​This study evaluates how residents' evaluations and self-evaluations of surgeon’s teaching performance evolve after two cycles of evaluation, reporting, and feedback. Furthermore, the influence of over- and underestimating own performance on subsequent teaching performance was investigated.

In a multi-center cohort study, 351 surgeons evaluated themselves and were also evaluated by residents during annual evaluation periods for three subsequent years. At the end of each evaluation period, surgeons received a personal report summarizing the residents' feedback. Changes in each surgeon's teaching performance evaluated on a five-point scale were studied using growth models. The effect of surgeons over- or underestimating their own performance on the improvement of teaching performance was studied using adjusted multivariable regressions. Compared with the first and second evaluation period, residents evaluated surgeon's teaching performance higher during the third evaluation period. Surgeons did not alter self-evaluation scores over the three periods. Surgeons who overestimated their teaching performance received lower subsequent performance scores by residents and self. Surgeons who underestimated their performance subsequently scored themselves higher, but were evaluated equally by residents. Residents' evaluation of surgeon's teaching performance was enhanced after two cycles of evaluation, reporting, and feedback. Overestimating own teaching performance could impede subsequent performance.