Medical appraisal and revalidation: can it improve patient care?

Caesar, Susi; Locke, Rachel; Scallan, Samantha

doi:10.1080/14739879.2013.11494208

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…The skills of the appraiser (context) were reported as being crucial to an effective appraisal . The success of appraisal partially depends on the quality of the feedback provided by the appraiser .…”

Section: Resultsmentioning

confidence: 99%

“…The skills of the appraiser (context) were reported as being crucial to an effective appraisal. 14,33,34,[47][48][49][50][51][52] The success of appraisal partially depends on the quality of the feedback provided by the appraiser. 50 Thus if the appraiser is highly skilled (context) and able to effectively deliver feedback (context), this triggers the dissonance mechanism, which is more likely to lead to the appraisee developing insight (outcome).…”

Section: Dissonancementioning

confidence: 99%

See 1 more Smart Citation

Towards an understanding of how appraisal of doctors produces its effects: a realist review

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Section: Dissonancementioning

confidence: 99%

Towards an understanding of how appraisal of doctors produces its effects: a realist review

et al. 2017

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“…This study specifically explores SI from the perspective of the appraiser, often neglected in previous studies [ 20 , 21 ]. This was a unique opportunity to access a cadre of highly experienced appraisers and their appraisees at the forefront of revalidation; a group not only able to report their own experiences about SI in appraisal but meaningfully reflect on how the process may affect the doctors under their remit.…”

Section: Introductionmentioning

confidence: 99%

Paper trials: a qualitative study exploring the place of portfolios in making revalidation recommendations for Responsible Officers

et al. 2016

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BackgroundA portfolio of supporting information (SI) reflecting a doctor’s entire medical practice is now a central aspect of UK appraisal for revalidation. Medical revalidation, introduced in 2012, is an assessment of a doctor’s competence and passing results in a five yearly license to practice medicine. It assesses of a doctor’s professional development, workplace performance and reflection and aims to provide assurance that doctors are up-to-date and fit to practice. The dominant assessment mechanism is a portfolio. The content of the revalidation portfolio has been increasingly prescribed and the assessment of the SI is a fundamental aspect of the appraisal process which ultimately allows Responsible Officers (ROs) to make recommendations on revalidation. ROs, themselves doctors, were the first to undergo UK revalidation. This qualitative study explored the perceptions of ROs and their appraisers about the use of this portfolio of evidence in a summative revalidation appraisal.Methods28 purposefully sampled London ROs were interviewed following their revalidation appraisal and 17 of their appraisers participated in focus groups and interviews. Thematic analysis was used to identify commonalities and differences of experience.ResultsSI was mostly easy to provide but there were challenges in gathering certain aspects. ROs did not understand in what quantities they should supply SI or what it should look like. Appraisers were concerned about making robust judgements based on the evidence supplied. A lack of reflection from the process of collating SI and preparing for appraisal was noted and learning came more from the appraisal interview itself.ConclusionsMore explicit guidance must be available to both appraisee and appraiser about what SI is required, how much, how it should be used and, how it will be assessed. The role of SI in professional learning and revalidation must be clarified and further empirical research is required to examine how best to use this evidence to make judgments as part of this type of appraisal.

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“…Supplementary data from interviews with the doctors concerned and their appraisers helped to provide context and additional insights into the gathering and discussion of supporting information. While other studies have examined appraisal summaries and PDPs, 24 and assessed patient and colleague feedback gathered by GPs, 25 to our knowledge this is the first full analysis of portfolios for revalidation.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, there is little indication of reflection/resultant change to practice. For example, a locum GP used the CARE 23 questionnaire, obtained 29 responses, wrote a reflective piece on the results but planned no changes as they were satisfied with the feedback. A consultant in Mental Health (R0030) included only seven patient feedback forms, but again the feedback was good and no changes were planned.…”

Section: Supporting Information Prompting Changes To Practicementioning

confidence: 99%

Reflective Practice for Patient Benefit: An Analysis of Doctors' Appraisal Portfolios in Scotland

Wakeling

Holmes

Boyd

et al. 2019

J Contin Educ Health Prof

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Introduction: Reflective practice has become the cornerstone of continuing professional development for doctors, with the expectation that it helps to develop and sustain the workforce for patient benefit. Annual appraisal is mandatory for all practising doctors in the UK as part of medical revalidation. Doctors submit a portfolio of supporting information forming the basis of their appraisal discussion where reflection on the information is mandated and evaluated by a colleague, acting as an appraiser. Methods: Using an in-depth case study approach, eighteen online portfolios in Scotland were examined with a template developed to record the types of supporting information submitted and how far these showed reflection and/or changes to practice. Data from semi-structured interviews with the doctors (n=17) and their appraisers (n=9) were used to contextualise and broaden our understanding of the portfolios. Results: Portfolios generally showed little written reflection and most doctors were unenthusiastic about documenting reflective practice. Appraisals provided a forum for 2 2 verbal reflection, which was often detailed in the appraisal summary. Portfolio examples showed that reflecting on continued professional development, audits, significant events and colleague multi-source feedback were all felt to be useful. Reflecting on patient feedback was seen as less valuable because feedback tended to be uncritical. Conclusion: The written reflection element of educational portfolios needs to be carefully considered, since it is clear that many doctors do not find it a helpful exercise. Instead, using the portfolio to record topics covered by a reflective discussion with a facilitator would not only prove more amenable to many doctors, but would also allay fears of documentary evidence being used in litigation.

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Medical appraisal and revalidation: can it improve patient care?

Cited by 5 publications

References 15 publications

Towards an understanding of how appraisal of doctors produces its effects: a realist review

Towards an understanding of how appraisal of doctors produces its effects: a realist review

Paper trials: a qualitative study exploring the place of portfolios in making revalidation recommendations for Responsible Officers

Reflective Practice for Patient Benefit: An Analysis of Doctors' Appraisal Portfolios in Scotland

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