title: The impact of resident- and self-evaluations on surgeon's subsequent teaching performance.
abstract: 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.
authors.affiliation: Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands, b.c.boerebach@amc.uva.nl.
authors.forename: Benjamin C M
authors.initials: BC
authors.lastname: Boerebach
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
authors.forename: Maas Jan
authors.initials: MJ
authors.lastname: Heineman
authors.forename: Olivier R C
authors.initials: OR
authors.lastname: Busch
authors.forename: Kiki M J M H
authors.initials: KM
authors.lastname: Lombarts
mesh_terms: D015331:Cohort Studies; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007721:Knowledge of Results, Psychological; D011361:Professional Competence; D066231:Surgeons; D013663:Teaching