A survey feeding back from colleagues (previously called multisource feedback, or MSF) is a recognised way for a person to gain formative information on how they are seen by those with whom they work.
The value for doctors, including general practitioners, allows a doctor to reflect on their practise and help support professional development. They are not a ‘pass/fail’ assessment, but provide an opportunity for a doctor to discuss the feedback with their appraiser and, if appropriate, change their behaviour. As such, colleague surveys can be used to demonstrate that a general practitioner is both reflecting and improving. As part of revalidation all doctors are required to do one colleague feedback in each revalidation cycle – that is, usually every five years.
The following five steps will ensure that GPs get the most out of the process.
1 Select an appropriate survey tool
The RCGP has to date commissioned three reviews of colleague survey instruments and currently considers that the following are suitable for use by GPs for revalidation:
- Sheffield Peer Review Assessment Tool Version 2 (GP-SPRAT)
- Colleague Feedback Evaluation Tool Version 2 (CFET)
- GMC colleague questionnaire
- EDGECUMBE 360o Colleague Feedback
- 2Q MSF
However if you have used a colleague feedback tool which is not on this list, it will still be acceptable if it is focused on you, what you do, and the quality of your care for your patients; and if it was conducted objectively and confidentially. This will normally mean that the data is externally collated and the feedback uses national or group norms for comparison.
The RCGP has recently incorporated the GMC patient and colleague questionnaires into the RCGP Revalidation ePortfolio.
2 Select your recipients
You will need to identify a number of medical colleagues including those who you work with in your clinical practise, for instance:
- GP partners
- GPs who you work with
- peripatetic sessional doctors
- other people (nurse, practice manager, practice secretary, or receptionist) with whom you works sufficiently closely to enable informed and representative opinions to be made. This could include doctors who you refer to in secondary care and GP trainees if you are involved in training.
If you work in multiple roles you can ask individuals from any of these roles to provide feedback , accepting that some colleagues may not be able to comment directly on your clinical practise. The selected colleagues, who should represent an appropriate mixture of clinical and non-clinical, will be asked to complete a questionnaire giving their view on key attributes concerning yourself.
Completing an MSF should be straightforward for GPs in the diversity of roles that we undertake. In particular locums and sessional doctors could use peer group colleagues in addition. Questionnaire providers will state a minimum number of colleagues to ensure reliable feedback. In uncomplicated cases the questionnaire should take 5 to 10 minutes to complete, but it may take longer if reflection and consideration are required.
Check the recommended number of colleagues to survey in your system. The GMC, for instance recommends you ask at least 20 colleagues if using their questionnaires, and advises a minimum of 15 questionnaires returned for reliable results.1 The RCGP follows the GMC’s recommendations.
3 Reflect on the results
The most important aspect of doing colleague surveys is reflecting upon the results and, if appropriate, implementing changes. The analysis of the MSF needs to be carried out independently and bench marked to peer averages. This facility is available for the GMC questionnaires on the RCGP e portfolio. The result of your survey should be discussed in your annual appraisal, and the revalidation portfolio will need to show supporting information from that discussion. Any agreed actions should be included in that appraisal’s PDP and should be reviewed at the next appraisal.
4 Implement the learning in your practise
Participation in colleague feedback would not have much value unless learning from the process was translated into practise. The MSF should cover the whole scope of the doctor’s practise and so the feedback should provide an opportunity for learning and implementation in practise. The learning and implementation could be used as part of the CPD credit portfolio, with each hour taken to learn and implement represented by a CPD point.
5 Carry out a follow up survey
If a colleague survey identifies issues, you may agree with your appraiser that a follow up survey should be undertaken at a later stage in that revalidation cycle. It is important to recognise that a low score in a particular area does not necessarily indicate a concern of personal competence as this could be as a result of organisational issues such as workload or system problems. This can be discussed in the appraisal interview and will feed in to the PDP.
Professor Nigel Sparrow is the RCGP Medical Director for Revalidation and a GP in Nottingham.
1 GMC. Instructions for administering GMC colleague and patient questionnaires. http://www.gmc-uk.org/Instructions_for_questionnairesfinal.pdf_48334410.pdf