Insightful practice: a reliable measure for medical revalidation

Abstract

BackgroundMedical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback.Setting and participants60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK.MethodsA feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory.Main outcome measuresCoverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation.ResultsFace-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83).ConclusionsUnlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed.

Pilot study assessing reflection ability of practicing Australian and New Zealand ophthalmologists using the Groningen Reflection Ability Scale

“…Developing a better understanding of one's individual reflection profile may assist in learning self-regulation (Sobral, 2001). Reflection has been proposed to be important in revalidation of medical licensure (Murphy et al 2012, Wittich et al 2014, and adopted worldwide by various professional bodies and medical regulators in continuing professional development and revalidation activities. Mandated professional development plans including demonstration of the learning cycle as a product of reflection can work as an appropriate vehicle for CPD (Institute of Medicine, 2010).…”

Exploring whether (and how) self-reflection can improve practice as a teacher educator

“…For example, appraisals (with reflective interviews with appraisers) have been chosen as the way to ensure ongoing competence for registration as a healthcare professional. This is quite prominent in the UK with bodies such as the General Nursing Council or the General Medical Council requiring annual or every five years appraisals to allow you to register for a license to practice (Archer and de Bere 2013;Bolsin et al 2015;Dawda 2013;Murphy et al 2012;Wright et al 2016). …”

The United Kingdom's Experience With and Future Plans for Revalidation

“…Feedback from colleagues and patients is collected using multisource feedback (MSF) approaches. 10 Various tools have been developed by Royal Colleges, 11,12 , academics. 13 , private companies, and the GMC themselves.…”