Effective Appraisal Process

Lipsita Patnaik TPD HENW – North West

Consultant Histopathologist

Blackpool Teaching Hospitals

29.01.2015

Parkin D, McKimm J (2009): Managing the appraisal. British J Hospital Medicine. Vol 70 (9). Pp 528-531.

What is appraisal?

Benefits of appraisal

Appraisal process

◦ Preparation

◦ Environment

◦ Managing an effective appraisal

◦ Outcome of appraisal

Challenges

What is appraisal?

Gold guide section 7.9 "...the three key elements which support trainees in (the training) process are appraisal, assessment and annual planning. These three elements are individual but integrated components of the training process. Together they contribute to the Annual Review of Competence Progression (ARCP)."

Different aspects of performance review

Assessment

Targets / audits /

standards

Complaints

Significant events

Appraisal

Formative

Developmental

Confidential

Performance management

Assessment against

organisational agenda

Revalidation

Summative

Declaration of fitness to practice

Public

Appraisal - definitions An opportunity for individuals to discuss

their performance, and to develop personal needs and professional development. (Murdoch-Eaton & Levene, 2004)

Appraisal - definitions A structured process of facilitated self

reflection. It allows individuals to review their professional activities comprehensively and to identify areas of real strength and need for development.

Appraisal is formalised means of helping a professional move through the learning cycle.

Reflection forms the link between experience and the generation of ideas, which results in altered behaviour. (Conlon, 2003)

Appraisal - definitions

A formal process for doctors at all levels, including doctors in training, which supports professional development and stimulates improvements in clinical practice. (Parkin & McKimm, 2009)

Benefits of appraisal

Benefits for the appraisee

Encourages self assessment/evaluation

Considering future plans and aspirations

Formulate an agreed PDP, outlining resources and opportunities required to fulfill future learning and developmental needs

Benefits for the organisation

Identification of development / educational needs across teams and the wider organisation

A consistency of approach to manage staff performance

Equalities of opportunities

Improved quality of care and governance

Benefits for the appraiser

A forum for evaluation and future planning

An overview of team development

A chance to gain feedback on management and facilitation skills

Appraisal process

Two-way process : by both appraisee and appraiser

Both parties should identify examples of good performance and difficulties encountered

On-the-job feedback for the trainee

Personal reflection by the trainee

Preparation

Private, quiet, relaxed, neutral territory

Free from distractions !!!

Professional but comfortable

Interpersonal environment

◦ 70:30 conversation ratio between appraisee: appraiser

◦ Empathy and rapport

◦ Begin with a friendly, non-threatening question to shake off early nerves and concern

Environment

Structuring and managing the appraisal interview

Follow a structure (forms, proforma, ESSR) for appraisal discussion

Trainee led

Effective feedback

◦ productive praise & constructive feedback

◦ related to specific examples which should be descriptive or illustrative

◦ NOT judgemental

Each discussion point

Introduce with a good open

question

Develop by listening & asking probing

questions

Consolidate by adding observations, feedback, agreeing objectives for future

PDP

Confirm by briefly

summarising

Skilful questioning – The ‘funnel’ technique

checking

Closed Q

Probing Q

Open Q

Question sequence

“Tell me how you went about...?

“How did you prepare?”

“What was your staring point?”

“So, what happened next?”

“Who else was involved?”

“What were your thoughts at that stage?”

“What were the main outcomes?”

“So, that took a total of 6 weeks?”

“Was it your idea of someone else’s?”

“So, let me see if I have followed you...”

Skilful questioning – The ‘funnel’ technique

checking

Closed Q

Probing Q

Open Q

Question sequence

“Tell me how you went about...?

“How did you prepare?”

“What was your staring point?”

“So, what happened next?”

“Who else was involved?”

“What were your thoughts at that stage?”

“What were the main outcomes?”

“So, that took a total of 6 weeks?”

“Was it your idea of someone else’s?”

“So, let me see if I have followed you...”

•Green – Open Q •Amber – probing Q •Red – closed Q •Black – checking Q

Active listening

L – Look interested

I – Involve yourself by responding

S – Stay on target

T – Test your understanding

E – Evaluate the message

N – Neutralise your feelings

Outcome of appraisal

Educational & personal developmental objectives

Objectives should incorporate 3 development areas –

◦ Remedy – to address poor performance

◦ Consolidation – to maintain and push forward an ‘acceptable’ level of performance

◦ Growth and diversification – to encourage and ‘stretch’ individuals who perform above normal standards

SMART objectives

S – specific

M – measurable

A – agreed/achievable

R – realistic

T - time bound

Challenges against an effective appraisal

Time for preparation

Uninterrupted and private time for appraisal

Resources to implement developmental plan

Different focus of educational and annual workplace appraisal

Trainee in difficulty

High flying trainees

Conclusion

Appraisal is a two-way process, requires good preparation from both parties

Not an one-off discussion but a positive, developmental and structured process

Poor appraisal can be discouraging and demotivating

Good appraisal in valuable in improving future clinical, managerial and educational performance while reviewing the past performance