Sources of assessment of physician performance: a study of comparative reliability and patterns of intercorrelation

The technical and the interpersonal skills of resident physicians in four separate samples were examined with subjective performance evaluations from four different sources: attending physicians, peers, patients and the residents themselves. Residents were from programs in internal medicine, family practice and general surgery. The reliabilities of measures from all four sources were found to be substantial, suggesting the potential usefulness of these sources of physician evaluation. Ratings or technical and interpersonal skill were found to be highly intercorrelated within each source. Reasons for this high degree of overlap are discussed. Finally, the ratings from the four sources were found to be fairly independent, indicating that they provide relatively separate measures of physician performance. The implications of these findings for medical care, education and research are considered.