Reflecting upon multisource feedback as ‘assessment for learning’

from novice through advanced beginner to competence [3], in multiple domains of clinical performance (e.g., the various CanMeds roles) [4]. Assessment with feedback of specific performance in each domain provides the information and guidance which learners require to know how best to progress to the next level or milestone of performance. Multisource feedback is particularly suited to assessing and providing feedback in domains of practice other than the ‘medical expert’; e.g., the communicator, collaborator, professional roles. The MSF performance data can be provided quantitatively using the mean scores of reviewers’ scores, and qualitatively by including narrative reviewer comments. Ten Cate and colleagues report that residents found the narrative comments, offered as ‘tips’ for improvement and ‘tops’ identifying strengths, were much more helpful than the numerical scores. This is important and supports earlier findings about formative feedback; i.e., that narrative comments can provide specific and relevant observations which can inform how and what to improve, while numerical scores can only identify the presence or absence of a performance gap or a need to improve [5]. Seen in this way, MSF which includes narrative comments can prove useful for learning and improvement and in fact, for various reasons as Ten Cate et al. explain, is better suited for formative feedback than summative. Some models of MSF include a self-assessment questionnaire in addition to questionnaires completed by reviewers. The Dutch model described in this article does not include such a questionnaire and participating programme directors suggested that adding one could be helpful. There are several benefits to adding a specific self-assessment questionnaire comprised of the same items as those completed by reviewers. Research has shown that the presence of the learner’s self-assessment provides additional information as it tells the supervisor how accurately the learner is able The paper by Olle ten Cate et al. on ‘User reception of a simple online multisource feedback tool for residents’ in this issue is a welcome segue into considering how best to use multisource feedback (MSF) in education, especially for residents [1]. For a number of years, Ten Cate has maintained an MSF website for Dutch programme directors and their residents, to enable residents to receive formative feedback from medical colleagues, other health care practitioners and patients. The nationwide offering of MSF is innovative and impressive, and provides an opportunity for reflection from several perspectives. One is seeing MSF through the lens of formative assessment and ‘assessment for learning’, not solely ‘assessment of learning’. Another is consideration of the potential value of adding a self-assessment questionnaire for residents to complete, and the contribution that this might make to the overall impact of the report. A third perspective for consideration is the feedback conversation which occurs between programme directors and their residents about their MSF reports’ and the influence which these conversations may have upon residents’ learning from their reports. Each of these is discussed in more detail below. As educators we are becoming increasingly aware of our obligation to provide assessment for learning as well as of learning [2]. The notion of assessment for learning appears to fit particularly well with the tenets of competency-based medical education. In competency-based education we think of learners as progressing through various stages or levels