Search

Few studies have engaged in data-driven investigations of the presence, or frequency, of what could be considered retaliatory assessor behaviour in Multi-source Feedback (MSF) systems. In this study, authors explored how assessors scored others if, before assessing others, they received their own assessment score. The authors examined assessments from an established MSF system in which all clinical team members - medical students, interns, residents, fellows, and supervisors - anonymously assessed each other. The authors identified assessments in which an assessor (i.e., any team member providing a score to another) gave an aberrant score to another individual. An aberrant score was defined as one that was more than two standard deviations from the assessment receiver's average score. Assessors who gave aberrant scores were categorized according to whether their behaviour was preceded by: (1) receiving a score or not from another individual in the MSF system (2) whether the score they received was aberrant or not. The authors used a multivariable logistic regression model to investigate the association between the type of score received and the type of score given by that same individual. In total, 367 unique assessors provided 6091 scores on the performance of 484 unique individuals. Aberrant scores were identified in 250 forms (4.1%). The chances of giving an aberrant score were 2.3 times higher for those who had received a score, compared to those who had not (odds ratio 2.30, 95% CI:1.54–3.44, P < 0.001). Individuals who had received an aberrant score were also 2.17 times more likely to give an aberrant score to others compared to those who had received a non-aberrant score (2.17, 95% CI:1.39–3.39, P < 0.005) after adjusting for all other variables. This study documents an association between receiving scores within an anonymous multi-source feedback (MSF) system and providing aberrant scores to team members. These findings suggest care must be given to designing MSF systems to protect against potential downstream consequences of providing and receiving anonymous feedback. [ABSTRACT FROM AUTHOR]

Introduction: The Accreditation Council for Graduate Medical Education (ACGME) specifically notes multisource feedback (MSF) as a recommended means of resident assessment in the emergency medicine (EM) Milestones. High-fidelity simulation is an environment wherein residents can receive MSF from various types of healthcare professionals. Previously, the Queen’s Simulation Assessment Tool (QSAT) has been validated for faculty to assess residents in five categories: assessment; diagnostic actions; therapeutic actions; interpersonal communication, and overall assessment. We sought to determine whether the QSAT could be used to provide MSF using a standardized simulation case.Methods: Prospectively after institutional review board approval, residents from a dual ACGME/osteopathic-approved postgraduate years (PGY) 1-4 EM residency were consented for participation. We developed a standardized resuscitation after overdose case with specific 1-5 Likert anchors used by the QSAT. A PGY 2-4 resident participated in the role of team leader, who completed a QSAT as self-assessment. The team consisted of a PGY-1 peer, an emergency medical services (EMS) provider, and a nurse. Two core faculty were present to administer the simulation case and assess. Demographics were gathered from all participants completing QSATs. We analyzed QSATs by each category and on cumulative score. Hypothesis testing was performed using intraclass correlation coefficients (ICC), with 95% confidence intervals. Interpretation of ICC results was based on previously published definitions.Results: We enrolled 34 team leader residents along with 34 nurses. A single PGY-1, a single EMS provider and two faculty were also enrolled. Faculty provided higher cumulative QSAT scores than the other sources of MSF. QSAT scores did not increase with team leader PGY level. ICC for inter-rater reliability for all sources of MSF was 0.754 (0.572-0.867). Removing the self-evaluation scores increased inter-rater reliability to 0.838 (0.733-0.910). There was lesser agreement between faculty and nurse evaluations than from the EMS or peer evaluation.Conclusion: In this single-site cohort using an internally developed simulation case, the QSAT provided MSF with excellent reliability. Self-assessment decreases the reliability of the MSF, and our data suggest self-assessment should not be a component of MSF. Use of the QSAT for MSF may be considered as a source of data for clinical competency committees.

