Feedback for general practice trainers: developing and testing a standardised instrument using the importance−quality−score method


Dr Norbert Donner-Banzhoff MHSc, Department of General Practice/Family Medicine, University of Marburg, Robert-Koch-Strasse 7A, D-35033 Marburg, Germany. Tel.: 00 49 6421 28 65119; Fax: 00 49 6421 28 65121; E-mail:


Introduction  Although general practice vocational training has been mandatory in Germany since 1993, a service philosophy still prevails. To help general practice trainers develop their identity and skills as trainers we developed and tested a standardised instrument. The questionnaire is to be filled in by registrars after their attachment to a given practice and handed to the trainer as personal feedback on the training provided.

Methods  Items were collected by asking experts in the field to name content that should be covered. The resulting items were reduced using the importance−quality method derived from health-related quality of life research. Reliability was tested by registrars rating their training twice 3 weeks apart. They also provided free text comments that were coded and analysed to establish criterion validity.

Results  A total of 121 items were collected. Eighty registrars provided importance and quality ratings to reduce these to 43 items. Test−re-test reliability and criterion validity were also established.

Conclusion  The importance−quality method proved to be useful for item reduction according to the objective of the questionnaire. Instruments evaluating the quality of vocational training must be context-sensitive.