A New Multisource Feedback Tool for Evaluating the Performance of Specialty-Specific Physician Groups: Validity of the Group Monitor Instrument

J Contin Educ Health Prof. 2019 Summer;39(3):168-177. doi: 10.1097/CEH.0000000000000262.


Introduction: Since clinical practice is a group-oriented process, it is crucial to evaluate performance on the group level. The Group Monitor (GM) is a multisource feedback tool that evaluates the performance of specialty-specific physician groups in hospital settings, as perceived by four different rater classes. In this study, we explored the validity of this tool.

Methods: We explored three sources of validity evidence: (1) content, (2) response process, and (3) internal structure. Participants were 254 physicians, 407 staff, 621 peers, and 282 managers of 57 physician groups (in total 479 physicians) from 11 hospitals.

Results: Content was supported by the fact that the items were based on a review of an existing instrument. Pilot rounds resulted in reformulation and reduction of items. Four subscales were identified for all rater classes: Medical practice, Organizational involvement, Professionalism, and Coordination. Physicians and staff had an extra subscale, Communication. However, the results of the generalizability analyses showed that variance in GM scores could mainly be explained by the specific hospital context and the physician group specialty. Optimization studies showed that for reliable GM scores, 3 to 15 evaluations were needed, depending on rater class, hospital context, and specialty.

Discussion: The GM provides valid and reliable feedback on the performance of specialty-specific physician groups. When interpreting feedback, physician groups should be aware that rater classes' perceptions of their group performance are colored by the hospitals' professional culture and/or the specialty.

MeSH terms

  • Clinical Competence / standards
  • Feedback*
  • Group Practice / standards*
  • Group Practice / statistics & numerical data
  • Humans
  • Netherlands
  • Peer Review / methods
  • Peer Review / standards*
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Quality of Health Care / standards
  • Quality of Health Care / statistics & numerical data
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Work Performance / standards*
  • Work Performance / statistics & numerical data