Abstract Background In medical students’ workplace learning, feedback is important for effective learning regarding communication and clinical skills. The provision of multisource feedback (MSF) in clinical practice with focus on the patient’s perspective is rarely addressed in the literature. The overall objective was to explore the experience of MSF in medical students’ clinical learning in primary healthcare (PHC). Methods In the study, patients provided feedback by use of the Patient Feedback in Clinical Practice (PFCP) questionnaire. By use of adapted PFCP questionnaire versions peers and clinical supervisors provided feedback and students performed a self-evaluation. The MSF learning activity was evaluated using surveys (4-point Likert scale/open-ended questions), (students (n = 26), peers (n = 9) and clinical supervisors (n = 7)). Data were analysed using descriptive and qualitative content analysis. Results Results (mean 4-point Likert scale) from participants evaluation of the MSF learning activity visualises the value of feedback in terms of patient-centred communication (students 3.50, peers 2.44 and clinical supervisors 3.57), guidance for further training (students 3.14, peers 2.89 and clinical supervisors 3.00) and clarification of pedagogical assignment (students 3.14, peers 2.89 and clinical supervisors 3.00). Thematic analysis of participants’ free-text answers in the evaluation surveys resulted in three themes: (1) applicability of the MSF, (2) MSF – collaborative learning process and (3) MSF as a facilitator in students’ clinical skills development. The participants experienced that the written MSF provided multi-facetted perspectives, which contributed to students’ and peers’ clinical and communication learning. MSF experience also enhanced clinical supervisors’ feedback regarding communication skills, targeting the supervisors’ pedagogical assignment. Conclusion Our findings indicate that MSF provided directly after a patient encounter, using the PFCP questionnaire as feedback provider, could be an adequate learning activity for medical students’ workplace learning. The MSF, provided through the PFCP questionnaire, was experienced to neutralise and operationalise the provision of concrete feedback, facilitating peers’ learning and clinical supervisors’ tuition. The results visualise the importance of patients in MSF, as a valuable resource in students’ workplace learning. Our study implies that this learning activity could be an applicable tool to facilitate learning and pedagogic development in clinical education in PHC.

Background: In medical students' workplace learning, feedback is important for effective learning regarding communication and clinical skills. The provision of multisource feedback (MSF) in clinical practice with focus on the patient's perspective is rarely addressed in the literature. The overall objective was to explore the experience of MSF in medical students' clinical learning in primary healthcare (PHC). Methods: In the study, patients provided feedback by use of the Patient Feedback in Clinical Practice (PFCP) questionnaire. By use of adapted PFCP questionnaire versions peers and clinical supervisors provided feedback and students performed a self-evaluation. The MSF learning activity was evaluated using surveys (4-point Likert scale/open-ended questions), (students (n = 26), peers (n = 9) and clinical supervisors (n = 7)). Data were analysed using descriptive and qualitative content analysis. Results: Results (mean 4-point Likert scale) from participants evaluation of the MSF learning activity visualises the value of feedback in terms of patient-centred communication (students 3.50, peers 2.44 and clinical supervisors 3.57), guidance for further training (students 3.14, peers 2.89 and clinical supervisors 3.00) and clarification of pedagogical assignment (students 3.14, peers 2.89 and clinical supervisors 3.00). Thematic analysis of participants' free-text answers in the evaluation surveys resulted in three themes: (1) applicability of the MSF, (2) MSF – collaborative learning process and (3) MSF as a facilitator in students' clinical skills development. The participants experienced that the written MSF provided multi-facetted perspectives, which contributed to students' and peers' clinical and communication learning. MSF experience also enhanced clinical supervisors' feedback regarding communication skills, targeting the supervisors' pedagogical assignment. Conclusion: Our findings indicate that MSF provided directly after a patient encounter, using the PFCP questionnaire as feedback provider, could be an adequate learning activity for medical students' workplace learning. The MSF, provided through the PFCP questionnaire, was experienced to neutralise and operationalise the provision of concrete feedback, facilitating peers' learning and clinical supervisors' tuition. The results visualise the importance of patients in MSF, as a valuable resource in students' workplace learning. Our study implies that this learning activity could be an applicable tool to facilitate learning and pedagogic development in clinical education in PHC. [ABSTRACT FROM AUTHOR]

