Read again: What you need to know about appraisals

What are appraisals for? And what should be included in portfolios to make the system as time-efficient and effective as possible?

CREDIT: This is an edited version of an article that originally appeared on Medscape

Primarily, appraisals serve to provide support to the appraisee. This is exemplified by the Academy of Medical Royal Colleges’ (AOMRC) insightful depiction of the appraisal’s objectives:

“The primary focus of the appraisal process is to facilitate the professional and personal growth of the physician. To achieve this, the appraisal must establish a secure and confidential environment where physicians can assess their accomplishments, challenges, and aspirations. Through participation in the appraisal, physicians exhibit the crucial professional behaviour of learning through reflection. This reflection should encompass the entirety of their work, whether in direct clinical service, education and training, research, or the broader domain of ‘health policy’.”

Streamlining Administrative Aspects

Given the aim of supporting appraisees, the administrative facet of appraisals should not be excessively burdensome. Notably, this aspect has significantly improved in recent times. The Royal College of General Practitioners suggests that appraisees should not devote more than half an hour to gather supporting information and update their portfolios in preparation for an appraisal.

The impact of the COVID-19 pandemic led to an adjustment in the appraisal process, placing greater emphasis on professional development and well-being. This modification, initially prompted by the pandemic, has been formally incorporated into the 2022 guidance following positive feedback from an NHS England survey.

Pre-Appraisal Preparations

Typically, personal information and the nature of one’s work require minimal updating. Thus, the pre-appraisal process primarily involves the appraisee selectively collecting supportive data and documenting:

• Recent challenges, achievements, and aspirations

• Reflections on personal and professional well-being

• Progress in relation to the personal development plan since the last appraisal

This pre-appraisal preparation aids self-evaluation facilitates a comprehensive overview for appraisers, and guides discussions during the appraisal itself.

Required Information for Appraisals

As outlined by the GMC, the information GPs should bring to their appraisal can be categorised into four sections:

•General information: Providing context about various aspects of work.

• Keeping up to date: Enhancing the quality of professional work.

• Practice review: Evaluating and enhancing the quality of professional work.

• Practice feedback: Seeking and acting on feedback about the quality of professional work.

Debunking Myths Surrounding Appraisals and Portfolio Requirements

‘Five Appraisals in Five Years for Revalidation’

The GMC underscores that missing annual appraisals due to clear and reasonable mitigating circumstances is permissible. Completing five appraisals is not an absolute requirement for revalidation.

‘Annual Audit for Revalidation’

While an annual audit is commonly associated with appraisal, other forms of quality improvement activity (QIA) can fulfil this role. Case reviews, learning event analysis, performance evaluation, and teaching effectiveness assessment also qualify as QIA.

‘Documenting Mandatory Training’

Training such as basic life support, safeguarding, and mandatory requirements falls under the purview of employers, not appraisers. While documentation might be beneficial for future job applications, it is not mandatory for appraisal.

‘Hours of Learning for Revalidation’

The GMC no longer requires counting CPD hours or points. Instead, reflection on diverse activities like lectures, articles, guidelines, and interactions constitutes CPD. Certificates are not mandatory for proving CPD.

‘Extensive Reflection is Essential’

Quality prevails over quantity in supporting information and reflection. The GMC advises against accumulating excessive examples of similar skills-related reflection.

Effective Reflection Methods

Keeping a record of reflections throughout the year simplifies the appraisal process. The “What? So what? Now what?” model, involving describing events, understanding their significance, and proposing future steps, is a practical approach.

Documenting Reflection

Various methods can be employed for documenting reflections, such as the Guidelines in Practice Reflection Record. The objective is to capture meaningful insights, enhancing the appraisal portfolio’s quality and relevance.