1. Mr Mark Golder PhD, MB BChir [Cantab] FRCS [Gen]
A Practical Approach To Appraisals
Mr Mark Golder PhD, MB BChir [Cantab] FRCS [Gen]
General and Colorectal Surgeon
Senior Medical Appraiser
BMA presentation

2. Aims Overall approach to an appraisal An Appraiser’s appraisal
Appraisal quality assurance
Reflection on activities across the 4 Domains of GMP
PDP
Patterns of risk

3. Approach and Framing Support and motivate
Positive experience – avoid confrontation, criticism or negative statements, including on appraisal outputs
Guide / challenge / facilitate reflection
Patient safety
PDP

4. The Appraiser’s Appraisal
Domain 1: update workshops, appraiser network meetings, courses plus reflection, add to PDP
Domain 2: audit of appraisal outputs, complaints, SE’s, plus reflection, add to PDP
Domains 3 and 4: formal appraisee feedback questionnaires plus reflection, add to PDP

10. Good Medical Practice Surveys .com

11. 1.1.1 Setting the scene and overview of supporting information
1.1.2 Reflection and effective learning
1.1.3 The PDP and developmental progress
1.1.4 General standards and revalidation readiness
TOTAL SCORE (OUT OF 50)

12. Reflection

13. Reflection
The General Medical Council’s core guidance, Good Medical Practice, requires doctors to “reflect regularly on [their] standards of medical practice, and evidence of personal reflection is critical for revalidation. Appraisal, personal learning plans, assessment of critical incidents, and educational portfolios are just a few of the areas in which doctors are encouraged to reflect.

14. Reflection Linking past, present, and future experience
Integrating cognitive and emotional experience
Considering the experience from multiple perspectives
Reframing the experience
Stating the lessons learnt, and
Planning for future learning or behaviour
Hatton N, Smith D. Reflection in teacher education: towards definition and implementation. Teach Teach Educ  1995;11:33-49

15. Reflection Appraisees’ Approach

16. Reflection - Appraisees’ Approach
Domain 1 GMP
Evidence of CME / CPD
Written reflection – not just a topic heading
Verbal discussion / reflection / challenge
Add elements to PDP

17. Reflection - Appraisees’ Approach
Domain 2 GMP
Evidence of QIAs: Audit, CBDs, SIAs
Written details and reflection – need to demonstrate QI
Verbal discussion / reflection / challenge
Add elements to PDP

18. Reflection - Appraisees’ Approach
Domain 2 GMP
Evidence of Complaints and SEs – Letters / Incident reports / RCA
Written details and reflection – formulate plan for risk reduction
Verbal discussion / reflection / challenge
Add elements to PDP

19. Reflection – Appraisees’ Approach Complaints - recurring themes
Communication – verbal and written: advanced communication skills workshop, assertiveness/ conflict resolution course, emotional intelligence course
Team work vs working in isolation: leadership and team work courses
Consent: Material risk - Montgomery (Appellant) v Lanarkshire Health Board (Respondent) [2015]
Confidentiality: patient notes, computer screens and bed side curtains

20. Reflection – Appraisees’ Approach Significant events – recurring themes
Diagnoses (delayed / misdiagnoses): Imps vs differential diagnosis
Documentation / patient hand overs: medical record keeping, communication skills, time management, due diligence
Recognizing and working within limitations: team work, discussing [complex] cases, shared management, calling for help

21. Reflection – Appraisees’ Approach Domains 3 and 4 GMP
Evidence of MSF and patient feedback: survey company reports, references and compliments
Written reflection: strengths / potential weaker areas
“what”, “why” and “how”? - not just “what” the strengths are
Verbal discussion / reflection / challenge
Add elements to PDP

22. PDP

23. PDP - Appraisees’ Approach
There are clear links between the summary of discussion and the agreed PDP
The PDP has SMART objectives (specific, measurable, achievable, relevant, timely)
The PDP covers the doctor's whole scope of work and personal learning needs and goals
The PDP contains between 3-6 items

24. A Final Thought - Patterns of Risk
Recurring themes of Complaints and SE’s
Could we use the information gained from appraisals, to add to information collected from National Audits of Complaints and SE’s?