360 degree assessment in Family Medicine Residency: perception of citizen-users and preceptors

Introduction:

In the context of Family Medicine Residency (FMR), assessment tools aimed at improving resident physician training should be (re)constructed in the daily routine of healthcare services. The 360-degree or multi-source assessment stands out as it involves the participation of team professionals, patients, and the resident physician, guided by the preceptor.

Objective:

To analyze the 360-degree assessment in FMR from the perspective of citizen-users and preceptors.

Method:

A qualitative approach study (case study), approved by a Research Ethics Committee. It was conducted in Primary Health Care (PHC) Units in two municipalities of Rio Grande do Sul, where the residents worked. The sample was intentional. Semi-structured individual interviews, recorded and transcribed, were conducted with citizen-users treated by the residents and with the two medical preceptors. The sample size for citizen-users was defined based on the theoretical saturation criteria combined with the analysis of the density of the textual material produced. Contextual data from participants were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis.

Results:

The study included 17 citizen-users and two preceptors. The 360-degree assessment was recognized as an evaluation tool that fosters and values popular protagonism. Citizen-users perceived that by participating in the resident’s evaluation, changes in the resident physician’s conduct could occur. In this participatory process, they felt privileged and as contributors to the resident physician’s work. Preceptors recognized that the participation of users and the team in the resident’s evaluation process contributes to the assessment and strengthens the relationship between the team, residents, and users, as well as interprofessional work in PHC. Challenges were observed in conducting the resident’s assessment by team professionals due to the work routine and in the management of the feedback process by preceptors. An adequate environment and strong bonds between preceptors and residents were considered facilitators of feedback.

Conclusion:

The 360-degree assessment proved to be an effective educational evaluation strategy in training the healthcare workforce. It provides an opportunity for resident physicians to develop, recognize their mistakes, and become closer to both users and the healthcare team. Further research is recommended, including the perceptions of residents, healthcare teams, and managers.

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