GP experiences of partner and external peer appraisal: a qualitative study.
BACKGROUND: Appraisal is being adopted both in the UK and internationally as a means of aiding personal development for family doctors. However, it is not clear by whom they should be appraised. AIM: To explore attitudes of GPs towards being appraised by externally appointed GP colleagues and by their own partners. DESIGN OF STUDY: Semi-structured interviews of GPs who had experienced both forms of appraisal. SETTING: Lothian, Scotland. METHOD: Sixty-six GPs agreed to take part in a study of partner (n = 46) and external (n = 20) peer-based appraisal. Six months later this group was followed up by questionnaire to determine views of the process, in order to obtain a purposeful sample of 13 GPs who were interviewed in depth. RESULTS: We uncovered concern and a need for clarity about the linkage of appraisal to revalidation. Interviewees felt that the potentially charged nature of appraisal could lead to collusion between appraiser and appraisee, which may lead to a superficial engagement. Similarly, lack of local knowledge of an appraisee potentially enabled a strategy of avoidance. GPs opting for partner appraisal were less likely to undergo appraisal due to lack of protected time. CONCLUSION: There are reported advantages and disadvantages to having an external peer or partner appraisal. The relationship between revalidation and appraisal needs to be clarified as this leads to collusion and avoidance strategies by both appraisers and appraisees. Good training is required to both recognise and address these strategies. Protected time is essential for effective appraisal.