Multisource feedback in the ambulatory setting.

Area of Science:

• Medical Education
• Internal Medicine Residency Training
• Ambulatory Care

Background:

• Accreditation Council for Graduate Medical Education mandates multisource feedback (MSF) for internal medicine residents in ambulatory settings.
• Limited data exists on actual MSF results, clinical quality measures, and knowledge-based testing performance within residency classes.

Purpose of the Study:

• To evaluate the utility of multisource feedback in identifying resident performance variations.
• To assess the correlation between MSF, clinical quality, and knowledge-based testing.
• To inform the development of targeted formative feedback strategies.

Main Methods:

• Residents in a year-long group practice experience (
• long-block
• ) received MSF including self, peer, staff, attending, and patient evaluations.
• Concomitant clinical quality data and knowledge-based testing scores were collected.
• Residents were ranked against peers, and data was reviewed with program leadership for formative feedback.

Main Results:

• Multisource feedback categorized residents into three performance groups: high performers (10%), low performers (10%), and those with mixed performance (80%).
• Each resident, regardless of overall performance level, had at least one MSF aspect significantly lower than peers.
• These identified performance gaps served as the basis for formative feedback.

Conclusions:

• Multisource feedback in ambulatory settings effectively identifies high, intermediate, and low-performing residents.
• MSF provides a basis for specific, individualized formative feedback during residency.
• Further research is needed on the impact of MSF feedback and the interrelationships between its components.