Abstract: Background Within highly specialized medical systems, medical social workers often face challenges of role ambiguity, marginalization, and instrumentalization. To date, few studies have systematically examined the effectiveness of medical social workers in multidisciplinary collaboration or clarified the mechanisms through which they overcome these barriers. Objective This study aims to explore how medical social workers play an effective role in multidisciplinary teams,identify the influencing factors and mechanisms underlying their effectiveness, and provide insights and practical implications for professionalized and sustainable interdisciplinary collaboration. Methods Adopting a single-case study design, this research analyzes the representative practice of medical social workers at Hospital E in Shanghai from 2012 to 2025. Grounded in the Input Mediator-Output-Input (IMOI) model, it constructs a theoretical and practical framework for understanding how effectiveness is generated in multidisciplinary cooperation. Results Under policy-driven initiatives, the integration of medical social workers into clinical practice is shaped by multi-level contextual factors, including the macro environment, organizational setting, team structure, and member composition. The interactive tension between passive embedding and active integration continuously reconstructs the professional boundaries and positions of social workers, forming a dynamic foundation for emotional trust, behavioral coordination, and cognitive co-construction within teams. Through positive outputs at the patient, team, and organizational levels, and via cyclical feedback between endogenous motivation and exogenous drivers, multidisciplinary collaboration evolves toward greater safety, professionalism, and efficiency. Conclusion This study develops a localized IMOI-based framework for understanding the generation of effectiveness among medical social workers in multidisciplinary settings. It reveals that team effectiveness emerges as a dynamic and interactive process rather than a static outcome.

Key words: Social work, Medical social work, Effectiveness, Multidisciplinary collaboration, Multidisciplinary clinical Practice, IMOI model

摘要： 背景 在高度专业化的医疗体系中，医务社工面临角色模糊化、边缘化与工具化等困境。当前尚未有研究系统地对医务社工在多学科合作中的有效性进行解析，以及明晰突破合作困局的发展路径。目的 探讨医务社工在多学科合作中如何发挥有效作用，揭示其效能发挥的影响因素和实现机理，为医务社工的专业化合作与可持续发展提供机制路径的思考与实践经验的启示。方法 采用单案例研究法，基于上海市E医院在2012——2025年医务社工参与多学科合作的典型案例，结合IMOI模型提出医务社工在多学科合作效能的生成机制及实践路径。结果 在政策主导推动背景下，医务社工嵌入临床诊疗的实现源于宏观环境、组织环境、团队结构与成员构成的多层次条件的影响，医务社工在“被动嵌入”与“主动融入”之间形成的互动张力，不断重构实践边界与专业位置的动态，为多学科协作中的情感信任、行为协同与认知共建奠定了现实基础。通过患方增益、团队提效与组织拓展的正向输出，经由内源性激发与外源性驱动的再输入促进团队协作优化，持续推动多学科合作向更安全、专业、高效的演进。结论 本研究构建了基于IMOI理论的本土医务社工在多学科合作有效性生成的整体框架，揭示了多学科团队有效性的生成是一个动态互动过程。

关键词: 社会工作, 医务社会工作, 有效性, 多学科合作, 多学科协作诊疗, IMOI 模型