Development and Validation of a Trustworthy Multisource Feedback Instrument to Support Nurse Appraisals

Abstract

Nurse appraisal is well established in the Western world because of its obvious educational advantages. Appraisal works best with many sources of information on performance. Multisource feedback (MSF) is widely used in business and in other clinical disciplines to provide such information. It has also been incorporated into nursing appraisals, but, so far, none of the instruments in use for nurses has been validated. We set out to develop an instrument aligned with the UK Knowledge and Skills Framework (KSF) and to evaluate its reliability and feasibility across a wide hospital-based nursing population. The KSF framework provided a content template. Focus groups developed an instrument based on consensus. The instrument was administered to all the nursing staff in 2 large NHS hospitals forming a single trust in London, England. We used generalizability analysis to estimate reliability, response rates and unstructured interviews to evaluate feasibility, and factor structure and correlation studies to evaluate validity. On a voluntary basis the response rate was moderate (60%). A failure to engage with information technology and employment-related concerns were commonly cited as reasons for not responding. In this population, 11 responses provided a profile with sufficient reliability to inform appraisal (G = 0.7). Performance on the instrument was closely and significantly correlated with performance on a KSF questionnaire. This is the first contemporary psychometric evaluation of an MSF instrument for nurses. MSF appears to be as valid and reliable as an assessment method to inform appraisal in nurses as it is in other health professional groups.