The benefits of appraisal: a critical (re)view of the literature

Abstract

It has been acknowledged that little is known about the impact of general practice (GP) appraisal on clinical and professional practice, as may be demonstrated by identifiable or 'hard' outcomes, and further, that the way in which appraisal informs professional development is unclear. In spite of this acknowledgement and the existence of a substantial number of studies about GP appraisal, to date an overview of the field of enquiry which maps what is known, has been lacking. In this leading article we present the first extensive thematic narrative synthesis of the literature on appraisal. In it we highlight the issues and tensions around research into appraisal, based on what we found (or didn't find) in our review. Key conclusions concern the focus of existing research - which has tended to report the perceptions of change from individual appraisees, rather than specific examples of change captured from other sources and perspectives - and the scope of research - which has been limited to certain data collection methods. Based upon our review, we draw out implications for research and researchers in the future.

GP appraisal: an evaluation of generational differences on the utility of GP appraisal

“…Appraisals may have less perceived benefit in interaction with patients and colleagues than other aspects of appraisal although the percentage in our study was less than that in a previous paper [1] which may suggest that this aspect reflects changes in the RCGP guidance on appraisal in 2016 in elevating quality over quantity in the evidence submitted at annual appraisal. The burden of preparing for appraisal has been noted in previous studies [2,5,9,10] was reported as too high by both cohorts in our study.…”

“…Scallan et al [10] identified surveys of appraisal as a 'snapshot' of data and that a clear link between the process of appraisal and the impact on clinical practice/ quality of care had not been established and cautioned against the roll-out of appraisals to other professions before effectiveness had been demonstrated. We support this conclusion and while our survey does not provide the evidence, it does confirm the need to reconsider the value of appraisals when many doctors find the process burdensome.…”

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

“…Despite the increased importance of the appraisal process to the medical profession, and the change in nature of medical appraisal, there is little understanding of the theory of how and why appraisal is supposed to improve doctors' performance. Scallan et al's scoping review of the literature on appraisal found that to date the literature has mainly focused on: ‘engagement’ from the perspective of the doctor being appraised; exploration of different models of appraisal (internal versus external appraisal, peer and practice appraisal, and appraisal for revalidation); the benefits of appraisal; GPs' perceptions of the problematic link between appraisal and performance assessment or revalidation; administrative and management issues; and developing appraisers' skills.…”

Evaluation of misrepresented findings in the abstracts of acute respiratory distress syndrome randomised trials with nonsignificant primary endpoints

“…One of the goals of graduate medical education is to train physicians to critically appraise the literature so they can practice evidence‐based medicine 28 . Both the quality and quantity of scholarly activity being pursued is highly variable among physicians and evidence suggests that more education is needed to improve accurate appraisal of the literature, including and especially in the area of spin 29,30 …”