Multisource feedback: a method of assessing surgical practice

Abstract

New methods are needed for assessing surgeons' performance across a wide range of competencies. Violato and colleagues describe the development of a programme based on feedback from medical colleagues, coworkers, and patients for the assessment of surgeons throughout Alberta, CanadaThe assessment and maintenance of competence of physicians has received worldwide attention, 1-4 partly in response to concerns about poor performance by physicians and the safety of patients 5 6 and partly as a result of demands for accountability to patients and funding agencies. 2-4New approaches to quality improvement have resulted, as have initiatives focusing on identifying and assessing poor performance. [7][8][9] Throughout the Western world, thinking about competence has shifted. Medical expertise and clinical decision making are increasingly recognised as only components of competence. Communication skills, interpersonal skills, collegiality, professionalism, and a demonstrated ability to continuously improve must also be considered when assessing physicians.2-4 7 8 10 11Multisource feedback, using questionnaire data from patients, medical colleagues, and coworkers, is gaining acceptance and credibility as a means of providing primary care physicians with quality improvement data as part of an overall strategy of maintaining competence and certification.1 7 8 Work with Canadian, American, and Scottish generalist physicians shows that this method is reliable, valid, and feasible.7 8 12-15 Research in both industry and medicine shows that multisource feedback systems (or 360°f eedback) can result in individual improvement and the adoption of new practices.12 [16][17][18] The College of Physicians and Surgeons of Alberta, the statutory medical registration body for the province of Alberta, adopted a performance appraisal or multisource feedback system for all physicians in its jurisdiction-the physician achievement review program. This system focuses on quality improvement and operates entirely separately from the complaints and disciplinary procedures. Medical colleagues, coworkers (for example, nurses, pharmacists, and psychologists), patients, and the physician (self) all provide survey based data, which are summarised by item and category and compared with the physician's specialty group. The instruments for family physicians were psychometrically tested and adopted.7 8 19 As part of its overall goal of ensuring that all physicians in the province participate in a multisource feedback process every five years, the college asked a committee of surgeons and social scientists to design and test instruments that could be used for the surgical specialties. This paper describes the development and evaluation of a multisource feedback system for surgeons designed to assess a broad range of competencies.

Incorporating multi-source feedback into a new clinically based revision course for the FRCS(Plast) exam

“…Use of such feedback is important for reflective practice and development and has been shown to initiate change in a group of surgeons (Violato et al 2003). Uniquely, this course used scores from peers and senior medical staff as well as nurses and patients to provide the candidate with detailed feedback.…”

Achtergronden bij de Richtlijn multisource feedback voor de aios

“…[8][9][10][11][12][13] In deze verantwoording wordt ingegaan op de belangrijkste aspecten van MSF en worden de in de Richtlijn gegeven adviezen, mede aan de hand van relevante literatuur, toegelicht.…”

Using a structured clinical coaching program to improve clinical skills training and assessment, as well as teachers’ and students’ satisfaction

“…A case study is an exploration of a ''bounded system'', i.e. bounded by time and place and is designed to adduce the details of a study from the viewpoint of all participants (Cresswell 1998;Violato et al 2003).…”