A randomized, controlled crossover study to discern the value of 360-degree versus traditional, faculty-only evaluation for performance improvement of anesthesiology residents.

Background: 360-degree evaluation, or multi-rater feedback, is a means of providing evaluation from a variety of stakeholders. The Accreditation Council for Graduate Medical Education (ACGME) lists 360-degree feedback as a recommended method for evaluating residents. Our study determines if 360-degree evaluation, as compared to traditional evaluation, affords anesthesiology residents greater potential for performance improvement.

Methods: After IRB exemption and resident consent to participate, sixteen anesthesiology residents of various training levels at The George Washington University Medical Center were randomly assigned to receive either 360-degree evaluation or traditional evaluation. Mid-way through the study, the groups were crossed over. Three faculty members blinded to which type of evaluation each resident received evaluated all residents pre-study, midway, and at the conclusion of the study according the six core competencies set forth by the ACGME. The 360-degree study included evaluations by faculty (traditional), self, medical students, nursing staff and patients.

Results: Performance improvement in all core competencies demonstrated a trend toward greater scoring for residents who received early exposure to 360-degree evaluation compared to later exposure. Paired t-Tests demonstrated significance for resident performance improvement with early 360-degree evaluation versus early traditional evaluation for the Interpersonal and Communication Skills core competency over the entire study. Systems-based Practice and Practice-Based Learning and Improvement suggested improvements, but failed to reach statistical significance (P = 0.09, 0.07 respectively).

Conclusions: Does a 360-degree evaluation, as compared to traditional, faculty-only evaluation afford anesthesiology residents greater potential for performance improvement? Sixteen residents were exposed to a prospective, single-blinded, crossover design study to determine the answer. For 360-degree evaluations, residents were rated according to the ACGME core competencies after adjusting to Program Director review of evaluations from self, faculty, nursing staff, medical students and patients.