Appraisal in detail
According to the GMC these are six types of supporting information you must collect, reflect on and discuss at your appraisal.
1 Continuing professional development
2 Quality improvement activity
3 Significant events
4 Feedback from patients or those to whom you provide medical services
5 Feedback from colleagues
6 Compliments and complaints
1.Continuing professional development (CPD)
What is a CPD?
A CPD is essentially any learning (formal and informal) outside of undergraduate education or postgraduate training that helps you maintain and improve your performance. This learning should aim to improve the care you give to patients and the standards of the team and services you work in.
You should make a Personal Development Plan (PDP) to outline your learning needs and use CPD’s to reflect these. You should reflect on your CPDs to show what you learned from them and whether they have had any impact on your performance and practice.
The Good medical practice framework for appraisals and revalidation provides a structure on discussing your CPDs during your appraisal. Broadly they should show the following domains:
1 knowledge, skills and performance
2 safety and quality
3 communication, partnership and teamwork
4 maintaining trust
How many do I need?
This is not very clear. The GMC say you should have “enough”. Most doctors agree on around 50 CPD points a year. (Sounds a lot but there are many easy ways to get them).
How do I get a CPD point?
-Currently there are lots of free webinars providing CPD points. Some are “CPD certified” also.
– Royal colleges provide courses and seminars that can give you points
-Going to conferences gives you points.
-BMJ e learning also has online learning that gives you CPD points.
-If you attended any teaches (e.g. lunch time teaches) you can keep a list of all the ones you attend and each can count as a CPD point)
-Informal teaching on the wards with seniors gives you CPD points also, as long as you are able to reflect on them to show what you have learned and how it will improve your practice.
You should reflect on them!
You also do not need any formal certificates or signatures but some people find it useful to get a confirmatory email for their own records.
Your appraiser should not usually ask to see a list of your CPD’s necessary but it’s good for you to keep one for your own reference. This could be an email or a list you have made yourself.
2. Quality improvement activity
Quality improvement activities cover many different types of things:
1. Reviewing your performance against local, regional or national benchmarking data where this is robust, attributable and validated. (This could include morbidity and mortality statistics or complication rates.)
2. Clinical audit. This must be evidence of effective participation in clinical audit or an equivalent quality improvement exercise that measures the care with which you have been directly involved.
3. Case review or discussion. A documented account of interesting or challenging cases that you have discussed with a peer, another specialist or within a multidisciplinary team.
4. Learning event analysis.
5. Audit and monitoring of the effectiveness of a teaching programme.
6. Evaluating the impact and effectiveness of a piece of health policy or management practice.
Whatever you do, you should reflect on it. You could reflect on the following:
– How this is relevant to you and your work
– Reflect on how this has helped your personal development
– What actions do you plan on taking in view of your QI activity?
Not sure how to do a QI?
Tips QI is a great website which talks you through the process step by step. https://tipsqi.co.uk/
What if I can’t do a QI?
The GMC requirements state the following:
“If you have been unable to evaluate the result of the changes you have made or plan to make to your practice, you must discuss with your appraiser how you will include this in your personal development plan for the following appraisal period.”
3. Significant events
You have to declare any significant events since your last appraisal or ARCP.
You should demonstrate your insight into these events (what happened and why) and also reflect on them. What have they changed about your practice? How have they helped you improve?
At your hospital they may be called DATIX, serious events or IR1’s.
If you are involved in a serious event, you should speak to MDU/MPS and sending them your event summary and reflection on this as soon as possible after the event.
4. Feedback from patients
The GMC says the following: “At least once in each revalidation cycle you must collect, reflect on and discuss feedback from patients about their experience of you as their doctor.”
So you have to do one every 5 years to pass revalidation, but not for appraisal. This means you don’t have to do one every year!
5. Colleague feedback
GMC requirements: “At least once in your revalidation cycle you must collect, reflect on, and discuss at your annual appraisal, feedback from your colleagues.”
So this too, is only required once every 5 years.
Has to be from a range of health care workers.
Reflect on your current and future practice based on this feedback.
If your appraisal system does not have a feedback form already or a way for you to collect this, use the GMC validated feedback forms. Found here.
This is quite easy to do so definitely worth doing if you can.
6. Compliments and complaints
You have to declare and reflect on all formal complaints made about you and what you learnt from them.
If you don’t have any specific complaints naming you, you can reflect on other local complaints or compliments that helped you to change your practice or confirm good practice you already do.