Individuals vary greatly in their skills as appraisers. The aim is to ensure that those variations are minimised and that every appraiser can demonstrate that their skills are sufficient for revalidation purposes. There are a number of ways to assess skills at appraisal.
You will have the opportunity for direct feedback at the appraisal meeting. It is sometimes difficult, or off putting, to directly question the doctor. It may however be obvious that someone is very happy at the end of a meeting. Conversely you may sense dissatisfaction and this can be addressed by probing. Questions such as “you seem uncomfortable, is it something I have said or we have discussed?” or “Now we have finished the appraisal, tell me how that made you feel”.
Post appraisal questionnaires may be used. Remember the appraisal has not finished until the doctor has agreed the appraisal summary. Obtaining feedback after the doctor has had time to reflect on the meeting and read their summary, may produce a more measured feedback. Anonymous collated feedback may be used. MARS gives every appraisee the opportunity to complete an electronic feedback form when they agree their appraisal summary. These are collated and may be fed back to the appraiser once a minimum of five appraisals are completed. They can be used personally by the appraiser and they also form part of the annual performance management discussion.
Reflection is a word that has different meanings to different people. Some doctors say they cannot reflect- improvement in performance is nigh on impossible without reflection. At its simplest, reflection is a process of thinking “what went on there?” and deciding “I should do this next time”. Those two questions could be used by an appraiser when reflecting on a recent appraisal.
Of course reflection can be far more structured and written reflection is sometimes advocated. Perhaps when the review of your appraisal work is due, writing down what you think you do well and why, would be a start. Moving on you could identify areas for change, writing them down and then think (or discuss) how you would instigate that change.
Have you ever been though a particularly good personal appraisal? If so write down why it was good. The opposite (writing down things that went less well) may also help you gain insight into behaviours or techniques that should be avoided.
There are many potential means of external scrutiny. Peer review – with another appraiser sitting in and observing would be one, video of appraisal another. Both methods have their advantages and drawbacks. The dynamics of the appraisal would likely be affected by such direct observation.
Scrutiny of the outputs (appraisal summary) is another way – the RSU has systems to capture and anonymise appraisal summaries (with the permission of the doctor). These anonymous summaries are then tested against quality criteria.
Dr Lynne Rees and Dr Mark Rowlands, two of the GP appraisal co-ordinators in Wales have developed an advanced tool for self or peer assessment of appraisal skills. The documentation is attached; this probably should be used after an appraiser gains experience and is a formative development tool.
Exercise continued on the next page.