Niall Cameron

GP peer appraisal in Scotland: an ongoing and developing exercise in quality.

GP appraisal in Scotland is a strong and vibrant process. Not least this is due to NESs commitment to the ongoing development of its appraisers. Research suggests that the key to effective appraisal is the skill of the appraiser. Training in Scotland has developed using feedback from a wide range of sources. The move from information-based courses towards skills-based courses enhances appraiser development and allows the effective evaluation of appraiser competencies. With appraisal becoming a key element in the revalidation process the quality assurance of appraisal and appraisers becomes increasingly important.

A review of further training for GP appraisers in Scotland.

A one-day further intensive skills (FIS) course has been developed to provide additional training for existing general practitioner (GP) appraisers in Scotland. The course focuses on skills in developing the appraisees personal development portfolio (PDP) and skills in responding to significant issues (with emotional content) presented by appraisees - both key areas for effective appraisals. The course is briefly described. An initial pilot of the course led to some changes being made to the content, as it was discovered that the inclusion of training on Summary Form completion in the pilot made the course too dense and distracted from the experiential elements of the training. Two subsequent course deliveries were evaluated by conducting semi-structured interviews with over 40% of the participants from these two courses. The main purpose of the evaluation was to discover to what extent the participants felt they had benefited from the training and whether they felt the training had led to any changes in their practice as appraisers. Secondary aims were to discover the acceptability of the use of video recording as a training technique and views regarding a reaccreditation process for appraisers. Key findings were that almost all participants found this training beneficial and judged it to have led to positive changes in their practice, as well as reassuring them that their skills were up to scratch. Some appraisers felt that it had encouraged a slightly more challenging approach. The acceptability of the use of video recording during the training, as a means of allowing participants to gain further benefit from the work undertaken after the course was finished, was tested. This technique received a mixed response, with opinion divided as to whether it added value. Opinion amongst the participants was also mixed regarding whether this training should contribute towards their reaccreditation as appraisers. However, a number of participants felt this could be a valid element in an appraiser reaccreditation process.

What Factors Impact on General Practitioners’ Engagement with Appraisal? A Qualitative Evaluation In Scotland

Although appraisal has gained acceptance as a supportive and developmental process, it has been proposed that it should become an explicitly summative element of revalidation. This study aimed to explore the views of general practitioners (GPs) in Scotland about appraisal in the light of the proposed changes. The method used semi-structured interviews with a sample of 18 GPs who have undergone appraisal at practices throughout Scotland. The interviews were transcribed in full and a thematic analysis conducted. The study showed that the majority of interviewees derive some benefit from appraisal – mostly in planning learning needs and through the support provided by a confidential discussion with Education for Primary Care (2008) 19: 615–23 # 2008 Radcliffe Publishing Limited

Enhancing Communication Skills by Peer Review of Consultation Videos

This paper describes an intervention designed to encourage general practitioners (GPs) to develop their communication skills and participate in analysis of videorecordings of their consultations. The need to develop communication skills teaching has long been recognised by providers of medical education. Videorecording of consultations offers one method of permitting reflection and analysis by individual doctors and provides material that can be submitted for external peer review. However, experience in this area is limited and the number of doctors involved in this type of educational activity has been small. Education for Primary Care (2006) 17: 40–48 # 2006 Radcliffe Publishing Limited

What are the concerns of prospective responsible officers about their role in medical revalidation

Introduction  The Health and Social Care Act 2008 sets out the requirement for the introduction of responsible officers for the NHS. The paper states that these individuals will be responsible for ensuring that doctors who are revalidated meet the required standards. It is not known how well prepared prospective responsible officers are for their new role. Methods  Semi-structured interviews were conducted with 12 medical directors from Scottish health boards who agreed to participate. Results  Prospective responsible officers remain uncertain about their role in medical revalidation. Specific concerns were raised: (1) What will responsible officers be responsible for? (2) How can appraisal be quality assured? (3) How will the information requirements for revalidation be met? and (4) How can organizations meet the requirement for revalidation? Conclusion  We found important issues regarding the arrangements for revalidation which have not previously been described which may impact on the effectiveness of prospective responsible officers.INTRODUCTION The Health and Social Care Act 2008 sets out the requirement for the introduction of responsible officers for the NHS. The paper states that these individuals will be responsible for ensuring that doctors who are revalidated meet the required standards. It is not known how well prepared prospective responsible officers are for their new role. METHODS Semi-structured interviews were conducted with 12 medical directors from Scottish health boards who agreed to participate. RESULTS Prospective responsible officers remain uncertain about their role in medical revalidation. Specific concerns were raised: (1) What will responsible officers be responsible for? (2) How can appraisal be quality assured? (3) How will the information requirements for revalidation be met? and (4) How can organizations meet the requirement for revalidation? CONCLUSION We found important issues regarding the arrangements for revalidation which have not previously been described which may impact on the effectiveness of prospective responsible officers.

Appraisal; the next steps?

ABSTRACT Appraisal offers an opportunity for both the clinician and the employer to demonstrate commitment to their professional responsibilities in a tangible manner that can benefit patients, the individual clinician and the service. One unintentional consequence of revalidation may have been to foster a belief that it has undermined the educational and developmental aspects of appraisal. The objective of promoting transparency and accountability through revalidation may have led some clinicians to feel they work in a culture of greater scrutiny and assessment, leading to an erosion of their engagement with the process. Some appraisers previously comfortable with the educational and supportive ethos of appraisal may be less likely to continue in that role if they are viewed or see themselves as GMC assessors. Priorities include a need for research to evaluate the impact and outcomes of appraisal and revalidation, to evaluate how appraisal can meaningfully feed into improving patient care and the contribution that medical education can make to the process.

What are the concerns of prospective responsible officers about their role in medical revalidation?: Role in medical revalidation

Introduction  The Health and Social Care Act 2008 sets out the requirement for the introduction of responsible officers for the NHS. The paper states that these individuals will be responsible for ensuring that doctors who are revalidated meet the required standards. It is not known how well prepared prospective responsible officers are for their new role. Methods  Semi-structured interviews were conducted with 12 medical directors from Scottish health boards who agreed to participate. Results  Prospective responsible officers remain uncertain about their role in medical revalidation. Specific concerns were raised: (1) What will responsible officers be responsible for? (2) How can appraisal be quality assured? (3) How will the information requirements for revalidation be met? and (4) How can organizations meet the requirement for revalidation? Conclusion  We found important issues regarding the arrangements for revalidation which have not previously been described which may impact on the effectiveness of prospective responsible officers.INTRODUCTION The Health and Social Care Act 2008 sets out the requirement for the introduction of responsible officers for the NHS. The paper states that these individuals will be responsible for ensuring that doctors who are revalidated meet the required standards. It is not known how well prepared prospective responsible officers are for their new role. METHODS Semi-structured interviews were conducted with 12 medical directors from Scottish health boards who agreed to participate. RESULTS Prospective responsible officers remain uncertain about their role in medical revalidation. Specific concerns were raised: (1) What will responsible officers be responsible for? (2) How can appraisal be quality assured? (3) How will the information requirements for revalidation be met? and (4) How can organizations meet the requirement for revalidation? CONCLUSION We found important issues regarding the arrangements for revalidation which have not previously been described which may impact on the effectiveness of prospective responsible officers.