Impact of Self- and Peer Assessment on the Clinical Performance of Physiotherapists in Primary Care: A Cohort Study

Abstract

Purpose: This study evaluated the impact of a quality improvement programme based on self-and peer assessment to justify nationwide implementation. Method: Four professional networks of physiotherapists in The Netherlands (n ¼ 379) participated in the programme, which consisted of two cycles of online self-assessment and peer assessment using video recordings of client communication and clinical records. Assessment was based on performance indicators that could be scored on a 5-point Likert scale, and online assessment was followed by face-to-face feedback discussions. After cycle 1, participants developed personal learning goals. These goals were analyzed thematically, and goal attainment was measured using a questionnaire. Improvement in performance was tested with multilevel regression analyses, comparing the self-assessment and peer-assessment scores in cycles 1 and 2. Results: In total, 364 (96%) of the participants were active in online self-assessment and peer assessment. However, online activities varied between cycle 1 and cycle 2 and between client communication and recordkeeping. Personal goals addressed client-centred communication (54%), recordkeeping (24%), performance and outcome measurement (15%), and other (7%). Goals were completely attained (29%), partly attained (64%), or not attained at all (7%). Self-assessment and peer-assessment scores improved significantly for both client communication (self-assessment ¼ 11%; peer assessment ¼ 8%) and recordkeeping (self-assessment ¼ 7%; peer assessment ¼ 4%). Conclusions: Self-assessment and peer assessment are effective in enhancing commitment to change and improving clinical performance. Nationwide implementation of the programme is justified. Future studies should address the impact on client outcomes.

Impact and feasibility of a tailor-made patient communication quality improvement programme for hospital-based physiotherapists: a mixed-methods study

“…29 Also, in a primary care setting, both selfassessment and peer assessment were shown to be effective in improving the physiotherapist's clinical performance. 30 In line with our findings, experienced physiotherapists perceived, observing colleagues while doing their job, to be the most powerful learning process that enabled them to develop their clinical expertise further. 31 The results of this study thus support and extend previous findings of the potential value of peer observation and feedback as a quality improvement strategy.…”

Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study

“…An example of an approach for daily practice is comparing outcomes and receiving feedback from supervisors or colleagues in peer-review assessments. 32 , 33 In such an approach, it is important to formulate explicit targets and action plans to enhance quality improvement initiatives. 32 A plan-do-study-act cycle is a way to provide a structure for iterative testing and evaluation of change to improve quality of care.…”

The application of the tracer method with peer observation and formative feedback for professional development in clinical practice: a scoping review

“…In most studies, the tracer method has been used in the context of quality assessment and as an accreditation tool for healthcare organizations [20,21,[23][24][25][26][27]. Other forms of peer observation and feedback, for instance through indirect observation via video, have been used to improve the quality of healthcare, for example in improving hand hygiene and medical administration [30][31][32][33][34]. Our results agree with these findings, and with those of studies on the feasibility of peer observation and feedback in clinical practice [35,36].…”