MSF Implementation Barriers

Raters without proper training may provide unbalanced or unhelpful feedback, reducing the tool's validity and perceived fairness. In settings where hierarchical structures are strong, power-related dynamics can impede honest evaluation from lower-status raters such as nurses rating doctors. Collecting, synthesising, and acting on feedback from multiple sources is time-consuming and adds to an already demanding residency schedule. Anonymous feedback may encourage harsh or unconstructive evaluations, creating morale problems and interpersonal tension. Structured educational initiatives, rater training, transparent role clarification, and time-efficient system design are the critical enablers for MSF adoption in postgraduate medical training.