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Colleague feedback questionnaire

A diverse group of healthcare professionals gathered in a discussion, with emphasis on collaboration and feedback exchange in a clinical setting.

Colleague Feedback Questionnaire

Engage in a comprehensive colleague feedback questionnaire designed for licensed doctors. This survey aims to enhance professional development by gathering insights from peers about key clinical competencies.

Key features of the questionnaire include:

Assessment of clinical knowledge and decision-making skills
Evaluation of communication and teamwork
Insights into teaching and supervising abilities

28 Questions7 MinutesCreated by EvaluatingExpert37

Licensed doctors are expected to seek feedback from colleagues and review and act upon that feedback where appropriate. The purpose of this exercise is to provide doctors with information about their work through the eyes of those they work with, and is intended to help inform their further development. Please do not write your name on this questionnaire. No one will be identified when this information is given back to the doctor.

Please answer all the questions. If you feel you cannot answer any question, please tick ‘Don’t know’.

Date:

Please rate your colleague in each of the following areas by ticking one box in each line.

1 Clinical knowledge

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

2 Diagnosis

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

3 Clinical decision making

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

4 Treatment (including practical procedures)

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

5 Prescribing

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

6 Medical record keeping

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don't know

7 Recognising and working within limitations

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

8 Keeping knowledge and skills up to date

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

9 Reviewing and reflecting on own performance

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

10 Teaching (students, trainees, others)

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

11 Supervising colleagues

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

12 Commitment to care and wellbeing of patients

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

13 Communication with patients and relatives

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

14 Working effectively with colleagues

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

15 Effective time management

Poor

Less than satisfactory

Satisfactory

Good

Very good

Don’t know

Please decide how far you agree with the following statements by ticking one box in each line.

16 This doctor respects patient confidentiality

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Don’t know

17 This doctor is honest and trustworthy

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Don’t know

18 This doctor’s performance is not impaired by ill health

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Don’t know

19 This doctor is fit to practise medicine

Yes

Don’t know

20 Please add any other comments you want to make about this doctor

The next questions will give us some information about who took part in the survey.

21 What is your role?

Doctor

Registered Nurse

Health Care Assistant

Allied Healthcare Professional

Health Visitor/Midwife

Administrator/Receptionist/Secretary

Non-clinical Manager

Pharmacist

Other

22 How recently have you been familiar with this doctor’s practice?

Current colleague

Within the last 2 years

2 - 5 years ago

6 - 10 years ago

10+ years ago

23 How often do you have contact with the doctor?

Most days

Weekly

Monthly

Less often

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