Peer evaluation and feedback for invasive medical procedures: a systematic review

Area of Science:

• Medical Education
• Quality Improvement
• Health Services Research

Background:

• Variability in invasive procedure performance necessitates robust clinician assessment.
• Peer evaluation is a potential method for assessing clinician performance and care quality in medical procedures.
• Existing literature lacks a comprehensive review of peer evaluation tools and their effectiveness.

Purpose of the Study:

• To systematically review peer evaluation tools for practicing clinicians performing invasive procedures.
• To assess the evidence supporting the validity of peer evaluations.
• To describe best practices for peer evaluation programs across various medical specialties.

Main Methods:

• Systematic search of Medline and Embase databases for studies on peer evaluation and feedback in internal medicine and subspecialties.
• Methodological quality assessment of included studies.
• Data extraction on evaluation methods, feedback structures, validity, reproducibility, and associations with quality measures.

Main Results:

• 32 studies met inclusion criteria, predominantly from gastroenterology, cardiology, pulmonology, and interventional radiology.
• 22 studies described peer scoring systems, with 18 reporting good or excellent inter-observer agreement.
• Limited studies linked scoring systems to quality measures; no studies assessed impact on patient outcomes. Best practices include standardized scoring and collaborative review.

Conclusions:

• Peer evaluation of invasive procedures is feasible and demonstrates good inter-observer agreement with structured tools.
• Common elements of successful peer evaluation programs were identified across specialties.
• Further research is required to establish links between peer-evaluated performance, quality measures, and patient outcomes.