The International Council of Ophthalmology 360-degree assessment tool: development and validation Ana Gabriela Palis, MD, ⁎ Karl Clifford Golnik, MD, MEd, †,‡ Eduardo Pedro Mayorga, MD, ⁎ Helena Prior Filipe, MD, MSc, §,║ Prashant Garg, MD ¶ ABSTRACT ● Background: The Accreditation Council for Graduate Medical Education and other organizations recommend 360-degree assess- ments for evaluation of interpersonal and communication skills, professional behaviours, and some aspects of patient care and system-based practice. No such tool has been developed for ophthalmology or received international content validation. Objective: To develop a valid, internationally applicable, ophthalmology-specific 360-degree assessment tool. Design: Exploratory study. Methods: A literature review was conducted. Individual 360-degree evaluation items from several publications were catalogued and classified according to different groups of assessors. A panel of international authors reviewed the list and voted on items that were most appropriate for international use. The list was trimmed to reduce redundancy and to make it as brief as possible while still capturing the essential components for each category. A second panel of international ophthalmic educators reviewed the international applicability and appropriateness of this collated list; relevant comments and suggestions were incorporated. Results: A tool for the evaluation of interpersonal and communication skills, professionalism, and system–based practice was developed. The tool has face and content validity. Conclusion: This assessment tool can be used internationally for giving formative feedback based on the opinions of the different groups of people who interact with residents. The need to assess medical competence has recently driven the development of tools that provide a more valid evaluation of many aspects of medical competence. Accrediting bodies and organizations around the world have recommended the use of multisource (also called 360-degree) assessment tools to provide physicians in training (e.g., residents) with feedback about how they are performing and, consequently, to improve their performance. The 360-degree assessments of residents consist of questionnaires that are completed by groups of assessors who have interacted with residents (e.g., peer residents, patients, medical students, coworkers–nurses, technicians). Recent publications recommend the use of 360-degree assessments as particularly good for the evaluation of what are commonly called the “soft” competencies, that is, those that are more subjective to assess (e.g., interpersonal and communication skills and professionalism). 1–4 The International Council of Ophthalmology (ICO) has defined as part of its mission “to enhance ophthalmic education to improve eye care and contribute to the preservation and restoration of vision around the world.” 5 To fulfil this commitment, the ICO offers educational programs and initiatives to invigorate and support oph- thalmic education, especially in developing countries. As part of these initiatives, the ICO, in conjunction with its member national societies and supranational societies, has organized several Residency Program Director Courses and Regional Conferences for Educators around the world (over 50 meetings in the last decade), which gather ophthalmic educators to discuss, inform, and receive training on modern educational strategies and tools. Informal requests for internationally valid assessment tools have led to the development of surgical skill rubrics designed to more objectively assess and teach a variety of surgical skills. These tools were created by international panels of experts and are known as the ICO-Ophthalmol- ogy Surgical Competency Assessment Rubrics (ICO- OSCARs). 6–10 They have been translated into multiple languages and are available at the ICO Center for Ophthalmic Educators web site (www.educators.icoph. org). Similar requests for a globally applicable multisource assessment tool designed specifically for ophthalmologists in training stimulated the creation of the ICO 360-degree assessment tool. The purpose of this study is to describe how this tool was developed and validated. METHODS A literature review on 360-degree assessments in the health professions was conducted, and publications relevant to ophthalmology were selected by the authors, 5 ophthalmologists on the ICO Education Committee practicing in different backgrounds (Argentina, India, Por- tugal, and the United States). All members of the panel have more than 10 years of experience in residents’ education. & 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jcjo.2017.09.002 ISSN 0008-4182/17 CAN J OPHTHALMOL —VOL. ], NO. ], ] 2017 1