Medical Journal of Dr. D.Y. Patil Vidyapeeth

: 2020  |  Volume : 13  |  Issue : 4  |  Page : 300--301

Multi-source feedback: A tool for assessment

Mausumi Basu 
 Department of Community Medicine, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India

Correspondence Address:
Mausumi Basu
Department of Community Medicine, IPGME and R and SSKM Hospital, Kolkata, West Bengal

How to cite this article:
Basu M. Multi-source feedback: A tool for assessment.Med J DY Patil Vidyapeeth 2020;13:300-301

How to cite this URL:
Basu M. Multi-source feedback: A tool for assessment. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Aug 9 ];13:300-301
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Full Text

Multi-source feedback (MSF), also known as 360° feedback, multi-rater feedback, or multi-source assessment refers to a process for appraisals of a person through feedback, derived from two or more distinct categories of individuals, often including a self-evaluation.

Actually, it is the combined evaluation of a person by various individuals, both by physicians and nonphysicians called the “Raters” (physicians include seniors, specialists, peers, teammates, and supervisors; nonphysicians include patients, administrative personnel, support staffs, nursing staff, attenders, laboratory staff, and relatives of the patient) that have different working relationships with the person, through the use of questionnaires and a compiled feedback report.

MSF was started as an alternative method from the traditional style of “downward reviews” to combination of “upward” (feedback delivered to management by subordinates only), “downward” (the reverse), and “'lateral” feedback (among peers), plus self-assessment.

The 360° assessment is has its origin in the military assessment centers developed during World War II. The private industry started to experiment with the MSF in the 1960s and 1970s. Corporations such as Federal Express, Bank of America, Bell Labs, and Disney World used the method in job evaluations, promotion boards, and talent selection (Boyd, 2005).[1]

In recent years, MSF is a central element of assessments in several countries. Canada was the first country to start MSF questionnaires in a revalidation programs for doctors.[2]

Although it is widely used in industrial settings; nowadays, it is gaining acceptance as a quality improvement method in health systems also and used by clinicians, students, house surgeons or interns, postgraduate students, and senior resident. MSF is now widely accepted as a competency-based assessment technique globally.

MSF was originally designed to be formative in purpose – to provide feedback to individuals to increase their awareness of their performance, and to guide learning and improvement.

It can be used for both formative and summative assessments and can be used for teachers and students.

There is significant evidence to support its use within the medical education field (Norcini, 2003; Ramsey et al., 1993). Many reviews have been undertaken in Canada and the UK (Archer et al., 2005; Hall et al., 1999; Sargeant et al., 2005; Violato et al., 2003; Violato et al. 1997; Whitehouse et al., 2005).

Moonen-van Loon et al. believed that the reliability of MSF is influenced by the assessor groups and the competencies included in the assessment, which should be considered when designing assessment instruments.[3]

As per Probyn et al.,[4] the self-assessment feature of MSF helps a resident to compare the accuracy of his/her assessments to improve his/her life-long learning skills.

MSF is most effective:

When it includes both narrative comments and statistical dataWhen the sources are credibleWhen the feedback is constructively framedWhen the whole process is tag along with good mentoring and follow-up.

Berk proposed MSF to evaluate students' professionalism, as more accurate, reliable, fair, and equitable decisions than the one based on just a single source.[1]

There are several characteristics of 360° MSF models[1] which include: (1) employee must be involved in selection of rates; (2) raters must be credible and knowledgeable; (3) behaviors and outcomes rated must relate to actual job tasks; (4) medium size sample of raters to promote anonymity and to increase reliability; (5) a common scale for all raters; (6) The Likert scale with 4–7 options can be used; (7) scales should be administered online, not on paper to maintain anonymity, increase response rates, increase quality of comments; (8) feedback should be face-to-face, timely, sensitive, and regular; and (9) improvements in performance must be documented over time.

Nowadays, MSF is changing focus from industry to academia. Different methods are available to assess the performance.[5] However, in India, its use is limited.

Few universities at West made available an easy-to-use, web-based MSF instrument for residents.

Mini-peer assessment tool, modified from Sheffield peer review assessment tool, is an established MSF (360°) instrument.[6]

The team assessment behavior is another assessment tool used for MSF in postgraduate and undergraduate medicine.[7]

“Feedback on performance for trainers” tool is also an MSF instrument that may be used to gather information.[8]

Many studies supported the fact that MSF creates positive changes in behavior, though it may be in small amount, especially in the first 6 months between the pre- and post-assessment deployment, often sustained for as many as 4 years.

Advantages of MSF are:

Relatively inexpensive and flexible way of compiling data from a variety of sourcesWith multiple points-of-view considered, reduces the chance of biasSince the observations are from the learner's workplace, they are based on actual, not potential, and performance.

Possible pitfalls that can arise in MSF:

Destructive feedback can be damaging to individualAnonymity may be used to express grudgesIt is a very time-consuming processInadequate feedbackRequires significant cooperation from the participantsProtecting patients and coworkers confidentiality is paramount.


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2Hall W, Violato C, Lewkonia R, Lockyer J, Fidler H, Toews J, et al. Assessment of physician performance in Alberta: The physician achievement review. CMAJ 1999;161:52-7.
3Moonen-van Loon JM, Overeem K, Govaerts MJ, Verhoeven BH, van der Vleuten CP, Driessen EW, et al. The reliability of multisource feedback in competency-based assessment programs: The effects of multiple occasions and assessor groups. Acad Med 2015;90:1093-9.
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