Appraisal the body of evidence
In the second of her two-part series on appraisal for registrars, Dr Mei Ling Denney looks at the evidence you must collect
Appraisal is based around the GMC document Good Medical Practice which also describes the standards of competence, care and conduct expected of doctors in all aspects of their professional work. These are:
• Good clinical care
• Maintaining good medical practice
• Teaching and training
• Relationships with patients
• Working with colleagues
Remember, though, that your statements and documentation should reflect personal involvement – it is not appropriate simply to submit the practice QOF data.
Try to include relevant information and evidence from your training to help give an overall picture of you and your development needs. If you practise outside the NHS, this should be included. Some suggestions of relevant documentation are listed under each heading.
Good clinical care
This is specialty specific so it might be worth referring to the curriculum statements available on the RCGP website to remind you of the scope of general practice.
• RITA forms from previous posts, trainer's reports
• Learning portfolio, including log of interesting patients seen
• Records of your out-of-hours work
• Any previous personal development plan
• Audit, including that for summative assessment
• Projects/guidelines and so on you have been involved in
• Basic life support certificate
• Complaints/significant events and their outcomes
• Reflections on your own clinical practice, your training and progress
Maintaining good medical practice
Here you should demonstrate that you keep up to date, so record continuing educational activities undertaken over the past year.
• Any courses you have attended; how you've spent your study leave
• Examples of attendance at VTS teaching sessions or residential workshops
• List of tutorials from your trainer and
• Attendance at in-house educational activities within the practice
• Certificates of completion of any modules on the e-learning sites
• List of regular journals you read, or any books relevant to general practice
• Participation in registrar study groups
• Examination results from diplomas, summative assessment, MRCGP
• Other examples of participation in relevant CPD
Working with colleagues
This section is for you to reflect on your relationship with your colleagues.
• Write a four-line statement on how you feel you relate to, and are part of, the team.
• Relevant section from your trainer's report; personal references
• Peer review/360° – this could include the 360° SHO assessment forms from the Joint VTR/2 RITA forms from hospital jobs or the Doctors' Interpersonal Skills Questionnaire from Client-Focused Evaluations Program (CFEP)
• In future, 360° review will form part of the nMRCGP workplace-based assessment
Relations with patients
Here you reflect on your relationships with your patients.
• Patient questionnaires-include the RITA patient SHO assessment forms from hospital posts
• There is still funding for the national CFEP patient feedback process based in Exeter; each participant gets a individualised feedback with comparisons of the performance against all the other GPRs who have done it so far.
• Evidence of good consultation skills-
results of your video exams
• Thank you letters
• Patient complaints with outcomes
• Patient surveys will also form part of the nMRCGP workplace-based assessment
Teaching and training
Most registrars have limited involvement in teaching and training activities.
• Participation in teaching of VTS sessions
• Teaching activities in the practice, for example to medical students/nurses
• Any formal research commitments
• Involvement in clinical trials
• Any publications
Refer to Good Medical Practice.
• A self-declaration about how effectively you are meeting good practice standards of probity will suffice
Again, refer to the GMC's guidance, and take advice if your health may put patients at risk.
• Complete a self declaration form, available on the Department of Health site, Form 4 and the personal development plan.
Form 4 is a summary of your appraisal discussion and is based on all of the standards laid out in Good Medical Practice and review of your evidence provided under the sections above. After completion, it should be agreed and signed by your trainer.
The personal development plan (PDP- Form 5) is there for you to focus on your developmental needs and plan the training for the remainder of your time at the practice, or your next post. In this section, you can include your reflections on training and development which should contribute to the PDP.
In conjunction with your trainer, you should identify key development objectives for the year ahead. This may also include activities relevant to career planning. You should try to indicate the timescale in which these objectives should be met on the template provided.
All the documentation from appraisal and its summary will provide the evidence for future revalidation of your licence to practise, and remains your property.
Your trainer should retain a copy of Form 4 (summary of appraisal discussion) in his/ her file of your personal training. Many deaneries also ask you to provide a copy to the associate director, or whoever holds responsibility for training and appraisal within the deanery.
MeiLing Denney is a trainer, and GP appraiser – she works part-time as a GP in Peterborough