Colleague feedback questionnaire
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
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’.
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’.
Please rate your colleague in each of the following areas by ticking one box in each line.
Please rate your colleague in each of the following areas by ticking one box in each line.
4 Treatment (including practical procedures)
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
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
Please decide how far you agree with the following statements by ticking one box in each line.
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
The next questions will give us some information about who took part in the survey.
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
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