Multidisciplinary Feedback Improves Surgeons' Performance

Certain healthcare provider behaviors can threaten team performance and patient safety. As task complexity increases, so do the team's interdisciplinary responsibilities. Medical organizations that take steps to identify troublesome behaviors can help employees correct the problem, thereby fostering teamwork and a culture of safety.

One method used in a number of employment systems is the 360^o evaluation‑‑up to 90% of Fortune 500 companies use some kind of 360^o evaluation to ensure that evaluations are balanced and unbiased. A team of surgical researchers from the Boston, MA, area collaborated to look at the use of 360^o evaluations to give surgeons feedback. Their results, which appeared in the October 2015 issue of the Journal of the American College of Surgeons, indicate that this process can help surgeons make positive behavioral changes.

The researchers instituted a customized version of a validated 360^o evaluation instrument at 8 academically affiliated hospitals with a common Code of Excellence, enrolling 385 surgeons in a variety of specialties. All surgeons were evaluated by more than 10 individuals from different areas of their work environment, and surgeons were allowed to self-select some of their evaluators. The median number of reviewers per surgeon was 29.

Six months after evaluation, surgeons, department heads, and reviewers completed follow-up surveys to assess feedback accuracy; willingness to participate in repeat evaluations; and behavior change. Department heads were most likely to respond to the survey, with 10 of 17 (59%) sending comments. Thirty-one percent of surgeons (118 of 385) responded, and 36% of the 2,928 reviewers responded.

The vast majority of surgeons and department heads indicated that reviewers' feedback about surgeon performance was accurate. Sixty percent of surgeons indicated that the feedback had prompted them to change their practice behaviors.

Reviewers also tended to be positive about 360^o evaluation, with 70% reporting the evaluation process was valuable, and 82% willing to participate in future 360-degree reviews. Approximately one-third of reviewers said that they had seen behavior change in surgeons that appeared related to the evaluation process.

Areas that improved most were service, openness, and humility. Traditional evaluations often emphasize surgeon technical proficiency and clinical knowledge. This study suggests that coworker impressions of performance encompasses "soft skills" that are also important.