Appraisal: a guide for medical practitioners
October 2003
What is appraisal?
Appraisal is a well-established procedure in many sectors and organisations. It is an ongoing, two-way process involving reflection on an individual’s performance, identification of education needs and planning for personal development. Appraisal allows doctors to take time to reflect on their performance and skills and examine how successes in particular areas can be transferred to other areas of their work. If no formal appraisal process is in place, doctors may be too busy to take the time to do this. A formal process should ensure that doctors are provided with the time and means necessary to achieve their appraisal. There should be no requirement to participate in appraisal unless proper resources, time and support are provided.
There is often confusion between assessment and appraisal. These are two distinct processes with different aims. Assessments measure progress based on relevant curricula, while appraisals provide a complementary or parallel approach which focuses on the trainee and his or her professional needs [Go to reference 3]. Assessment involves the measurement of an individual’s performance at a particular point in time, usually against predetermined standards. Different types of assessment measure different aspects of being a doctor.
Recently assessment methods have been developed to assess not only factual knowledge but also other areas such as communication, clinical skills, attitudes, ethics and professionalism [Go to reference 4]. The Junior Association for the Study of Medical Education (JASME) has produced an excellent guide to medical student assessment [Go to reference 4]. There are several different types of written exams designed to test knowledge, and sometimes also the student’s ability to critically appraise information. They all assess knowledge of basic clinical science, patient investigation and management, health promotion, clinical reasoning and judgement. In addition to written assessments, medical students will also encounter many forms of assessment designed to assess their practical skills.
Results of assessments can feed into appraisals if appropriate.
The School of Health and Related Research (ScHARR) report ‘Appraisal for GPs’ defines appraisal as a process for:
- exploring role expectations, negotiating relative priorities, and setting and aligning individual and organisational objectives at a local level
- reviewing progress towards achieving previously agreed objectives and agreeing future objectives
- recognising, acknowledging and valuing achievements
- exploring what is needed from the organisation to help and support the individual in making the best contribution they can.
Appraisal should generate a personal development plan, which is an opportunity to register a desire to participate in development opportunities. It can be used as a bargaining tool with an employer or trust for protected study time or appropriate resources [Go to reference 6]. Appraisals are also closely related to the development of job plans. The appraisal process provides an opportunity to draw together information from which the job plan can subsequently be reviewed.
Appraisal is not designed to identify poor clinical performance. That is something that may, however, arise in an assessment. If performance problems are highlighted they must be dealt with outside the appraisal process.