Appraisal is not the same as assessment. For NHS UK GPs (for whom yearly appraisal is a contractual requirement) peer appraisal is least threatening when seen as a chat with a colleague about one's professional development.
What form does UK appraisal take?
Log on to http://www.appraisals.nhs.uk and complete 2 administrative forms (Forms 1&2); then there is Form 3 which needs some thought and data gathering (in protected time)with a commentary on your work, an account of how it has developed since your last appraisal, your view of your developmental needs, and cataloguing of factors which constrain you in achieving your aims. Sample questions:
- What are the main strengths and weaknesses of your clinical practice?
- How has the clinical care you provide improved since your last appraisal?
- What do you think are the clinical care development needs for the future?
- What factors constrain you in achieving your aims for your clinical work?
- What steps have you taken to improve your knowledge and skills?
- What have you found particularly successful or otherwise about these steps?
- What professional or personal factors constrain you in maintaining and developing your skills and knowledge?
- How do you see your job and career developing over the next few years?
- What are your main strengths and weaknesses in your relationships with patients? How have these improved? What would you like to do better? What factors in the workplace (or more widely) constrain this?
- What are your main strengths and weaknesses in your relationships with colleagues? How have these improved? What would you like to do better? What factors in the workplace or more widely constrain this?
- Do you have any health-related issues which might put patients at risk?
Other areas
Teaching; financial probity; research; management activities.
During the appraisal Form 4 is completed and signed by the assessor and the assessee. In anonymized format, Form 4 feeds through to Clinical Governance Leads, who identify trends, and makes a report to the Chief Executive of his or her Primary Care Organization. Form 5 is a non-obligatory form containing background ideas supporting Form 4 which may be used to inform subsequent appraisals. Finally there is a mechanism for supportive follow-up (eg a further visit or phone call).
In the words of the chief medical officer, appraisal is a positive and supportive developmental process, a constructive dialogue structured in such a way that those being appraised have the opportunity to reflect on their work and consider any developmental needs. It gives individuals the chance to assess their career path and consider how they might gain more job satisfaction from their current role. And by giving feedback on performance it provides the opportunity both to identify any factors that adversely affect performance, and to consider how to minimize or eliminate their effects. It is an important building block in a clinical governance culture that ensures high standards and the best possible patient care.http://www.doh.gov.uk/cmo/cmo0203.htm
There is a big question-mark over ensures, above. The effect of appraisal on patient care is unknownbut, appraisal, it is hoped (and it only is a hope) can offer opportunities, for interdependent support, self-education, self- motivation, and career development in the wider medical world. It may also be a catalyst for change and even a tonic against complacency.
Appraisal only makes sense assuming that GPs want to be good, professional, life-long learners. If this is not the case, the less soft realms of revalidation, performance management/assessment will bite.
Revalidation
(eg every 4-5yrs) gives authority to continue practicing, and to some extent guarantees public safety. Appraisals feed into this process.
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