Purpose Occupational integration is vital for the health of all people, also for people with Limited Work Capacity (LWC). Therefore, participation in regular work is a legal right for people that are restricted in their work capacity due to a disability and/or lack sufficient education. Full and effective integration is dependent on the person-job fit, and adequate vocational support should focus on meeting performance standards, as is common practice in traditional personnel selection and development programmes. Despite the huge amount of valid instruments for personnel selection and development, these tests are not suitable people with LWC. Recently, an instrument was developed for assessment and development purposes specifically for this target group. That study provided evidence for reliability and dimensionality this instrument. In our study, we add criterion-related measures to this instrument to demonstrate that assessment at T1 predict performance at T2, thus validating the instrument. Method We conducted a four-source data study, two sources for independent and two for outcome variables, to test the predictive validity of this instrument in a multi-wave setup. Results This study largely supports the validity of the instrument in predicting work behaviour and task performance of people with LWC. More specific, when measures are tailored to this target group, this group is able to predict their work behaviour and task performance accurately just like the general population. Conclusion We conclude that this instrument contributes to science, vocational support practices, and the personal and professional development of people with LWC, which is required for sustainable work. [ABSTRACT FROM AUTHOR]

Researchers and practitioners in multi-source feedback (MSF) context generally use the average-based methods to aggregate ratings. Because of the uncertainties in the raters' opinions, it is believed that the use of conventional averaging methods is not appropriate for aggregating MSF data. So, in MSF approach, there is a need to design a proper aggregation method that is capable to cope with the uncertainty in ratings. In this regard, in this paper, each rating group has been considered as a source of evidence, and a new aggregation model based on evidence theory has been proposed. In the proposed model, the collected data from each rating group by designing three different methods have been converted to the basic belief assignments and then aggregated using the Dempster rule of combination. In order to resolve the conflict between evidences, the discounting and compromise methods were used, and the output of the combination process was extracted using three different methods including the pignistic probability criterion, the plausibility transformation method and the expected value method. Finally, through a simulation study, the performance of the proposed model under various configurations was investigated. The results of the simulation study show that the proposed model, in almost all configurations, provides more accurate results than traditional aggregation method in MSF approach. [ABSTRACT FROM AUTHOR]

Many engineering faculty have limited skills and/or assessment tools to evaluate team dynamics in multidisciplinary team-based capstone courses. Rapidly deployable tools are needed here to provide proactive feedback to teams to facilitate deeper learning. Two surveys were developed based on industrial and organizational psychology theories around desired high performance industry characteristics. A case study experiment was conducted in an architectural engineering capstone. Here, these surveys were deployed in conjunction with traditional qualitative verbal feedback and technical assessments. Results presented here suggest that capstone teams exhibit high-functioning attributes of effective teams based on the course formulation. Team dynamics evolved as the course progressed naturally and with the help of faculty based on the survey results. Discussions in this paper detail survey development, implementation, and sampled trends to represent how to use and interpret the survey output. Furthermore, best practices for implementing these ideas in other courses is touched on. Evidence is presented to support the surveys as a tool and to show correlations between the results and other technical assignments. [ABSTRACT FROM AUTHOR]

