Getting the most out of your appraisal

Advice to help GPs prepare for their annual appraisal. By Dr Marika Davies from Medical Protection.

The annual appraisal is now an established fixture in every practising doctor’s calendar. As well as being essential for revalidation, many doctors find the appraisal meeting a useful opportunity to discuss the achievements and challenges of the past year.

But putting together the necessary paperwork and completing the forms can be a time-consuming exercise, and doctors may sometimes be uncertain about what should be included. Here are some tips on how to prepare and get the most out of your appraisal.

Be aware of deadlines

Plan ahead and take annual leave dates into account when arranging your appraisal meeting, which must take place within each appraisal year. Your appraiser may request your completed appraisal documents up to 14 days before your appraisal meeting, and after the meeting you and your appraiser must finalise and submit the documentation to your responsible officer within 28 days.

Gathering documents throughout the year and not at the last minute will make the process smoother and less stressful.

Anonymise patient information

A recent case in which a trainee’s reflections in their portfolio were used as evidence against them in a claim continues to cause concern amongst doctors.

In theory, the contents of an appraisal could be used as evidence in litigation, however this would only be admissible if the entry identified a patient. It is therefore important to make sure all information is anonymised so that patients cannot be recognised.

The GMC says that anonymised information will be sufficient and should be used whenever practicable.

Reflect, reflect, reflect

Reflection is an essential part of the appraisal, and you should include reflections on various aspects such as complaints or adverse incidents, feedback, and your CPD points. Quality not quantity is key: you can, for example, provide a summary of all CPD activity and then add reflective comments about the most valuable activities.

However, reflection itself is not enough - you need to demonstrate that you have done so adequately and it is worth developing this skill. A useful approach to writing reflection notes on an adverse incident is to describe what happened, how you responded, what you learned, and what you will do in the future.

Be constructive about negative feedback

Positive feedback from colleagues and patients is always rewarding, but negative comments can be upsetting and demoralising. Anonymous feedback that does not give you the opportunity to respond may be frustrating, and dealing with negative feedback in a constructive way can be challenging if you feel that you have been unfairly criticised.

Showing that you have taken on board any concerns, reflected on them and considered how you can address the issues will demonstrate that you are a taking the opportunity to learn and develop. Talking about feedback can be one of the most helpful parts of the appraisal discussion.

Include the good and the bad

You should discuss significant events that you were involved in at your appraisal, emphasising those that have led to a specific change in practice or demonstrate learning. A complaint is defined as a formal expression of dissatisfaction or grievance, and you should discuss any change in your practice that you have made as a result.

Do take the opportunity to include compliments too – although you may not be able to attach actual letters or cards for confidentiality reasons, a log of anonymised comments as simple as ‘thank you for taking the time to go the extra mile’ can help demonstrate that your work is appreciated.

Give some thought in advance to your personal development needs

This can be a tricky part of appraisal preparation for many doctors. Identifying strengths, weaknesses, opportunities and threats (SWOT) can help to determine your learning and development needs.

As well as improving your knowledge you can also explore developing in other areas, such as skills or behaviour. And try to think beyond just listing training courses by considering other ways of learning – for example job shadowing or gaining practical experience.

Be prepared to disclose your appraisal

As well as revalidation, there may be other occasions when your appraisal documentation is reviewed - for example, it can be used as supportive evidence when the GMC is considering a complaint against a doctor, so it is important to bear this in mind when completing the form.

You should anonymise all patient information and use professional language throughout: an ill-judged remark about a complainant or difficult colleague is unhelpful and can come across badly.

  • Dr Marika Davies is medicolegal adviser at Medical Protection

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