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<p>Traditional evaluations of medical residents often rely on subjective assessments by faculty, standardized exams, and direct observations. Multisource feedback (MSF) is widely adopted in residency training, yet less is known about whose ratings best detect change and how/why MSF produces behaviour change in context. The study aimed to assess the feasibility and impact of 360-degree feedback in improving clinical skills, professionalism, and interpersonal communication among ENT residents. Explanatory‑sequential mixed methods over 10 months in an ENT residency at a tertiary centre in Western UP, India. Twelve residents (PG1–PG3) were evaluated by faculty Lockyer (J Contin Educ Health Prof 23(1):4–12, 2003), peers Archer (Med Educ 4(1):101–8, 2010), paramedical staff Archer (Med Educ 4(1):101–8, 2010), and patients Eva (Med Educ 10 Suppl):S46–54, 2005) across three MSF rounds. Stakeholder‑specific 0–9 Likert MSF forms with free‑text comments, aligned to six competency domains. Internal consistency was good across domains (α = 0.81–0.90). Peer ICCs were moderate‑good (ICC = 0.74, 95% CI 0.63–0.83); patient ICCs were fair‑moderate (0.60, 0.47–0.72). LMMs showed a significant Time × Rater interaction for Communication (F(4, 228) = 5.92, <i>p</i> &lt; 0.001) and Professionalism (F(4, 226) = 4.88, <i>p</i> = 0.001). From MSF1 to MSF3, peer‑rated Communication improved more than self‑ratings. Staff/patient‑rated Professionalism rose markedly (<i>p</i> = 0.001; g = 0.56). The self–other gap narrowed for PG2 (<i>p</i> = 0.012) but remained stable for PG1/PG3. Motivation and goal‑setting partially mediated Communication gains. Qualitatively, one‑to‑one coaching and repeated cycles with concrete goals to psychological safety, accountability, improved practice of specific micro‑behaviours (e.g., conflict de‑escalation, bedside empathy). Barriers included rater time and item clarity for staff; item revisions and protected time were instituted. Repeated measures ANOVA confirmed performance improvements over successive feedback rounds (F = 5.34, <i>p</i> = 0.002). The study highlights the efficacy of multi-source feedback in fostering professional growth. Beyond improvement, MSF effects were rater‑specific and mechanism‑driven: peers and staff/patients were more sensitive to changes in Communication/Professionalism, while residents’ motivation and goal‑setting helped translate feedback into behaviour change. Programmes should purposefully include non‑physician raters, protect time for narrative feedback, and pair MSF with coaching and goal tracking.</p>

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Transforming Ent Residency Training: The Impact of Multi Source Feedback on Clinical and Professional Skill Development

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • Amit Kumar Rana,
  • Rohit Sharma,
  • Ashish Mehrotra,
  • Mamta Verma,
  • Abhay Deep Singh,
  • Huma Khan,
  • Anand Gautam Jadhao

摘要

Traditional evaluations of medical residents often rely on subjective assessments by faculty, standardized exams, and direct observations. Multisource feedback (MSF) is widely adopted in residency training, yet less is known about whose ratings best detect change and how/why MSF produces behaviour change in context. The study aimed to assess the feasibility and impact of 360-degree feedback in improving clinical skills, professionalism, and interpersonal communication among ENT residents. Explanatory‑sequential mixed methods over 10 months in an ENT residency at a tertiary centre in Western UP, India. Twelve residents (PG1–PG3) were evaluated by faculty Lockyer (J Contin Educ Health Prof 23(1):4–12, 2003), peers Archer (Med Educ 4(1):101–8, 2010), paramedical staff Archer (Med Educ 4(1):101–8, 2010), and patients Eva (Med Educ 10 Suppl):S46–54, 2005) across three MSF rounds. Stakeholder‑specific 0–9 Likert MSF forms with free‑text comments, aligned to six competency domains. Internal consistency was good across domains (α = 0.81–0.90). Peer ICCs were moderate‑good (ICC = 0.74, 95% CI 0.63–0.83); patient ICCs were fair‑moderate (0.60, 0.47–0.72). LMMs showed a significant Time × Rater interaction for Communication (F(4, 228) = 5.92, p < 0.001) and Professionalism (F(4, 226) = 4.88, p = 0.001). From MSF1 to MSF3, peer‑rated Communication improved more than self‑ratings. Staff/patient‑rated Professionalism rose markedly (p = 0.001; g = 0.56). The self–other gap narrowed for PG2 (p = 0.012) but remained stable for PG1/PG3. Motivation and goal‑setting partially mediated Communication gains. Qualitatively, one‑to‑one coaching and repeated cycles with concrete goals to psychological safety, accountability, improved practice of specific micro‑behaviours (e.g., conflict de‑escalation, bedside empathy). Barriers included rater time and item clarity for staff; item revisions and protected time were instituted. Repeated measures ANOVA confirmed performance improvements over successive feedback rounds (F = 5.34, p = 0.002). The study highlights the efficacy of multi-source feedback in fostering professional growth. Beyond improvement, MSF effects were rater‑specific and mechanism‑driven: peers and staff/patients were more sensitive to changes in Communication/Professionalism, while residents’ motivation and goal‑setting helped translate feedback into behaviour change. Programmes should purposefully include non‑physician raters, protect time for narrative feedback, and pair MSF with coaching and goal tracking.