Background: Since 1994, Taiwanese medical universities have employed the multiple application method comprising "recommendations and screening" and "admission application." The purpose of this study is to examine whether medical students admitted using different admission programs gave different performances. Methods: To evaluate the six core competencies for medical students proposed by Accreditation Council for Graduate Medical Education (ACGME), this study employed various assessment tools, including student opinion feedback, multi-source feedback (MSF), course grades, and examination results.MSF contains self-assessment scale, peer assessment scale, nursing staff assessment scale, visiting staff assessment scale, and chief resident assessment scale. In the subscales, the CronbachÊs alpha were higher than 0.90, indicating good reliability. Research participants consisted of 182 students from the School of Medicine at Chang Gung University. Results: Regarding studentsÊ average grade for the medical ethics course, the performance of students who were enrolled through school recommendations exceeded that of students who were enrolled through the National College University Entrance Examination (NCUEE) p = 0.011), and all considered "teamwork" as the most important. Different entry pipelines of students in the "communication," "work attitude," "medical knowledge," and "teamwork" assessment scales showed no significant difference. The improvement rate of the students who were enrolled through the school recommendations was better than that of the students who were enrolled through the N CUEE in the "professional skills," "medical core competencies," "communication," and "teamwork" projects of self-assessment and peer assessment scales. However, the students who were enrolled through the NCUEE were better in the "professional skills," "medical core competencies," "communication," and "teamwork" projects of the visiting staff assessment scale and the chief resident assessment scale. Conclusion: Collectively, the performance of the students enrolled through recommendations was slightly better than that of the students enrolled through the NCUEE, although statistical significance was found in certain parts of the grades only.

Background: The Physician Quality Improvement Initiative (PQII) uses a well-established multi-source feedback program, and incorporates an additional facilitated feedback review with their department chief. The purpose of this mixed methods study was to examine the value of the PQII by eliciting feedback from various stakeholders. Methods: All participants and department chiefs (n = 45) were invited to provide feedback on the project implementation and outcomes via survey and/or an interview. The survey consisted of 12 questions focused on the value of the PQII, it's influence on practice and the promotion of quality improvement and accountability. Results: A total of 5 chiefs and 12 physician participants completed semi structured interviews. Participants found the PQII process, report and review session helpful, self-affirming or an opportunity for self-reflection, and an opportunity to engage their leaders about their practice. Chiefs indicated the sessions strengthened their understanding, ability to communicate and engage physicians about their practice, best practices, quality improvement and accountability. Thirty participants (66.7 %) completed the survey; of the responders 75.9, 89.7, 86.7 % found patient, co-worker, and physician colleague feedback valuable, respectively. A total of 67.9 % valued their facilitated review with their chief and 55.2 % indicated they were contemplating change due to their feedback. Participants believed the PQII promoted quality improvement (27/30, 90.0 %), and accountability (28/30, 93.3 %). Conclusions: The PQII provides an opportunity for physician development, affirmation and reflection, but also a structure to further departmental quality improvement, best practices, and finally, an opportunity to enhance communication, accountability and relationships between the organization, department chiefs and their staff. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this research was to investigate the use of multi-source feedback in assessing the effectiveness of a strength-based coaching methodology in enhancing elements of the full range leadership model. It also investigated the effects of self-other rater alignment on leadership outcomes after coaching. Design: A between-subject non-equivalent control group design was used to explore the impact of strengthbased coaching on transformational leadership behaviours measured in a 360-degree feedback process. Thirty-one executives and senior managers from a large not-for-profit organisation were non-randomly assigned to either a coaching or waitlist cohort. Methods: The coaching cohort received six sessions of leadership coaching involving feedback on leadership and strengths, goal setting and strengths development. After six sessions of coaching over three months, cohorts then switched roles. Results: The results showed that participants experienced statistically significant increases in their transformational leadership behaviour after coaching and this difference was perceived differentially at all levels within the organisation but not by the participants themselves. Raters at higher levels in the organisation were the most sensitive to change. The results also showed that self-other rater alignment was a significant factor in self-ratings of change over time with those participants who initially over-rated themselves, reducing their ratings over time as a consequence. Conclusion: The results suggest that changes in coachee transformational leadership behaviour after leadership coaching are perceived differentially by rater level within an organisation and that self-other rater alignment is an important moderator of self-ratings over time. [ABSTRACT FROM AUTHOR]

