Commentary: realizing the formative potential of multisource feedback in regulatory-based assessment programs.

Multisource feedback (MSF) is often promoted as a useful approach for formative assessment and is increasingly becoming part of regulatory-based assessment programs, such as revalidation and maintenance of certification. However, to achieve the full potential of MSF, substantially more attention should be directed at the specific purpose of the MSF instruments and processes and the ability of the results to drive and catalyze efforts to improve health care. MSF developers should revisit the use of comments and open-ended questions to detect contextually rich issues that can guide improvement in the local practice context. Greater attention is also needed around the processes of how the results are interpreted, processed, and applied by physicians. Both government and independent professional self-regulatory bodies walk a difficult tight rope in developing instruments that are psychometrically credible to both physicians and the public, yet truly drive improvements in quality and safety. Ultimately, a formative assessment approach is only as good as the quality of care it detects and improves for the benefit of patients and the public.