAIL Probing
Most assessments have directions that must be followed precisely, which means the administrator cannot
offer further help or clarification to the respondent. MED-SAIL is different. The MED
be encouraged to give the most complete answers possible so the administrator can understand and
record the respondent’s thought process. See specific instructions below.
Probing Instructions for the MED-SAIL Administrator:
If the respondent gives a vague answer without specific details:robing (see example phrases below) to encourage further elaboration
Ask another question
Rephrase the same question
Avoid asking questions that would lead the respondent to a particular answer or to a“yes” or “no” response
If the respondent still does not answer appropriately:
Continue further probing in the same mannerProbing and providing more details to your questions in encouragedContinue until it is clear that the respondent’s answer will not change significantly
If you find yourself having to probe for better responses, this should not lower the respondent’s
Helpful probes can be found on all scoring sheets below the questions asked for each scenario.
You may think of more probing phrases not found here. Keepin mind that you should encourage the respondent to think
through his/her answer and further elaborate; you should notprobe in any way that "leads" the respondent
Tell me more about that Would that be a negative
or a positive thing?
Can you explain a little more?
Can you be more specific?
21
Most assessments have directions that must be followed precisely, which means the administrator cannot
SAIL is different. The MED-SAIL respondent must
ers possible so the administrator can understand and
robing (see example phrases below) to encourage further elaboration
Avoid asking questions that would lead the respondent to a particular answer or to a
Probing and providing more details to your questions in encouragedContinue until it is clear that the respondent’s answer will not change significantly
for better responses, this should not lower the respondent’s
Helpful probes can be found on all scoring sheets below the questions asked for each scenario.
You may think of more probing phrases not found here. Keepin mind that you should encourage the respondent to think
through his/her answer and further elaborate; you should notprobe in any way that "leads" the respondent
Would that be a negative
or a positive thing?
Can you be more specific?
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 22
Domains Tested by MED-SAIL Questions
Understanding1. Please tell me in your own words
what I just saidThis question assesses whether a respondent can understand andrepeat a simple phrase back to you1, 2
Appreciation
2. Would this scenario be aproblem for you? Why or whynot?
This question is modeled on: 1) being open to the idea thattreatment may have benefits1 and 2) the ability to infer possiblebenefits of treatment.2
For MED-SAIL, this conceptual framework translates asunderstanding these scenarios are usually negative situations inwhich to find oneself.
Expressing a Choice
3. What would you do in thisscenario?
This question is viewed as “expressing a choice”. The literature onconsent to medical treatment1, 2 indicates that once a respondentthinks through possible options and how he or she feels about each,the doctor should ask the respondent to articulate a choice thatdescribes an action (i.e., “I will take medication A because it has theleast amount of side effects”).
With this question, you can screen for respondents who eithercannot articulate their choices/plans or express choices that mayindicate they have some impairment in decision making
Problem Solving / Consequential Reasoning
4. What would you do if(respondent’s answer to question#3) didn’t work?
This question is meant to push the respondent further and see ifhe/she can perform abstract problem solving in a new situation.The respondent may have given “rehearsed” answers to typicalquestions asked by the doctor.
This question is meant to get past those “rehearsed” answers byplacing the respondent in a new hypothetical situation
Comparative Reasoning5. So you’ve told me that
(respondent’s answer to question#3) and (respondent’s answer toquestion #4). Explain what isgood and bad about bothoptions.
This request is designed to test the respondent’s ability to comparetwo options by listing potential advantages and disadvantages ofeach answer.1
Reasoning – Generate Consequences
6. (a) What could you do to preventthis scenario from happening? or(b) What could you do toprepare for this scenario in caseit really happened?
Depending on the scenario, the administrator will find eitherquestion (a) or (b) listed. Some scenarios are situations that maynot be easy to prevent because they are accidents (i.e., a firestarting in your kitchen).
With these scenarios, it is more appropriate to ask how therespondent would prepare for the possibility of a particularaccident (i.e., he/she could buy a fire extinguisher and keep it in ahandy spot in the kitchen).
This question is meant to prompt the respondent to generate ideason how to prevent the scenario from happening or how to preparefor the scenario in case it does.
MED-SAIL was developed by a research team at Baylor College of Medicine (PI - Aanand D. Naik, MD) 23
References
1. Appelbaum PS. Assessment of patients’ competence to consent to treatment. N Engl J Med.
2007;357(18):1834-18402. Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists (2008).
American Bar Association Commission on Law and Aging – American Psychology
Association.
Recommended