Background: Medical professionalism helps physicians adopt a proper and good healing action for the patients based on their particular circumstance. This study was conducted to assess professionalism in surgical residents, using a 360-degree evaluation technique in several teaching hospitals in Tehran, Iran. Methods: This study was conducted on all the second and third year surgery residents from three university teaching hospitals in Tehran. Multi-source feedback questionnaire contained 10 questions on the residents' professional behavior and was completed by the faculty and staff members (nurses, operation room staff, and medical assistants) as well as other surgery residents, interns and patients to evaluate each resident. Response rates were used to determine feasibility for each of the respondent groups and the mean and standard deviation score for each question was computed to determine the viability of the items. Reliability was assessed using alpha Cronbach coefficient for each respondent group. The correlation between these scores and the residents' final and OSCE grade was also assessed. Results: The internal consistency reliability for 360-degree rating was 0.889. There was no significant difference in the residents' score in different hospitals. While male residents obtained higher total score, there was no significant difference between them. The residents, however, obtained lower scores compared to the staff. The highest score was recorded for question 6, suggesting that the residents treated the patients regardless of their socioeconomic status. Conclusion: This study revealed a strong agreement between the results gathered from different respondents, confirming the reliability of the questionnaire and the respondents' unbiased response. It also revealed that the residents did well in the whole test, showing they were conscientious and learning to become medical professionals. [ABSTRACT FROM AUTHOR]

Background: Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods: Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results: Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings - practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion: This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. [ABSTRACT FROM AUTHOR]

The acquisition of advanced skills and knowledge in leadership and management is cited as key to delivering a vision for quality care services. Managers need concrete tools for promoting their own learning within organisational cultures for self-managed learning to thrive. We report on the application of a tailor-made multi-source feedback tool to promote the advancement of management skills on a post-qualifying award for social work managers. This particular tool was based on English national leadership and management standards and its 10 ‘key principles’. Managers were required to analyse and reflect on their current level of skill using line-management, peer, supervisee, staff and service user appraisal. They then developed a work-based learning and development plan, supported by mentoring and supervision. How we actually measure skill and associated knowledge and values is an under-researched area. Determining the ideal structure for defining and measuring outcomes of skill development highlights the complexities involved. Data from the managers' own evaluations are used to debate the value of using skill definitions flexible enough to enable individual use and interpretation but not so general as to be meaningless. The discussion suggests that use of a multi-source assessment tool and the process were found to be useful on a number of dimensions. [ABSTRACT FROM PUBLISHER]

BackgroundAlthough multi-source feedback (MSF) has been used in primary healthcare, the development of an MSF instrument specific to this setting in the UK has not been previously described. The aims of this study were to develop and evaluate an MSF instrument for GPs in Scotland taking part in appraisal.Methods The members of ten primary healthcare teams in the west of Scotland were asked to provide comments in answer to the question, 'What is a good GP?'. The data were reduced and coded by two researchers and questions were devised. Following content validity testing the MSF process was evaluated with volunteers using face-to-face interviews and a postal survey.ResultsThirty-seven statements covering the six domains of communication skills, professional values, clinical care, working with colleagues, personality issues and duties and responsibilities were accepted as relevant by ten primary healthcare teams using a standard of 80 percent agreement. The evaluation found the MSF process to be feasible and acceptable and participants rovided some evidence of educational mpact.Conclusion An MSF instrument for GPs has been developed based on the concept of 'the good GP' as described by the primary healthcare team. The evaluation of the resultant MSF process illustrates the potential of MSF, when delivered in the supportive environment of GP appraisal, to provide feedback which has the possibility of improving working relationships between GPs and their colleagues. [ABSTRACT FROM AUTHOR]

