Multisource Feedback (MSF) Instructions for Local Pain Medicine Educational Supervisor

Multisource Feedback (MSF) Instructions for Local Pain Medicine Educational Supervisor

Multi-source feedback (MSF) instructions for Local Pain Medicine Educational Supervisor

The purpose of the multi-source feedback is to assess the competence of the trainee in areas of attitudes, values and communications skills. This will be done at the 7month stage and if unsatisfactory repeated again during the training year. You should choose a minimum of 6 and maximum of 15 raters, and code the forms you give to the trainee to give to the raters so that you are in a position to identify the raters if necessary. The trainee should also complete their own feedback.

The raters will return the form to you in a sealed envelope. You should collate their responses on the enclosed form. The best and worst score for each question should be omitted.There may be aspects of the feedback you wish to discuss in more detail with the rater and you will be able to identify them as above. The trainee should however not know which rater has made any specific comments about them.The outcome of the MSF exercise should be discussed with the trainee and the collated MSF form forwarded to the Regional Advisor in Pain Medicine (RAPM) who will discuss the results further if appropriate at the quarterly review. If you have concerns about the outcome of the MSF these should be raised with the RAPM. The trainee can be asked to undergo a further MSF later in the training year if necessary.

Multi-source feedback collated version

Trainee ______Educational Supervisor______

Rater 1 / Rater 2 / Rater 3 / Rater 4 / Rater 5 / Rater 6 / Self
Professional relationship with patients
The doctor is polite to patients
The doctor is caring of patients
The doctor is respectful of patients
The doctor shows no prejudice in the care of patients
Communication skills
The doctor communicates effectively with colleagues
The doctor speaks good English at the appropriate level for patients
The doctor writes good letters and notes
Team working/Working with colleagues
Doctor respects others role in the healthcare team
The doctor works constructively in the health care team
Maintaining trust
The doctor is conscientious with respect to his responsibilities
The doctor demonstrates commitment to their work in the team
Clinical care
The doctor is routinely able to take a structured history from the patients (carers)
The doctor is able to conduct examination of the patient in a structured manner taking full account of the patient’s dignity and autonomy
The doctor is able to assess a pain patient competently
The doctor is able to prescribe safely and appropriately
The doctor demonstrates competence in problem-solving
The doctor constructs appropriate management plans
The doctor seeks help where appropriate
The doctor maintains an appropriate clinical record
Probity
The doctor demonstrates a professional attitude
Global rating
The doctor’s overall performance

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