During the annual appraisal, GPs will use supporting information to demonstrate that they are continuing to meet the principles and values set out in Good Medical Practice.1
The appraisal should cover all of the GP's roles. Any teaching, training, assessing, or appraiser roles must undergo the same process as clinical work, including relevant supporting information.
Keeping up to date
Continuing professional development should encourage and support specific changes in practice and career development and be relevant to your practice. This should be linked to the personal development plan.
Activities that correspond to continuing, updating and improving the performance of the medical education role should be included in the portfolio (see box).
These can be for undergraduate, postgraduate or GP specialist training sessions, whether for education delivery or in assessor roles.
The student's unmet needs and the teacher's educational needs can be documented, alongside how they have been acted upon. This may include evidence and reflection from articles, books, webinars, feedback (see below) and online modules.
Review of practice
For revalidation, it is necessary to demonstrate regular participation in activities that review and evaluate the quality of your work (see box).
|Evidence of teaching activities|
Include in your portfolio
Supervised projects, such as GP registrar audits and undergraduate special study components, and published work written with the practice team, medical education colleagues, the GP registrar or supervised students, can also be included.
Significant events2 include incidents that did not cause harm, but could have done, or should have been prevented.
There may be occasions when a portfolio incorporates a significant event from a teaching event. There may also be documents relating to involvement in investigations and analyses of events on courses that have occurred.
The activities discussed should be reflected upon, individually or as part of a template, such as trainer needs assessment questionnaires3 and trainer-registrar reflective diaries.
Feedback on practice
Feedback is usually obtained from those who have been taught, appraised or examined.
Feedback from undergraduate students, foundation doctors, the GP registrar at the practice and learners at vocational training schemes and other teaching events can be included. These may be individual questionnaires, but if the teaching was part of a course, the medical school or deanery is likely to collate feedback.
As part of revalidation, feedback from colleagues is required, using standard questionnaires. Following informal and formal teaching opportunities, the views of members of the primary care team can be included. In certain cases, peer-observed teaching can be incorporated.
Feedback may be obtained from an employer. For example, training practices and trainers could include reapproval reports, and examiners could use feedback received from external examiners, as well as the university and college's reports. The administrative and teaching staff from such organisations can also be invited to help with the colleague feedback questionnaires.
A cycle of revalidation requires at least one formal patient feedback. Patients are occasionally included in teaching sessions or may have had a consultation observed by a student or colleague shadowing the GP. Obtaining a sample of feedback in this situation, as well as patient satisfaction surveys, can be valuable.
A complaint is a formal expression of dissatisfaction.4 In medical education, this may be about an individual doctor or the department.
Complaints should be seen as a type of feedback, allowing doctors and organisations to review and improve their practice. Consequently, any complaints should be included, as should resulting actions and modifications in teaching practice.
At the other end of the spectrum, compliments should not be neglected in the portfolio. Thank you cards and notes from those who have been taught, or grateful colleagues, will help to develop an overall impression of the GP being appraised.
- Dr Metcalfe is a GP in York
1. GMC. Good Medical Practice. London, GMC, 2013.
2. National Patient Safety Agency. Is this a patient safety incident? www.npsa.nhs.uk/nrls/reporting/what-is-a-patient-safety-incident/
3. McKinstry B, Dodd M, Blaney D. What teaching skills do trainers think they need to improve? Education for General Practice 2001; 4: 412-20.
4. GMC. Ready for revalidation: supporting information for appraisal and revalidation. London, GMC, 2012.