360-DEGREE EVALUATION FORM

RATER ASSESSMENT

For use by: Residents, Students, Attendings, Directors, and Health Care Team Members

INTERPERSONAL AND COMMUNICATION SKILLS

Background Information

The University of Maryland School of Medicine, Primary Care Education Initiative is piloting a 360-degree assessment system for residents and students.  360-degree assessment is a way of providing feedback about progress by placing the person to be evaluated at the “hub of the wheel” thus reflecting the center from all sides.

 

 

 

 

 

 

 

 

 

This process provides a full-circle view of resident/student skills and abilities by gathering information from various perspectives: the individual and others (peers, supervisors, patients, health care team members).  This profile provides a more balanced overview than self-evaluation or peer/supervisor review.

The completed questionnaires will be compiled into a final report for the resident/student. Anonymity for those completing the report helps ensure that ratings and comments are fair as well as skill and behavior-based.

Please rate the individual based on your recent experience with him/her. Be realistic, honest, and direct.  This is a formative evaluation process (one designed to provide feedback for improvement) not a summative one (designed for promotion or retention purposes).

 

Tips for Providing Useful Feedback

Not Applicable

Rarely demonstrates (<25% of the time)

Sometimes demonstrates (25-50% of the time)

Demonstrates in most cases (50-75% of the time)

Demonstrates in majority of cases (>75% of time)
  • Use the full range of the rating scale. Use “Demonstrates in majority of cases” if behavior is observed >75% of time.  Likewise with “Rarely demonstrates” – use it only if the behavior is observed less than 25% of the time. 
  • Use NA if you don’t interact with the student/resident in a way that would allow you to observe a certain behavior
  • If you give a score of either “Rarely demonstrates” or “Demonstrates in majority of cases” (the lowest or highest possible), please write in a comment for that question in the comments area that follows that section.
  • Base your feedback on your own observations of the resident’s/student’s behavior, not on what you've learned from other people.

 

Tips for Giving Useful Written Comments

  • Useful comments give examples of specific behaviors. For example: "He’s unreliable" is not specific. A much more useful comment would be: "He was absent from two of our last three journal club sessions without letting anyone know in advance.”
  • Ask yourself: "Will my comments guide the resident/student to improve?”
  • Consider stating the impact of the action you observed so consequences of behavior are realized.  This helps with motivation to improve.

Example:

            Benchmark: “Uses effective listening skills to elicit information”

            Comment: “Needs some improvement here.”  This is too vague.

Better comment: When with patients seems distracted by other things going on.  If patients sense this, they may feel unimportant.”

It is especially important to take the time to enter narrative comments in the text boxes provided. The value of the 360-degree process is largely dependent on you and others being thoughtful, candid and, where appropriate, constructively critical.

 

Adapted in part from RE Brown & Associates, El Cerrito, California