How should we train consultant appraisers? Description and evaluation of a pilot training model developed in Scotland.

OBJECTIVES: This paper outlines a model developed by NHS Education for Scotland to pilot consultant appraiser training. The training was aimed at both new/inexperienced appraisers and experienced appraisers. A Course for New/Inexperienced Appraisers was held over 2 days and the Experienced Course over 1 day. Both are described, as is an initial tutor induction day designed to recruit consultant tutors who could contribute to delivering the courses. A thorough qualitative evaluation of the courses was undertaken and this is reported. The paper also discusses the desirability and implications of rolling out the pilot on a wider scale. METHOD: A qualitative evaluation design using interviews to collect feedback from participants who had attended all three courses - the Induction event, the Inexperienced Appraiser Course and the Experienced Appraiser Course - was employed. Telephone interviews were transcribed and analysed using framework analysis and aided by NVivo 7. RESULTS: The response of those interviewed for this evaluation of the three courses was very positive. The content, organization, skills of the tutors and usefulness of the courses were commended. Suggested improvements were relatively minor and included: introducing more material on the requirements of revalidation, more small group discussions and making the course more secondary care-orientated. However, it was recognized that with the requirements for 'enhanced' appraisal and revalidation still uncertain, this created difficulties and the course would evolve to take account of further developments. CONCLUSIONS: The training piloted represents an effective way to train consultants in appraisal skills. Interviewees were supportive of the pilot being continued: either nationally or cascaded down locally. Exactly what model is achievable and desirable will depend on the number of appraisers to be trained and the availability of resources to support 'enhanced' appraisal in secondary care.

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 appraisee's 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.

Verifying appraisal evidence using feedback from trained peers: views and experiences of Scottish GP appraisers.

BACKGROUND: GP appraisal is currently considered inadequate because it lacks robustness. Objective assessment of appraisal evidence is needed to enable judgements on professional performance to be made. AIM: To determine GP appraisers' views of the acceptability, feasibility, and educational impact of external peer feedback received on three core appraisal activities undertaken as part of this study. DESIGN OF STUDY: Independent peer review and cross-sectional postal questionnaire study. SETTING: NHS Scotland. METHOD: One of three core appraisal activities (criterion audit, significant event analysis, or video of consultations) was undertaken by GP appraisers and subjected to peer review by trained colleagues. A follow-up postal questionnaire elicited participants' views on the potential acceptability, feasibility, and educational impact of this approach. RESULTS: Of 164 appraisers, 80 agreed to participate; 67/80 (84%) submitted one of three appraisal materials for peer review and returned completed questionnaires. For significant event analyses (n = 44), most responders believed the peer feedback method was feasible (100%) and fair (92.5%) and would add value to appraisal (95.5%). Peer feedback on criterion audits (n = 15) was believed to be acceptable and fair (93.3%) and it was thought it would be a useful educational tool (100%). Completing a consultation video (n = 8) was perceived to be feasible as part of normal general practice (n = 5). It was unanimously agreed that assessment of videos by peers has educational impact and would help improve appraisal. CONCLUSION: This group of GP appraisers strongly supported the role of external and independent feedback by trained peers as one approach to strengthening the existing appraisal process.

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 NES's 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.