How physicians change: Multisource feedback driven intervention improves physician leadership and teamwork

Multisource feedback provides a method of quantitatively assessing and improving physician professionalism, interpersonal communication, teamwork, and leadership behaviors. We sought to determine whether tiered educational interventions can improve measurements of multisource feedback for physicians across specialties, and whether multisource feedback baseline measurements and improvements after intervention vary by specialty designation. Multisource feedback assessments were performed on physicians from academic (34%) and community hospitals (66%) in the United States and Canada. PULSE 360 Survey data was obtained on 1,190 physicians from primary care (25%), surgical (46%), and other (29%) specialties. Physician respondents were 75% male and 24% female. Raters included administrators, colleagues, staff, and self-ratings with an average of 35.7 ratings per physician. A leadership teamwork index was measured before and after delivery of educational intervention. Three tiers of intervention were used depending on baseline leadership teamwork index score: (1) report only, (2) debriefing only, and (3) debriefing and development. Surgeons had a significantly lower baseline leadership teamwork index at 59.9, whereas primary care and specialists started with an leadership teamwork index of 67.1 and 65.9, respectively. Those who participated in a tier 3 intervention had the greatest change from an average baseline leadership teamwork index of 36.6 to 56.3 on follow-up. Surgeons experienced the largest mean increase of 9.1 leadership teamwork index points after intervention, whereas medicine specialists had a mean increase of 6.7 leadership teamwork index points. Baseline multisource feedback scores vary by specialty and improve based on feedback, goal-setting, coaching, and education. In particular, physicians who start with low scores have the greatest potential for leadership teamwork index improvement.