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North Northumberland Trainers Group
Appraisal Course held on
7-8/5/98 at Embleton Hall, Longframlington.
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Members Present:
Apologies:
Guest:
Appraisal
Definition: evaluation of the worth of something.
Useful reference: Vital Lies and Simple Truths by Daniel Goleman.
Appraisal should be conducted within a blameless society - the problem is already known about so the process should be faciltative, not autocratic, and result in empowerment.
For example, a receptionist job description might be:
Receptionist
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Keep patients happy
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Feed surgeries smoothly and efficiently
The responsibility for outcomes rests with the receptionist. Thus if there is a complaint, the response can then be "how do we tackle this?". Responsibilities and attitudes must be defined at the beginning of the process.
The process
The process as applied to GP Registrars
- Why do it?
To produce good doctors.
- What to do?
Aim: to facilitate the development of GP registrars. Consider educational contract, knowledge, skills and attitudes, explicit values (?define core set).
Set standards at start - "what makes a good doctor?". Could resource worked examples eg from Doctors, Dilemmas, Decisions.
Brainstorming of the qualities of a good doctor.
- How?
Development of a tool to assist in the appraisal process.
Brainstorming of the qualities of a good doctor
Values
(personal and group) Must start with a "happy doctor" in order to develop further.
- Respect
- Consideration
- Empathy
- Caring
- Confidentiality
- Ethical awareness
- Honesty
- Commitment
- Efficency
- Time management
- Delegation
- Teamwork/group work
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- Flexibility/adaptability
- Self-education
- Conscience
- Recognising limitations
- Self-awareness (SWOT)
- Creativity
- Vision
- Independent will
- Motivation
- Aproachability
- Patient-centredness
- Communication
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Central precept:
- Clinical judgement
- Patient judgement
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Knowledge and consultation skills
- Clinical competence
- Audit
- Communication
- Listening
- Problem-solving
- Disease management
- Prescribing
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Skills
(?optional)
- Leadership
- Teamwork
- Organisational
- Management
- Computer
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Development of a tool to assist in the appraisal process
| Area |
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Possible tools |
| 1 Technical skills (eg the consultation) |
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Observation, PEP, MCQ etc. |
| 2 Teamwork | |
STAR rating |
| 3 learning (self-directed) hunger | |
"What have you learned? What do you need to learn?" |
| 4 Patient satisfaction | |
CSQ, yes/no perception cards + 2 boxes. |
| 5 Work ethic (eg efficiency) | |
New tool? |
| 6 Integrity (personal and professional) | |
New tool? |
Some thoughts about the new tool
- Not distributed to all PHCT members, just selections or groups?
- Owned by appraisee ("you come to me" rather than I'll give you..."), who distributes, then collected and anonymised by someone else.
- Comments box attached to each question rather than at the end: eg "How can the GP registrar be a better team player? Please explain..."
- 2-point scale ie yes/no.
- Put points 1-6 above in rank order.
- Test on ourselves. Try with partners.
- Principles: why/what/how
- Be clear on what you are doing and why.
- Gather some information.
- Feed it back with discussion.
- This new tool needs a name!
- Can't do unless "happy" first.
- Refine the tool at the June meeting.
Appraisal in the partnership
Why - "fulfilling individual potential"
Could use this with partners:
- Who would you go to with a difficult clinical problem?
- Who would you go for a beer with?
- Who would you go to with a difficult financial problem?
- Who would you go to to help guide your family through a minefield?
- Who would you go to with a personal problem?
- etc...
...and map the answers with arrows from person A to person B etc.
The appraisal interview
- Feedback positive.
- Self-appraisal.
- No surprises: data before appraisal interview.
- Two way process.
- Look forwards.
- Developmental rather than judgemental
- Be factual.
- "How can we solve the problem?"
- Focus.
- Feeling good.
Summary and action points from Simon Parker
- WHY? Always needs to be simpler and clearer than you think; preferably in English as well!
- WHAT? Worth consulting a bit on the detail of this; The big 6 we came up with may need a little refining; this helps with "buy-in" from others as well.
- HOW? This is where the creativity comes in; you don't need to cast a scheme in stone for all time either; keep it fresh; The idea of piloting a couple of styles of questionnaire is a good one.
- Keep the appraisee at the centre of the process; give them some control; try basing your approach on the majority of good ones rather than the minority who might abuse the trust; it can be a good investment.
- Invest time at the start of the process with Trainees; set the scene and the expectations so that the trainee takes the responsibility for data collection; make the appraisal "interview" a joint problem solving session rather than a judging one.
- Try and clear out some of the old system and paperwork; it avoids conflicting messages and will probably save time as well
- Consider the language you use carefully; "you must" etc is more likely to build resistance.
- Why is "appraisal" in the bar always so good? - relaxation, humour and honesty; if you can manage this without alcohol in the appraisal interview you've got it cracked. By the way someone suggested you choose an alternative to the name "appraisal" - seems a good idea. I've seen "development interviewing", "personal development planning", "personal interviews", "annual chat", "360 degree feedback", "peer review" (for partners) but I am sure you can do better!
See also:
Future meetings
| Thursday 18/6/98: afternoon meeting |
Glendale Surgery, Wooler |
Click here for agenda |
| Wednesday 8/7/98 |
Embleton Hall for 8pm: Guru meeting with George Taylor |
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Brad Cheek 1998