Feedback from colleagues and patients is a core element of the revalidation process being developed by the General Medical Council. However, there are few feedback tools which have been specifically developed and validated for doctors in primary care. This paper presents data demonstrating the reliability and validity of one such tool. The CFEP360 tool combines feedback from the Colleague Feedback Evaluation Tool (CFET) and the Doctor's Interpersonal Skills Questionnaire (DISQ). The analysis of over 10 000 completed questionnaires presented here identifies that colleague feedback is essentially two-dimensional (i.e. clinical and non-clinical skills) and that patient feedback is one-dimensional. However, items from both scales also effectively predict combined global ratings, indicating that colleagues and patients are identifying similar levels of performance as accessed by the feedback. Doctors who receive low feedback scores may require further attention, meaning the feedback potentially has diagnostic value. Reliable feedback on this tool, as indicated by this analysis, requires 14 colleague responses and 25 patient responses, figures comparable to other MSF tools if CFEP360 is to be used for a high stakes performance evaluation and possible revalidation (generalisability statistic G⩾0.80). For lower stakes performance evaluations, such as personal development, responses from 11 colleagues and 16 patients will still return reliable results (G⩾0.70). [ABSTRACT FROM AUTHOR]

The article presents a study which examines the effectiveness of a multi-source feedback (MSF) as an educational tool in primary care and general practice. The study conducted a five-group preliminary research composed of practice managers, trainees, and doctors who were involved in the MSF delivery. The results show that MSF method has the potential to help in learning primary care. It also says that the College of General Practitioners (RCGP) has proposed the acceptance of the MSF process.

The ability to competently manage employee performance is critical for students graduating with degrees in management. This article provides a competency development exercise (CDE) for use in graduate and undergraduate management courses to increase students’ performance management competence. The CDE includes providing employee feedback, disciplining employees, and conducting termination meetings. Procedures and assessment tools are provided for utilizing the exercise in conjunction with video technology and multisource feedback. In addition, guidance is given for adapting and condensing the CDE from 3-6 hr to 30-60 min. Finally, data are presented showing that the exercise significantly affected students’ performance management competence. [ABSTRACT FROM AUTHOR]

Problem statement and background Feedback is essential to learning and practice improvement, yet challenging both to provide and receive. The purpose of this paper was to explore reflective processes which physicians described as they considered their assessment feedback and the perceived utility of that reflective process. Methods This is a qualitative study using principles of grounded theory. We conducted interviews with 28 family physicians participating in a multi-source feedback program and receiving scores across the spectrum from high to low. Results Feedback, especially negative feedback, evoked reflective responses. Reflection seemed to be the process through which feedback was or was not assimilated and appeared integral to decisions to accept and use the feedback. Facilitated reflection upon feedback was viewed as a positive influence for assimilation and acceptance. Conclusions Receiving feedback inconsistent with self-perceptions stimulated physicians’ reflective processes. The process of reflection appeared instrumental to feedback acceptance and use, suggesting that reflection may be an important educational focus in the formative assessment and feedback process. [ABSTRACT FROM AUTHOR]

