Foreword to the collection of appraiser workshops from Health Education England
The purpose of revalidation is to assure the public that doctors in the UK are up to date and fit to practise. The corner stone of the revalidation process is an annual professional appraisal for every doctor, within a context of effective clinical governance. If revalidation is to achieve its purpose, appraisal needs to be of as high a standard as possible; key to this is the talent and professional skill of the appraiser.
Collaboration, enthusiasm and vision have been central to the successful implementation of revalidation. Along the way, these factors have come from many different individuals and groups; people who have seen the potential for revalidation, via appraisal, to benefit doctors in their professional development, and patients through safer and better care.
This collection of appraiser workshops from Health Education England represents one of those instances of collaboration, enthusiasm and vision arising from within the system. Each workshop dissects one aspect of the appraisal process, and the collection as a whole represents a comprehensive analysis of the key aspects of appraisal that present daily challenge to appraisers throughout England.
I am delighted that Health Education England has compiled this collection of appraiser workshops, and that they are making it available to the whole health community. I am sure that designated bodies making use of it in their appraiser training and development programmes will find that it significantly stimulates high quality appraisal, supporting doctors in offering better and safer care for patients.
Maurice Conlon FRCGP, National Appraisal Lead, NHS England
Why we wrote this collection and who it is for
We wrote this collection of workshops to support the continuing professional development of medical appraisers who have completed their basic training and have started conducting appraisals. It is aimed at those leading the continuing professional development of appraisers in primary and secondary care working within NHS England.
Medical revalidation started on December 3rd 2012. Since then, every licensed doctor needs an annual appraisal (or ARCP for medical trainees) at which they provide evidence that they are up to date and fit to practise. Responsible officers rely on robust appraisal outputs to help determine their periodic recommendations about doctors to the General Medical Council.
As well as supporting the requirements of medical revalidation, appraisers help the doctors they appraise to reflect on their work and to identify their learning needs and career aspirations. They then work with the doctors to plan their future development in line with these needs, integrating with those of their employer(s) and the NHS. Well conducted appraisals can improve job satisfaction and performance and may ultimately increase the quality and safety of patient care. However, the job of an appraiser is not always straightforward. All appraisers, however experienced, need peer support and continuing professional development. We have produced the Collection of Workshops to support those faced with the challenge of leading the education of this experienced group of doctors.
The Collection is based on the RST Competency Framework for Medical Appraisers and also on many years’ experience of supporting appraiser education. We hope that it will help you to develop and deliver effective and stimulating educational programmes related to appraisal training. We also want to leave a legacy of our work for when NHS England becomes wholly responsible for medical appraisal on April 1st 2014
How to use this Collection
Different organisations use different forums to support their established appraisers, for example, some employ external facilitators and others rely on appraiser led groups. Please feel free to adapt the workshops to suit the needs of your group. The vast majority of appraiser skills are generic across all specialities and we have provided primary and secondary care scenarios. However, you may also want to fine tune the workshops to your speciality.
We recommend that you read the Quick Guide to Planning an Educational Workshop first. The other workshops can be delivered in any order. It might be helpful to prioritise them by reviewing appraiser outputs, such as the summaries of discussion, and asking appraisers what aspects of their work they find most challenging.
Doctors are busy people. We recommend you limit your workshops to two or three hours in length. Many of the workshops can be delivered in a one hour session and longer workshops can be split into one hour blocks. We have included indicative timing for each workshop and, for ease of use, wrote them in note form using bullet points and a standard format. No two appraiser groups are the same so you will need to adapt your workshop as you go along. Every group has its own dynamics and a good facilitator will use these to maximise the learning.
Depending on how much time you have and how well the appraisers know each other, you may want to include an ice breaker at the start of your workshops. This may be a good investment of a few minutes, helping to build team relationships and inject some energy into the discussions. The book, Prescription for Learning, contains plenty of ideas for ice breakers.
We have suggested intended learning outcomes for every workshop. However, the best educational events build on what the learners know already so you need to find this out. The
work shop plans also include ideas for learning needs assessments. It is best if the appraisers have ownership of these assessments. You might achieve this by encouraging them to reflect on their development needs but not necessarily asking them to share this information or expose their weaknesses unless they feel comfortable to do so. We recommend that you allow adequate time at the end of each workshop for the appraisers to assess whether they have achieved the intended outcomes.
Irrespective of the topic being covered, you can support the appraisers to use the workshop process to practise essential appraiser skills. Appraisers can practise their active listening, questioning and feedback skills at all workshops. This will, of course, require the group to plan and apply suitable ground rules.
Appraisers need to develop their attitudes as well as knowledge and skills, for example when learning cultural competency. This requires learner-centred reflective discussions. Through empowering the appraisers to contribute to the development and delivery of workshops you can increase the likelihood of them attending, participating and learning. Delegating some of the responsibility will also build their confidence as educators.
The workshops in this collection cover essential skills for appraisers, for example, communication skills and how to write an effective summary of discussion and personal development plan (PDP). Although it is rare for an appraiser to be faced with a dishonest or fraudulent doctor, we included a workshop on probity because of the importance of appraisers being able to recognise and manage such issues. After noticing that many appraisers find it challenging to appraise doctors with GMC undertakings or conditions we also included a workshop on this.
It can be difficult to get a group of busy appraisers in the same place at the same time to learn together. We believe that this can be overcome by good communication, careful choice of venue and by proving dates and information well in advance.
We encourage you to maximise your use of one of the powerful educational tools at your disposal; role modelling. Appraisers will learn by observing your communication skills. Try and talk to each appraiser, for a couple of minutes, as individuals, rather than just within the group. This is likely to increase their sense of belonging, motivation and learning. Our final advice is to make your workshops enjoyable so that appraisers value and look forward to them.
For a copy of any of the resources, click on the title below to download a zip file containing the workshop files, or appendices. Alternatively, please email firstname.lastname@example.org to receive a copy by email.
- Quick Guide to Planning an Educational Workshop
- Developing as a Professional Appraiser
- Professional Boundaries for Appraisers
- Calibration of the Supporting Information
- Supporting Information for Appraisal and Revalidation
- Communication Skills for Appraisers
- Giving Effective Feedback within Appraisal
- Negotiation and Challenge in Appraisal
- Multisource Feedback and Appraisal
- Cultural Competence for Appraisers
- Doctors’ Health and Appraisal
- Probity for Appraisers
- Managing Patient Safety Issues in Appraisal
- Summary of Appraisal Discussion
- Supporting Doctors to set up a Self Directed Learning Group
- Appraising Doctors with GMC Conditions or Undertakings
- Continuing Professional Development
- Generic Attendance List for Appraiser Workshops
- Reflective Writing Template for Appraiser Workshops
- Judging the Quality of Supporting Information, Dr Alex Jamieson, 2012
- NHS England Medical Appraisal Policy and relevant annexes, 2013
- Developing teachers and trainers in undergraduate medical education: Advice supplementary to Tomorrow’s Doctors (2009)
- The Good Medical Practice Framework for Appraisal and Revalidation, General Medical Council 2012
- Quality Assurance of Medical Appraisers, Revalidation Support Team (RST), 2012