Appraisal:
Problems and Lessons Learnt
Dr Ruth Chapman
NHS England Regional
Appraisal Lead
BMA 07.04.15
Problems/areas for development
1. Summative vs formative
2. Standardisation
3. Supporting information
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1. Summative vs Formative
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2. Standardisation of appraisal
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Appraisers
• Resources
• Development
• Benchmarking
• Valuing the role
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Sharing of information/standards
National Appraisal Network
(4 Regional Leads)
DB Appraisal Leads
Appraiser groups
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QA appraisers
• Doctors feedback
• QA outputs
• 1:1s
• PDP
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ASPAT Audit
• Good scene setting, scope covered, revalidation
stage
• Strengths and achievements
• Statements refer to evidence
• Quality of evidence
• Challenge
• Details of feedback
• Documentation of reflection
• SMART PDPs, ?completed, link summary to PDP
• No patient/third party identifiable info
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3. Supporting information
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Planning the appraisal
• Timeline
• Communication
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Quality & quantity of SI
• 6 types: CPD, QIA, SEA, feedback x2, complaints
and compliments
• 50 hours/college recommendations
• Scope of work
• Reflection
• PDP
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Reflection
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Issues in appraisal
• Has reflected but just hasn’t documented – early recognition
prior to 1:1 is helpful but reflection can also been drawn out
within the conversation
• Has not been taught how to reflect
• Resistant, non-engager, lacking insight, arrogant
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Questions to prompt reflection
What went well?
What could have been done better?
How will this learning/case/experience affect me
personally and my practice?
How will it improve my patient care and how can I
demonstrate that objectively?
How can I disseminate this learning to my
colleagues?
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Supporting information
• Appraisers to sign post
• GMC and college guidance
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In summary
Problems/areas for development
1. Summative vs formative
2. Standardisation
3. Supporting information
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Thank you
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Any questions?
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Useful references
http://www.gmc-uk.org/
Supporting_information__for_appraisal_and_revalid
ation.pdf_48977650.pdf
http://www.londondeanery.ac.uk/professionaldevelopment/appraisal-and-revalidation-support/elearning/files/appraisal-and-revalidation-reflection/
view
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Mann K et al
Reflection and reflective practice in health professions
education: A systematic review
Adv in health sci educ (2009) 14:595-621
There is evidence of the value of reflection
Reflection can be measured
Reflective thinking can be developed with interventions
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GMC Good Medical Practice
The unacceptable GP;
has limited insight into the current state of his or her
knowledge or performance
The GMC, Good Medical Practice
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Boud et al. (1985) define reflection as…
‘‘a generic term for those intellectual and affective
activities in which individuals engage to explore
their experiences in order to lead to a new
understanding and appreciation’’
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GMC 2012
Commitment to improving practice tends to flourish where
reflective practice and quality improvement is actively
supported
MC 2012
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