To investigate the reliability and feasibility of six potential workplace-based assessment methods in general practice training: criterion audit, multi-source feedback from clinical and non-clinical colleagues, patient feedback (the CARE Measure), referral letters, significant event analysis, and video analysis of consultations. Performance of GP registrars (trainees) was evaluated with each tool to assess the reliabilities of the tools and feasibility, given raters and number of assessments needed. Participant experience of process determined by questionnaire. 171 GP registrars and their trainers, drawn from nine deaneries (representing all four countries in the UK), participated. The ability of each tool to differentiate between doctors (reliability) was assessed using generalisability theory. Decision studies were then conducted to determine the number of observations required to achieve an acceptably high reliability for “high-stakes assessment” using each instrument. Finally, descriptive statistics were used to summarise participants’ ratings of their experience using these tools. Multi-source feedback from colleagues and patient feedback on consultations emerged as the two methods most likely to offer a reliable and feasible opinion of workplace performance. Reliability co-efficients of 0.8 were attainable with 41 CARE Measure patient questionnaires and six clinical and/or five non-clinical colleagues per doctor when assessed on two occasions. For the other four methods tested, 10 or more assessors were required per doctor in order to achieve a reliable assessment, making the feasibility of their use in high-stakes assessment extremely low. Participant feedback did not raise any major concerns regarding the acceptability, feasibility, or educational impact of the tools. The combination of patient and colleague views of doctors’ performance, coupled with reliable competence measures, may offer a suitable evidence-base on which to monitor progress and completion of doctors’ training in general practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Letters / Edebiyat Fakultesi Dergisi is the property of Hacettepe University Faculty of Letters and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Receiving negative performance feedback can elicit negative emotional reactions which can interfere with feedback acceptance and use. This study investigated emotional responses of family physicians’ participating in a multi-source feedback (MSF) program, sources of these emotions, and their influence upon feedback acceptance and use. The authors interviewed 28 volunteer family physician participants in a pilot study of MSF, purposefully recruited to represent the range of scores. The study was conducted in 2003–2004 at Dalhousie University. Participants’ emotional reactions to feedback appeared to be elicited in response to an internal comparison of their feedback with self-perceptions of performance. Those agreeing with their feedback; i.e., perceiving it as generally consistent with or higher than self-perceptions responded positively, while those disagreeing with their feedback; i.e., seeing it as generally inconsistent with or lower than self-perceptions, generally responded with distress. For the latter group, these feelings were often strong and long-lasting. Some eventually accepted their feedback and used it for change following a long period of reflection. Others did not and described an equally long reflective period but one which focused on and questioned MSF procedures rather than addressed feedback use. Participants suggested providing facilitated reflection on feedback to enhance assimilation of troubling emotions and interpretation and use of feedback. Negative feedback can evoke negative feelings and interfere with its acceptance. To overcome this, helpful interventions may include raising awareness of the influence of emotions, assisting recipients to focus their feedback on performance tasks, and providing facilitated reflection on feedback. [ABSTRACT FROM AUTHOR]

The article discusses the growth and utilization of multi-source feedback (MSF) in medicine. It states the objective of MSF is to collect information from a variety of sources. It says that the approach could be used to address behavior, attitudes and communication skills. According to the author, MSF is a powerful tool that can be perceived as intimidating and has to be introduced with tact and support.

There is still very little understanding of what exactly is being measured when peer review is undertaken and how it should be measured for different target groups. The aim of this study is to determine the basis on which raters distinguish between two sets of colleagues: GPs and consultants. From March to July 2005 a study was run to test a newly created peer assessment tool for doctors in primary and secondary care settings. A total of 33 doctors took part — 14 GPs and 19 hospital consultants. Each of the participants was asked to identify 15 colleagues as appraisers to complete the colleague feedback evaluation tool questionnaire. Factor analysis demonstrates that colleagues have rated all doctors along the four dimensions of effective communication, clinical competence, time- management and trust. After separating GP colleague responses from consultant colleague responses, the application of cluster analysis clearly demonstrates that overall ability as a GP is strongly linked to effective communication with colleagues, whereas for consultants overall ability is based mainly on clinical competence alone. The implications of these findings for the development of future peer evaluation tools are discussed. [ABSTRACT FROM AUTHOR]

Team assessment of behaviour (TAB) is the multi-source feedback assessment of professional behaviours that all UK foundation doctors must engage in twice during their twoyear programme. TAB can identify the few underperforming trainees and provide feedback to consolidate the good practice of most. For optimum validity, TAB must be undertaken by a range of assessors, as specifi ed in the national UK Foundation Programme curriculum. This study reports an audit of invalid TAB submissions over a three-year cycle in the West Midlands' Foundation Programme. In 2010, large numbers of TABs were invalid, owing to an incorrect selection or number of assessors. Introduction of validity checking before sign-off greatly improved the numbers of valid assessments in 2011. This was partially sustained in 2012. Assurance of assessment validity is important to ensure delivery of appropriate constructive feedback and to allow early detection and remediation of signs of poor professional behaviours in foundation doctors. [ABSTRACT FROM AUTHOR]

