How to... perform 360° feedback
The idea of 360° feedback was developed in business and refers to the 'full circle' when members of the team from all levels are involved in assessing colleagues. This contrasts with the traditional 'top-down' approach, whereby appraisals are carried out by a line manager. As relicensing and recertification for GPs approaches, this is a useful way to assess ourselves before assessment is thrust upon us. Annual appraisals are a useful tool but they are not enough.
Here are some ways GPs can adopt the method:
1) Ask the people we work with every day to perform 360° feedback on us. Not only is this a useful tool but it is likely to become a part of our recertification process.
2) In general practice all the staff will be asked their opinion, including the receptionists, secretaries, healthcare assistants, managers, nurses and other partners.
3) The system can vary from unstructured interviews, a series of questions with a rating scale based on 'good practice' or open questions. The questionnaire needs to be reliable and valid. The most straightforward and practical method in general practice is simply to ask 'What do you like about working with this person?' and 'In what areas do you think he/she could possibly improve?' Try to set a deadline for the responses.
4) All feedback must be anonymous. It is helpful for questionnaires to be computerised so the handwriting is not recognised.
5) The system will only work in a practice where there is a culture of openness. However, introducing the idea can send a positive message to the staff.
6) When asked to fill in a questionnaire about a colleague always put positive comments first. Any criticism needs to be constructive. Try to offer a solution.
7) If the process is not handled well, it can be painful and damaging. It is helpful if the doctor goes through the results with a trusted colleague in confidence. Typically this could be the GP appraiser.
8) Initially, focus on the good points. This will build confidence. Then look for trends – for example 'he is poor at timekeeping' or 'does not mix with others'.
9) There may be an individual who has their own reason to be negative. Ignore aberrations.
GPs can learn from 360° feedback, but it must be handled sensitivity.
Dr Peter Moore is a GP in Torquay, Devon