Quality and impact of appraisal for revalidation: the perceptions of London’s responsible officers and their appraisers

BMC Medical Education

Celia Ingham Clark¹  Ray Field¹  Lorraine Noble³  Laura-Jane Smith³  Anju Verma³  Catherine O’Keeffe²  Deborah Gill³  Daniel S. Furmedge³  Ann Griffin³ 

[1] NHS England, London, UK;Health Education North West London, London, UK;University College London Medical School, 74 Huntley Street, London WC1E 6 AU, UK

关键词: Management;    Clinical governance;    Quality;    Appraisal;    Revalidation;   

Others  :  1228689
DOI  :  10.1186/s12909-015-0438-7

 received in 2014-06-20, accepted in 2015-09-11,  发布年份 2015

【 摘 要 】

Background

To evaluate NHS England London region’s approach to the revalidation appraisal of responsible officers in London, exploring perceptions of the quality and impact of the appraisal process. Revalidation is the process which aims to ensure doctors in the UK are up-to-date and fit to practice medicine thus improving the quality of patient care. Revalidation recommendations are largely premised on the documentation included in annual appraisals, which includes the professional development a doctor has undertaken and supporting information about their practice.

Methods

A pan-London qualitative study exploring the views of responsible officers and their appraisers about the revalidation appraisal process. The study aimed to gain an in-depth understanding of the experiences and perceptions of the participants. Responsible officers were purposefully sampled to represent the broadest range of designated bodies. Data analysis generated themes pertaining to quality and impact of appraisal for revalidation with the potential to feed into and shape the evolving system under investigation.

Results

The central importance of highly skilled appraisers was highlighted. Both groups reported educational opportunities embedded within the appraisal process. Independent appraisers, not matched by clinical speciality or place of work, were considered to take a more objective view of a responsible officer’s practice by providing an ‘outsider perspective’. However, covering the breadth of roles, in sufficient depth, was challenging. Participants reported a bias favouring the appraisal of the responsible officer role above others including clinical work. Appraisal and revalidation was perceived to have the potential to improve the healthcare standards and support both personal development and institutional quality improvement.

Conclusions

Responsible officers play a central role in the revalidation process. Getting responsible officer appraisal right is central to supporting those individuals to in turn support doctors and healthcare organisations in continuous quality improvement. The complexity and importance of the role of responsible officer may make achieving an appraisal of all roles of such individuals problematic. This evaluation suggests responsible officer appraisal was perceived as educational and effective.

