Optimizing Multisource Feedback Implementation for Australasian Physicians

Abstract

Introduction: Medical regulatory bodies in Australasia are encouraging greater use of continuing professional development activities, such as multisource feedback (MSF), which are practice-based, include facilitated feedback, and improve performance. The aim of this study was to explore the feasibility, effectiveness, and sustainability of an MSF process that includes a telephone/videoconference debrief, to better design future MSF implementation. Method: Thirty-seven Australasian physician participants sought feedback from patients and colleagues and debriefed their feedback report with a trained facilitator. The impact was evaluated using quantitative and qualitative measures including surveys and semistructured interviews. Results: The feasibility of the MSF process was impacted by the level of support for the participant to complete the MSF, the nature and location of participants' work, and the use of telephone/videoconference to deliver the debrief. Regarding effectiveness, the MSF stimulated reflection on practice and action on areas identified for improvement. In addition, the quality of rater feedback and the inclusion of a debrief impacted participant and facilitator reports of effectiveness. The absence of a culture of feedback, the formative nature of the MSF, and the confidentiality of the results were factors impacting sustainability. Discussion: Optimizing MSF is important to encourage broad uptake in the wider medical community in Australasia. Although several factors were identified as having an impact, it is clear that inclusion of a quality debrief will increase the perceived value and the effectiveness of MSF. Delivering that debrief through telephone/videoconference can be effective and will increase the overall feasibility and sustainability.

How Feedback Is Given Matters: A Cross-Sectional Survey of Patient Satisfaction Feedback Delivery and Physician Well-being

“…Moreover, physicians have challenged the public dissemination of their performance information in other settings 43,54,55 and performance feedback delivered confidentially has been found to be preferable among physicians. 56 In addition, although financial incentives may improve subsequent performance, 57 they have been associated with increased opioid prescription rates when tied to patient satisfaction performance. 58 The presence of financial incentives may also moderate how physicians perceive performance feedback, though these questions were outside our scope.…”

Multisource feedback: an overview of its use and application as a formative assessment

“…Facilitated discussions are critical to guide the physician or learner in the co-development of the learning change plan and its follow-up. [11][12][13] These studies and other publications 1,2,30,43,48,49 have demonstrated the importance of discussion and follow-up and are informing best practices for MSF. The de-briefer or facilitator requires training and may be someone appointed for this purpose for medical students and residents so that they are at armslength from other evaluation and assessment processes or it may be a preceptor or supervisor.…”

“…9 Recent studies have examined consequential validity and demonstrated the importance of providing quantitative and qualitative data from MSF instruments, along with a facilitated discussion to ensure outcomes. [10][11][12][13] While there are other approaches, including providing a peer with a script for discussion 10 , the R2C2 model, which involves a facilitator building a relationship, exploring reactions to the feedback, exploring the content of the feedback and coaching for change, 14 has demonstrated its effectiveness as an approach to facilitated feedback. 11,12 MSF may be combined with other tools.…”

“…[10][11][12][13] While there are other approaches, including providing a peer with a script for discussion 10 , the R2C2 model, which involves a facilitator building a relationship, exploring reactions to the feedback, exploring the content of the feedback and coaching for change, 14 has demonstrated its effectiveness as an approach to facilitated feedback. 11,12 MSF may be combined with other tools. 5,15 As noted by van der Meulen, 15 while MSF tools can provide robust performance information, no instrument is able to capture the whole complex construct of physicians' professional performance, particularly when decisions are required for promotion, remediation, or suspension/termination.…”

“…Facilitated discussions provide physicians and medical students with an opportunity to gain a further understanding and interpretation of their data reports and use the data to develop an action plan. [11][12][13]43 However, there are a number of cautions to consider when deciding to include MSF amongst the tools for assessment and feedback.…”