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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Evaluation of physicians' professional performance: An iterative development and validation study of multisource feedback instruments

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Karlijn Overeem, Hub C Wollersheim, Onyebuchi A Arah, Juliette K Cruijsberg, Richard PTM Grol, Kiki MJMH Lombarts
Wichtige Hinweise
Karlijn Overeem, Hub C Wollersheim, Onyebuchi A Arah, Juliette K Cruijsberg, Richard PTM Grol and Kiki MJMH Lombarts contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

Conceived and designed the experiments: KO KML HCW. Analyzed the data: KO KML JC OAA. Contributed reagents/materials/analysis tools: KO JC OAA. Wrote the paper: KO. Editing and reviewing the manuscript: KML HCW PRTMG OAA JC. All authors read and approved the final manuscript.

Abstract

Background

There is a global need to assess physicians' professional performance in actual clinical practice. Valid and reliable instruments are necessary to support these efforts. This study focuses on the reliability and validity, the influences of some sociodemographic biasing factors, associations between self and other evaluations, and the number of evaluations needed for reliable assessment of a physician based on the three instruments used for the multisource assessment of physicians' professional performance in the Netherlands.

Methods

This observational validation study of three instruments underlying multisource feedback (MSF) was set in 26 non-academic hospitals in the Netherlands. In total, 146 hospital-based physicians took part in the study. Each physician's professional performance was assessed by peers (physician colleagues), co-workers (including nurses, secretary assistants and other healthcare professionals) and patients. Physicians also completed a self-evaluation. Ratings of 864 peers, 894 co-workers and 1960 patients on MSF were available. We used principal components analysis and methods of classical test theory to evaluate the factor structure, reliability and validity of instruments. We used Pearson's correlation coefficient and linear mixed models to address other objectives.

Results

The peer, co-worker and patient instruments respectively had six factors, three factors and one factor with high internal consistencies (Cronbach's alpha 0.95 - 0.96). It appeared that only 2 percent of variance in the mean ratings could be attributed to biasing factors. Self-ratings were not correlated with peer, co-worker or patient ratings. However, ratings of peers, co-workers and patients were correlated. Five peer evaluations, five co-worker evaluations and 11 patient evaluations are required to achieve reliable results (reliability coefficient ≥ 0.70).

Conclusions

The study demonstrated that the three MSF instruments produced reliable and valid data for evaluating physicians' professional performance in the Netherlands. Scores from peers, co-workers and patients were not correlated with self-evaluations. Future research should examine improvement of performance when using MSF.
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