Introduction Multi-source feedback (MSF) is an evaluation method mandated by the Accreditation Council for Graduate Medical Education (ACGME). The Queen's Simulation Assessment Tool (QSAT) has been validated as being able to distinguish between resident performances in a simulation setting. The QSAT has also been demonstrated to have excellent MSF agreement when used in an adult simulation performed in a simulation lab. Using the QSAT, this study sought to determine the degree of agreement of MSF in a single pediatric (Peds) simulation case conducted in situ in a Peds emergency department (ED). Methods This Institutional Review Board-approved study was conducted in a four-year emergency medicine residency. A Peds resuscitation case was developed with specific behavioral anchors on the QSAT, which uses a 1-5 scale in each of five categories: Primary Assessment, Diagnostic Actions, Therapeutic Actions, Communication, and Overall Assessment. Data was gathered from six participants for each simulation. The lead resident self-evaluated and received MSF from a junior peer resident, a fixed Peds ED nurse, a random ED nurse, and two faculty (one fixed, the other from a dyad). The agreement was calculated with intraclass correlation coefficients (ICC). Results The simulation was performed on 35 separate days over two academic years. A total of 106 MSF participants were enrolled. Enrollees included three faculty members, 35 team leaders, 34 peers, 33 ED registered nurses (RN), and one Peds RN; 50% of the enrollees were female (n=53). Mean QSAT scores ranged from 20.7 to 23.4. A fair agreement was demonstrated via ICC; there was no statistically significant difference between sources of MSF. Removing self-evaluation led to the highest ICC. ICC for any single or grouped non-faculty source of MSF was poor. Conclusion Using the QSAT, the findings from this single-site cohort suggest that faculty must be included in MSF. Self-evaluation appears to be of limited value in MSF with the QSAT. The degree of MSF agreement as gathered by the QSAT was lower in this cohort than previously reported for adult simulation cases performed in the simulation lab. This may be due to either the pediatric nature of the case, the location of the simulation, or both., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Nguyen et al.)

The article offers the author's insights regarding the value of confrontation in per review which general practitioners (GP) must learn in their general practice. The author discusses six dimensions of peer orientation which include valuing, confronting, and meaning and planning. He mentions the need of every GP to have a mentor and an appraiser to aid in the peer feedback.

Objective: Resident physicians must develop competence in interpersonal and communication skills, but workplace-based assessment of these skills remains challenging. We explored the feasibility of the Resident Communication Assessment Program (ReCAP) for eliciting patient feedback about resident physician communication in the emergency department (ED)., Methods: This study is a prospective, observational study conducted in the ED of a university-based hospital from December 2018 through April 2019. ReCAP is a program that interviews patients prior to discharge from the ED using the Communication Assessment Tool (CAT). CAT consists of 14 Likert style questions and 3 open-ended questions for patient feedback about residents' communication. Open-text, narrative responses from patients were coded using a modified version of the Completed Clinical Evaluation Report Rating tool., Results: We collected data from 42 subjects who completed the CAT, and provided 32 open-text, narrative responses about 20 resident physicians. Patient responses were overwhelmingly positive with 551/588 (94%) CAT responses scoring "Very Good," the highest category. Open-text, narrative comments analyzed using CCERR were unbalanced, favoring residents' strengths rather than areas for improvement. Patient comments offered more examples of strengths than weaknesses, and few subjects provided recommendations to improve resident performance., Conclusion: ReCAP represents a feasible method for eliciting patient feedback about resident communication skills in the ED. The CAT can be used to structure brief patient interviews by trained staff but generally elicits only positive feedback. Further studies are needed to identify more discriminatory assessment tools., Competing Interests: The authors declare no conflicts of interest., (© 2020 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)