Multisource feedback in the assessment of physician competencies.
Multisource feedback in the assessment of physician competencies.
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DOI：
10.1002/chp.1340230103
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发表时间：
2003-01-01
期刊：
影响因子：
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通讯作者：
Lockyer, Jocelyn
中科院分区：
文献类型：
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作者：
Lockyer, Jocelyn
多维度反馈（MSF），或360度员工评估，是一种基于绩效的评估方法，由同行、患者和同事对关键绩效行为进行评估。虽然该方法广泛用于工业环境中评估绩效，但作为卫生系统的质量改进方法，该方法正在获得认可。本文介绍了无国界医生组织，确定了无国界医生组织方案设计的关键方面，总结了一些突出的实证研究在医学，并讨论了可能的限制无国界医生组织作为评估工具，在医疗保健。在工业和卫生保健方面，经验表明，无国界医生组织最有可能取得成功，并导致业绩的变化时，注意到方案设计和实施的结构和心理测量方面。一个精心挑选的指导委员会确保所审查的行为是适当的，沟通包是明确的，并将对个人构成的威胁降到最低。必须对开发的工具进行测试，以确保它们是可靠的，达到Ep 2 = .70的概化系数，具有表面和内容有效性，并检查性能评级的方差，以了解评级是否归因于医生的表现，而不是超出医生控制的因素（例如，性别、年龄或环境）。研究表明，可靠的数据可以产生合理数量的受访者，医生将使用反馈来考虑和启动实践中的变化。评估者和被评估者之间的熟悉程度以及社会人口统计学和继续医学教育特征可能会影响评估结果;但是，医生控制之外的因素几乎无法解释评估结果的差异。当需要评估临床结果时，MSF不能替代稽查。然而，当需要评估人际关系、沟通、专业精神或团队合作行为并给予指导时，它是可以采用和实施的更好的工具之一，以提供反馈并指导绩效。
Multisource feedback (MSF), or 360-degree employee evaluation, is a questionnaire-based assessment method in which rates are evaluated by peers, patients, and coworkers on key performance behaviors. Although widely used in industrial settings to assess performance, the method is gaining acceptance as a quality improvement method in health systems. This article describes MSF, identifies the key aspects of MSF program design, summarizes some of the salient empirical research in medicine, and discusses possible limitations for MSF as an assessment tool in health care. In industry and in health care, experience suggests that MSF is most likely to succeed and result in changes in performance when attention is paid to structural and psychometric aspects of program design and implementation. A carefully selected steering committee ensures that the behaviors examined are appropriate, the communication package is clear, and the threats posed to individuals are minimized. The instruments that are developed must be tested to ensure that they are reliable, achieve a generalizability coefficient of Ep2 = .70, have face and content validity, and examine variance in performance ratings to understand whether ratings are attributable to how the physician performs and not to factors beyond the physician's control (e.g., gender, age, or setting). Research shows that reliable data can be generated with a reasonable number of respondents, and physicians will use the feedback to contemplate and initiate changes in practice. Performance may be affected by familiarity between rater and ratee and sociodemographic and continuing medical education characteristics; however, little of the variance in performance is explained by factors outside the physician's control. MSF is not a replacement for audit when clinical outcomes need to be assessed. However, when interpersonal, communication, professionalism, or teamwork behaviors need to be assessed and guidance given, it is one of the better tools that may be adopted and implemented to provide feedback and guide performance.