Researchers at Ariadne Labs, Boston, applied multi-source or so-called 360-degree feedback methodology in 2011-2013 to query all 385 surgeons who practice in the eight Harvard Medical School-affiliated hospital surgical programmes. This is a key method of professional development for many industries and used on a regular basis by 90 percent of Fortune 500 companies.
The current study is the first to use multi-source feedback in a large-scale, multi-institutional assessment of surgeons. The tool evaluated the degree to which the Harvard surgeons met an institutional code of excellence (COE) that is based on the American College of Surgeons Statement on Principles and defines a minimum standard of conduct in 11 domains: service, respect, teamwork, excellence, ethical discipline, personal responsibility to patients, openness, education, humility, health, and conflict of interest. To help surgeons integrate the COE in their daily practice, department heads decided to measure performance in all 11 domains by means of multi-source feedback.
A questionnaire was developed to assess a surgeon’s professionalism, communication skills, interpersonal style, leadership, and teamwork approaches. This was disseminated by a proprietary online 360-degree review system to every practising surgeon and to 20-30 individuals who evaluated the performance of each surgeon. Responses produced a composite COE score for each surgeon. A follow-up survey of all surgeons and 1,042 reviewers assessed the effect of 360-degree evaluation on surgeons’ behaviour and participants’ reactions to the methodology.
Results indicated that a high percentage of surgeons were adhering to COE principles. The mean COE score for all surgeons was 87.6, and the factors that contributed the most to the composite score were service, openness, and humility. Other key findings were:
- 87 percent of surgeons and 80 percent of surgical department heads believed the information was accurate.
- 63 percent of surgeons had changed behaviour as a result of the 360-degree evaluation.
- 60 percent of department heads noted overall improvement in surgeons’ behaviour, particularly in the areas of communication and professionalism.
- 77 percent of surgeons, 80 percent of department heads, and 85 percent of reviewers would participate in a similar evaluation process in the future.
“Multi-source feedback does not give people grades or try to regulate behaviour. It provides tools for identifying how we can be better at what we do every day," says lead author and surgical oncologist Alex B. Haynes, MD, MPH, associate director for the Safe Surgery Programme at Ariadne Labs.
Co-author William R. Berry, MD, MPH, MPA, the chief medical officer at Ariadne Labs adds, "This study shows that people are energised by the opportunity to turn a mirror on themselves and that 360-degree feedback is an effective tool for providing opportunities for self-evaluation and improvement.”
Source: American College of Surgeons
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