【 授权许可】

   
2015 Griffin et al.

【 图 表 】

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【 参考文献 】

• [1]Good medical practice. General Medical Council, London; 2006.
• [2]General Medical Council. The good medical practice framework for appraisal and revalidation. 2013; Available from:. http://www. gmc-uk.org/The_Good_medical_practice_framework_for_appraisal_and_revalidation___DC5707.pdf_56235089.pdf webcite
• [3]Buckley G. Revalidation is the answer. BMJ. 1999; 319(7128):1145-6.
• [4]Charlton R, Coomber J, Thistlethwaite JE. Re-licensing of general practitioners using the current UK revalidation proposals: a cross sectional study. Postgrad Med J. 2011; 87(1034):807-13.
• [5]Revalidation Support Team. The early benefits and impact of medical revalidation: report on research findings in year one. Mar 2014. www. revalidationsupport.nhs.uk/CubeCore/.uploads/documents/pdf/Early_benefits_impact_medical_revalidation_report_March_2014.pdf webcite
• [6]Grol R. Improving the quality of medical care: building bridges among professional pride, payer profit and patient satisfaction. JAMA. 2001; 286(20):2578-85.
• [7]West M, Borrill C, Dawson J, Scully J, Carter M, Anelay S, et al. The link between the management of employees and patient mortality in acute hospitals. Int J Human Resour Manag. 2002;13(8):1299–310.
• [8]Sutherland K, Leatherman S. Regulation and quality improvement: a review of the evidence. The Health Foundation, London, UK; 2006.
• [9]Sutherland K, Leatherman S. Does certification improve medical standards? BMJ. 2006; 333:439-41.
• [10]General Medical Council. Ready for revalidation: Supporting information for appraisal and revalidation. 2012a; Available from:. http://www. gmc-uk.org/Supporting_information__for_appraisal_and_revalidation.pdf_48977650.pdf webcite
• [11]General Medical Council. Making revalidation recommendations: the GMC responsible officer protocol. 2012b; Available from:. http://www. gmc-uk.org/doctors/revalidation/13631.asp webcite
• [12]Eaton K, Brooks J, Patel R, Batchelor P, Merali F, Narain A. The impact of continuing professional development in dentistry: a literature review. 2011;. http://www. gdc-uk.org/Aboutus/policy/Documents/Impact%20Of%20CPD%20In%20Dentistry.pdf webcite
• [13]Mathers N, Mitchell C, Hunn A. A study to assess the impact of continuing professional development (CPD) on doctors’ performance and patient/service outcomes for the GMC. 2012; available at. http://www. gmcuk.org/A_study_to_assess_the_impact_of_continuing_professional_development__CPD__on_doctors__performance_and_patient_service_outcomes_for_the_GMC_51707533.pdf webcite
• [14]Esmail A. Failure to act on good intentions. BMJ. 2005; 330:1144-7.
• [15]Gordon M, Stewart L. Conversing about performance: discursive resources for the appraisal interview. Manag Commun Quart. 2009; 22(3):473-501.
• [16]Prowse P, Prowse J. The dilemma of performance appraisal. Meas Business Excel. 2009; 13(4):69-77.
• [17]Woods L, Boudiono M, Mclaren S, Lemma F. Delivering the quality agenda: the experience of implementing appraisal systems in primary care. Qual Prim Care. 2006; 14(1):21-7.
• [18]McGivern G, Ferlie E. Playing tick box games: interrelating defences in professional appraisal. Human Relat. 2007; 60(9):1361-85.
• [19]NHS Revalidation Support Team. Organisational readiness self-assessment (ORSA) report 20. http://www. gmc-uk.org/3___Revalidation_Programme_Update_Report___Annex_B.pdf_45924907.pdf 11-12 webcite
• [20]Shepherd A, Cameron N. What are the concerns of prospective responsible officers about their role in medical revalidation? J Eval Clin Pract. 2010; 16(3):655-60.
• [21]Department of Health. The role of responsible officer: closing the gap in medical regulation - Responsible Officer Guidance. London, UK. 2010
• [22]NHS Revalidation Support Team. The appraisal and revalidation of responsible officers in England. London, UK; 2012.
• [23]The qualitative researcher’s companion: classic and contemporary readings. Sage, Thousand Oaks; 2002.
• [24]Smith J. The shipman inquiry fifth report: safeguarding patients: lessons from the past – proposals for the future. 2004.
• [25]Rhydderch M, Laugharne K, Marfell N, Pownceby P, Lewis M. Developing a skills-based model to promote effective appraisal discussions amongst GPs in Wales. Educ Prim Care. 2008;19(5):496–502.
• [26]Wakeling J, Cameron N, Lough M. What factors impact on general practitioners’ engagement with appraisal? A qualitative evaluation in Scotland. Educ Prim Care. 2008; 19(6):615-23.
• [27]Loughrey C, Boylan O. Dealing with difficult appraisals: an approach to training. Educ Prim Care. 2008; 19(6):639-42.
• [28]Wilcock C, Withnall R, Hopper T. DMS FCO GP revalidation pilot final report. Royal College of General Practitioners, London, UK; 2011.
• [29]Wakeling J, Cameron N. The implications of enhancing appraisal to meet the requirements of revalidation, as perceived by appraisers: a qualitative study in Scotland. Educ Prim Care. 2011; 22(6):377-85.
• [30]Mcgregor D. An uneasy look at performance appraisal. Harv Bus Rev. 1972; 501(5):133-8.
• [31]Randell G. Employee appraisal. Personnel management. Sisson K, editor. Blackwell, Oxford, UK; 1995.
• [32]Burke RJ, Wilcox DS. Characteristics of effective employee performance review and development interviews. Personnel Psychol. 1969; 22:291-305.
• [33]Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ Theory Pract. 2009; 14(4):595-621.
• [34]Finlay K, McLaren S. Does appraisal enhance learning, improve practice and encourage continuing professional development? A survey of general practitioners’ experiences of appraisal. Qual Prim Care. 2009; 17(6):387-95.
• [35]Nath V. The King’s Fund: Revalidation: the early experiences and views of the responsible officers in London. London, UK; 2013.
• [36]Mugweni K, Kibble S, Conlon M. Benefits of appraisal as perceived by general practitioners. Educ Prim Care. 2011; 22(6):393-8.
• [37]Cuschieri A, Francis N, Crosby J, Hanna GB. What do master surgeons think of surgical competence and revalidation? Am J Surg. 2001; 182(2):110-6.
• [38]Archer J, Regan De Bere S, Brennan N, Lyn N. Evaluating the strategic impact of medical revalidation. Building an evalidation framework. Final report. CAMERA with Plymouth University, Plymouth, UK; 2013.
• [39]Royal College of Nursing. NMC Revalidation: what nursing staff need to know. Available from http://www.rcn.org.uk/development/practice/revalidation. Accessed 15 September 2015
• [40]General Pharmaceutical Council. Revalidation:. www. pharmacyregulation.org/education/revalidation webcite