The impact of resident- and self-evaluations on surgeon's subsequent teaching performance.

BACKGROUND: This study evaluates how residents' evaluations and self-evaluations of surgeon's teaching performance evolve after two cycles of evaluation, reporting, and feedback. Furthermore, the influence of over- and underestimating own performance on subsequent teaching performance was investigated.
METHODS: In a multicenter cohort study, 351 surgeons evaluated themselves and were also evaluated by residents during annual evaluation periods for three subsequent years. At the end of each evaluation period, surgeons received a personal report summarizing the residents' feedback. Changes in each surgeon's teaching performance evaluated on a five-point scale were studied using growth models. The effect of surgeons over- or underestimating their own performance on the improvement of teaching performance was studied using adjusted multivariable regressions.
RESULTS: Compared with the first (median score: 3.83, 20th to 80th percentile score: 3.46-4.16) and second (median: 3.82, 20th to 80th: 3.46-4.14) evaluation period, residents evaluated surgeon's teaching performance higher during the third evaluation period (median: 3.91, 20th to 80th: 3.59-4.27), p < 0.001. Surgeons did not alter self-evaluation scores over the three periods. Surgeons who overestimated their teaching performance received lower subsequent performance scores by residents (regression coefficient b: -0.08, 95 % confidence limits (CL): -0.18, 0.02) and self (b: -0.12, 95 % CL: -0.21, -0.02). Surgeons who underestimated their performance subsequently scored themselves higher (b: 0.10, 95 % CL: 0.03, 0.16), but were evaluated equally by residents.
CONCLUSIONS: Residents' evaluation of surgeon's teaching performance was enhanced after two cycles of evaluation, reporting, and feedback. Overestimating own teaching performance could impede subsequent performance.