Annual trainer peer-review: impact on educational practice and sense of community

The General Medical Council (GMC) requires all doctors to undertake annual appraisal for all roles for which they hold a licence to practise. General Practitioner (GP) educational supervisors (ES) in the North of Scotland have undertaken annual ES peer-appraisal since 2002 which focuses on their role as ES and is separate to GMC appraisal.

To investigate whether participation in annual peer appraisal by GP trainers had affected their professional practice and sense of community Methods: Focus group methodology was utilised, supported by written reflective narratives. Thirty-five educational supervisors participated in three focus groups, moderated by educators from the north region of Scotland Deanery. The data included 35 narratives, flip charts and field notes. These were analysed using a thematic approach.

Thirty-five trainers participated and themes emerged around four areas: organisational, process, outcomes and challenges. Due to its formative peer related features, peer appraisal was more valued than mandatory annual NHS appraisal. The value of a personally known peer as appraiser emerged as a major recurrent theme. Positive affective and effective outcomes were described by several participants. These included feeling more valued and confident. Some reported empowering and motivating effects to implement changes and tackle difficult situations. Some felt that appraisal added to the sense of community by developing new relationships and deepening existing ones. The risk of collusion was raised in several narratives and explored more deeply during focus group discussions. There was agreement that the process could be improved by making explicit what to do if concerns were identified.

This study demonstrated the importance of peer appraisal for GP trainers, particularly in the context of locally based valued and trusted trainer groups. It affects their professional practice as educators and deepens their sense of community. This is of particular relevance to current discussions on medical educator appraisal in the context of re-approval and revalidation.