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Introduction:A system of teaching evaluation was developed at the Second Military Medical University, Shanghai. The system combined student ratings of teachers with peer reviews. This study explores factors that may influence teaching evaluations, as well as the perceptions of effectiveness of the evaluation system. Methods: Teaching evaluation data from 2006 to 2009 were analyzed. A survey was conducted to collect the perceptions of students and faculty members about the system. Results: Teaching evaluation ratings were higher when the faculty knew which course session would be observed. Student ratings showed a correlation with peer ratings. Advanced students provided higher ratings. Currently employed faculty peer reviewers provided higher ratings than retired reviewers. Peer reviewers in the same department as the faculty being observed provided higher ratings than peers from other departments. Reviewers with prior experience provided ratings similar to new reviewers. All faculty members indicated they would not make their course easier in response to student evaluations. Conclusion: The year of student enrollment in the program, relationships among peer reviewers and faculty, and whether faculty are cognizant of which session would be observed have a direct impact on rating results. There is a correlation between the student evaluation and peer evaluation. Training reviewers is important to improve rating validity. Faculty members appreciate the assistance for improvement of teaching provided by the evaluations.