The effect of measurement conditions on the psychometric properties of selfassessment was investigated in a selection context. Two experimental studies are reported which investigated the effect of format and instructions on leniency and halo. In Study 1 it was hypothesized that questionnaires based on overall descriptions of competencies and asking for examples of past behaviour would display less leniency and halo than when raters did not provide such evidence, or when the competency was broken down into its behavioural elements. The effect of social comparison instructions (SCI) was also explored. Participants were 738 candidates who applied to join a public sector organization. Contrary to predictions, it was found that questionnaires based on 'behavioural elements' displayed less leniency. Furthermore, an interaction between format and instructions was found; questionnaires based on behavioural elements/no SCI showed less leniency than 'competencies/no SCI' and 'competencies/evidence/SCI'. No signi cant ndings were obtained for halo. Study 2 used a subset of 224 candidates from Study 1 who attended the next stage of the selection process. It was hypothesized that unbalanced, positively toned scales would show less leniency and halo than conventional scales, as would instructions requesting a realistic self-assessment of the individuals' strengths and weaknesses. The rst hypothesis was supported. A trend towards lower leniency was observed for 'honesty' instructions, which failed to reach signi cance. Gender differences were observed such that males were signicantly less lenient when dimensional questionnaires were employed (Study 1), and unbalanced questionnaires and instructions pertaining to realism (Study 2). Females' self-assessment displayed less leniency and halo when unbalanced questionnaires were employed. Findings are discussed in terms of implications for practice.Self-assessment (SA) is a complex process that has been studied in a somewhat sporadic manner over the past few decades. In recent years, a rapid increase in the popularity of multi-source multi-rater (MSMR) assessment systems has led to renewed interest in the characteristics of self-ratings. MSMR systems, otherwise known as 360 degree feedback, typically involve a target manager providing a self-rating on various competencies, which is then compared with the ratings of relevant others such as supervisors, peers, subordinates and occasionally clients. In the UK, MSMR systems are used primarily for developmental purposes, and increasingly also for administrative ones (i.e. appraisal, performance-related pay, etc.).

AimTo develop and psychometrically test the Patient‐reported Experience Measure‐Cancer (PREM‐C), reflecting patients' perceptions of cancer care experiences according to the Institute of Medicine domains.DesignA three‐phase cross‐sectional survey was conducted.MethodsDevelopment, reliability and validity testing of the PREM‐C measure was undertaken. Data collection included three phases: firstly (development) between October and November, 2015; secondly (psychometric testing), May 2016–June, 2017, and finally, (revision and psychometric testing) May 2019–March 2020.ResultsThe final PREM‐C structure, created using the Institute of Medicine domains, was psychometrically sound with five factors identified in the Exploratory Factor Analysis, demonstrating internal reliability ranging from 0.8 to 0.9. Confirmatory Factor Analysis indicated the hypothesized model fitted well (Root mean square error of approximation = 0.076). External convergent and divergent validity was established with the PREM‐C found to be moderately correlated with the Picker Patient Experience Questionnaire but weakly correlated with the WHOQoL‐BREF.ConclusionThe development and testing of the PREM‐C demonstrated good fit as a clinically relevant measure of ambulatory cancer patients' experiences of care. To make meaningful changes to nursing practice and health services, patient experience measures such as the PREM‐C might support staff to identify areas for service improvement.ImpactFew reliable measures and less validated measures collect patients' perceptions of the quality of their healthcare provision. Rigorous psychometric testing of the newly developed PREM‐C demonstrated good internal consistency, test–retest reliability, and external convergent and divergent validity. The PREM‐C is a potentially relevant measure of cancer patients' experiences of care. It might be used to assess patient‐centred care and guide safety and quality improvements in clinical settings. PREM‐C use might inform service providers of experiences of care in their institution and inform policy and practice development. This measure is sufficiently generic, allowing potential use in other chronic disease populations.Patient or Public ContributionThis conduct of this study was supported by the participating patients of the hospital Cancer Outpatients Service.

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