Medical Appraisal in Scotland Course for Experienced Appraisers

1. Medical Appraisal in ScotlandCourse for Experienced Appraisers

2. Introductions ….. • Name • Specialty • Reasons for attending • Expectations of the course

3. Aims • Encourage appraisers to re-evaluate and refresh their skills in appraising medical colleagues (from a range of specialties): • feedback they receive on the course and • their experience of observing other appraisers

4. Aims continued…. • Encourage a consistent and high quality approach to medical appraisal across Scotland • Confirm that appraisers are appraising at an appropriate level and, if not, address concerns • Consider what changes to appraisal may be required as a result of revalidation

5. Programme for the day and working methods • Refresher on the Characteristics of a High Quality Appraisal - skills for appraisal • Working with MSF Feedback as the appraiser • Working in trios (& pairs) with a tutor • Experiential approach • Constructing and receiving feedback (evaluation sheets)

6. Ground rules • Confidentiality • Feedback • As an observer, as an appraiser, as an appraisee Protocol for Managing Concerns

7. Video / DVD • The purpose of the DVD • Consent, ownership and confidentiality

8. Course Pre-work • Preparing for the appraisal exercise • A discussion of the appaisee’s current role (10mins) • Quality Improvement Activities(15mins) • Personal Development Plans for the year ahead (15mins)

9. We need your feedback! • End of day evaluation • Post day evaluation questionnaires/interviews (research)

10. Delivering a High Quality Appraisal

11. Characteristics of a high quality appraisal • Structured • Safe/Supportive • Space for appraisee to talk & reflect • Emotional issues can be addressed • Challenges thinking • Encourages meaningful PDP • Probity and Health explored meaningfully

14. Learning and Challenge / Support Support Low challenge/ high support = warm/safe but unsatisfying High challenge/ high support = optimal learning Challenge Low challenge/ low support = safe but unsatisfying and boring High challenge/ low support = Anxiety provoking/ defence response

15. Comfort / Stretch / Panic Zones Comfort Zone Stretch Zone Panic Zone

16. Communication Skills for Appraisal • Listening Skills • Open and closed questions • Looking for cues – verbal/non-verbal • Reflecting • Summarising

17. Communication Skills for Appraisal • Acknowledge feelings and be accepting of the person • Allow silence • Be prepared to challenge • Facilitate reflection

18. Beware of blocking behaviour • Closed questions too soon • Leading questions • Rescuing • Switching topics • Overly task orientated • Jollying along • Ignoring cues

19. MSF feedback 19

20. What is MSF and what does it demonstrate? NES multi question tool, based on research looking at “what qualities or attributes should a doctor have when working with colleagues?” Rates a range of skills and professional behaviour Non clinical staff rate professional behaviour only Uses free text boxes to obtain specific feedback and suggestions for change The doctor also self rates using the same questions Covers multiple areas 20

21. The MSF tool Needs a certain number of raters for reliability Web based Prompt for free text boxes Changes made here Quality of feedback is determined by the free text comments 21

22. Factors that will influence acceptance of feedback Recipient’s attitude to feedback and appraisal, including the “psychological contract” or “inner deal” people strike with individuals and the organisation Perceived accuracy and reliability of assessment methods Congruence or otherwise of self perceptions with the feedback received Manner in which the feedback is delivered and discussed 22

23. Giving the feedback Literature suggests that a coaching model is valuable Initial screening and then preparation by the appraiser Timed and controlled delivery of feedback with discussion Time for reflection by the appraiser 23

24. Preparation and Planning The appraiser will review the feedback and consider what challenges might arise Appropriate time for appraisee reflection before the meeting: not so long as to leave the appraisee unsupported with difficult feedback not so little that they see only the negative and react by building up their defences to the feedback 24

25. Feedback facilitation-The “ECO” model Emotional Response Reflection Content of MSF clarification Outcomes of feedback Coaching Action Plan 25

26. A Quick Reminder!

27. Three Roles • Appraiser • Appraisee • Observer

28. As an appraiser …. • Open constructively • Cover confidentiality & caveats • Check agenda still relevant • Keep discussion on track • Probe & challenge • Summarise at end of key sections with agreed outcomes/action points • Action plan/PDP relevant & owned by appraisee

29. Understands the principles of the scheme Uses the interview to gain insight & professional needs Willing to spend time preparing Able to listen Assertive: confident enough to seek and handle challenges from appraiser & to express their needs Able to reflect on & analyse past performance & events As an appraisee ….

30. As an observer …. • Focus on appraisal skills & techniques • Takes notes with examples to support views/opinion • Give feedback to appraiser • Be supportive to appraiser but don’t fudge issues – address areas which could have been handled differently, or better, with suggestions

31. There are six types of supporting information that you will be expected to provide and discuss at your appraisal at least once in each five year cycle. They are: • 1. Continuing professional development (Core element A) • 2. Quality improvement activity (Core element B) • 3. Significant events (Core element C) 31

32. 4. Feedback from colleagues (Core element D) • 5. Feedback from patients (where applicable) (Core element D) • 6. Review of complaints and compliments (Core element E) • In addition, Health and Probity statements will be required (Core elements F and G) 32

33. Brief introduction to SOAR www.appraisal.nes.scot.nhs.uk 33

34. Overview: an Appraisal on SOAR Administrator Appraisee Appraiser Process completed: automated email confirmations sent Complete Appraisal Forms (inc. upload of supporting info) Assign login (on request) Reviews submitted Appraisal Docs Agrees and Signs Allocate Appraisers & Appraisees (& Appraisal Co-ordinator) Agree Confidentiality Statement (MUST) APPRAISAL INTERVIEW Disagrees Signs and Forwards Submit Appraisal Forms (MUST) Create Interview (usually done by Appraiser) Drafts Form 4 summary Requests changes

35. Appraiser Create Interview on SOAR • Login • Click on “Interviews” • Click on “New Interview”

36. Completing Appraisal Forms Appraisee • Appraisee logs in • Clicks on Forms 1-2 • Clicks on Form 3 • Save button provided on all forms (Appraisees not expected to complete forms in one sitting) • Form 3 documents the appraisee’s supporting information (file attachments / uploads)

37. Support • This is only a brief intro • www.appraisal.nes.scot.nhs.uk • Follow appropriate Primary/Secondary Care links Here to help! • Help desk SOAR@nes.nhs.scot.uk • Report problems: • We can only improve with YOUR feedback!

38. End of day evaluation Please complete the post course evaluation form Any further questions? Contact Ian Staples, NES