Questions for Strengthened Medical Appraisal

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1 Questions for Strengthened Medical Appraisal Revalidation FOR ANAESTHETISTS 2010 Royal College of Anaesthetists

2 Background and introduction The annual appraisal is a key element in revalidation and should be conducted in accordance with the guidance on strengthened medical appraisal (SMA) developed by the NHS Revalidation Support Team. SMA is both a summative (assessment of performance) and formative (professional development) process. The appraisal discussion will be structured around the 12 attributes found in the GMC Framework for Appraisal and Assessment. Defining each attribute are the generic standards derived from Good Medical Practice (GMC, 2006) and, for anaesthetists, the specialist standards derived from The Good Anaesthetist (RCoA, 2010). An appraiser will need to make a professional judgement as to whether a doctor is demonstrating compliance with these attributes and that there are no concerns about patient safety and quality of care provided. This judgement will feed into a doctor s personal development planning in ensuring their progress towards revalidation over a five year cycle. An important consideration for The Royal College of Anaesthetists is to develop a uniform, consistent and fair system of appraisal across the UK and one that takes into account anaesthesia specific issues. In pursuing these aims, the College has set up the Revalidation and Appraisal Experts Consensus Group (consisting of Regional Advisors, Clinical Directors and Lead Appraisers in the specialty). The Consensus Group has met a number of times to work on several projects, including the development of opening and supplementary questions for the appraisal discussion. The remit for the Consensus Group was to come up with opening and supplementary questions for each of the 12 GMC attributes covered in the appraisal. The questions should encourage responses from appraisees to confirm that they are meeting the generic and specialty standards that define each attribute. The questions have been piloted by members of the Consensus Group, in mock and some real appraisals in local Trusts, and subsequently refined. It was reported that, on the whole, the questions (mainly generic) worked quite well, in prompting responses (mainly specialty specific) from appraisees against each of the 12 attributes. The publication of these questions will provide an indication and guidance for both appraisers and appraisees as to what they can expect in SMA. If applied nationally the questions will help to achieve a uniform and consistent system of appraisal for all anaesthetists. The intention is not for the appraiser to rely solely on these questions when conducting an appraisal. Appraisers will need to ask their own questions related to the situation in hand and appraisee s personal circumstances. Instead, these questions (developed by the Consensus Group) can be used to structure the appraisal discussion. Each opening question is quite broad and will invite appraisees to demonstrate compliance with an attribute. If the answer is satisfactory the appraisal can move on to how quality of work can be maintained or improved further. If not, the supplementary questions can be used to discuss professional practice in more detail or probe into any problems or issues, so they can be addressed through the personal development plan. Examples of how these questions are used and responses to them, in an appraisal setting, can be found in a series of video clips produced by the College. These video clips can be viewed from the Appraisal and Revalidation section of the College website: These questions represent an area of work that is very much ongoing for the College. We welcome any comments and suggestions as to revising or adding to the questions listed below. Please revalidation@rcoa.ac.uk. 2

3 Attribute 1: Maintain your professional performance Are you able to provide assurance and evidence that you are maintaining a good level of professional performance? Have you maintained knowledge of the laws and GMC regulations relevant your practice? Have you learned any new skills or changed your practice over the last year? Can you provide evidence that you have contributed to the professional development and educational needs of yourself and others? Can you describe your contribution to departmental and personal reflective practice? If you have participated in research, can you demonstrate that you have met the necessary governance requirements? Attribute 2: Apply knowledge and experience to practice How do you recognise your responsibilities with regard to limitations of competency, both in yourself and others? Can you give me an example of your responsibilities? Attribute 3: Keep clear, accurate and legible records How do you record and respond to safety issues? Do you have any experience of a critical incident? Did your notes contribute to the outcome? 3

4 Attribute 4: Put into effect systems to protect patients and improve care Reflecting on your clinical practice what evidence can you provide to demonstrate that you provide safe, high quality care for patients? Since your last appraisal have you altered your practice and if so why? Can you describe what you have done, including any exercises and root cause analyses, in keeping up with the Trust risk assessment process? Attribute 5: Respond to risks to safety Can you demonstrate how you participate in ensuring patient and staff safety within the Trust? Have you undertaken any training and been involved in any issues relating to patient safety? Attribute 6: Protect patients and colleagues from any risk posed by your health How are you ensuring personal health issues do not affect your ability to safely deal with patients and colleagues? Are you registered with a general practitioner? Over the year have you had to arrange for someone else to cover your clinical commitments and if so why? 4

5 Attribute 7: Communicate effectively Can you describe, with examples, how you communicate with patients, team members and professional colleagues? What role do you have within the teams in which you work? Have you any serious untoward incidents (SUIs) or complications this year? How have you dealt with it? Have you received any complaints this year? How did you manage the complaint and communicate with the patient? Attribute 8: Work constructively with colleagues and delegate effectively Describe how you interact and relate with members of your team? In what ways do you and your colleagues support one another? In what ways do you act as a role model at work? Describe how you fulfil your on call commitments and availability? How do you ensure patient safety when delegating patient care? Can you give me examples? Attribute 9: Establish and maintain partnerships with patients How do you involve individual patients in planning their care? Have you needed to refer a patient for a second opinion? Please tell me about it. Do you have a clinical research role and if so do you abide and keep up to date with relevant governance procedures? 5

6 Attribute 10: Show respect for patients What steps do you take to show respect for your patients and maintain their confidentiality? Attribute 11: Treat patients and colleagues fairly and without discrimination Can you describe your involvement in appraising and assessing your colleagues? Do you work with trainees and specialty doctors? Do you write references? Attribute 12: Act with honesty and integrity How do you maintain your professional integrity? Have you got any unresolved conflicts of interest? Is there any conflict between your NHS and non NHS work? 6

7 Further reading and resources GMC Framework for Appraisal and Assessment uk.org/doctors/revalidation/revalidation_gmp_framework.asp NHS Revalidation Support Team: Strengthened Medical Appraisal to Support Revalidation RCoA: The Good Anaesthetist anaes.pdf RCoA Revalidation Website (Interim Guidance on Revalidation and Supporting Information and Appraisal Video Clips) 7

Good Practice Guidelines for Appraisal

Good Practice Guidelines for Appraisal Dr Laurence Mynors Wallis Dr David Fearnley February 2010 1 Contents Page Introduction 3 Link between appraisal and revalidation 4 Preparation for the appraisal meeting