Designing a system for performance appraisal: balancing physicians' accountability and professional development

Area of Science:

• Medical Education
• Healthcare Management
• Professional Development

Background:

• Physicians require performance appraisals for professional development and revalidation.
• Balancing accountability and personal development in appraisals can be challenging.
• New Dutch legislation mandates peer coaching for physician development.

Purpose of the Study:

• To design and implement a novel performance appraisal system for physicians in a Dutch academic medical center.
• To integrate accountability and professional development requirements within the appraisal process.
• To support physicians in discussing performance data and creating development plans with peer coaches.

Main Methods:

• A design-based research approach was employed by a hospital research group.
• A performance appraisal protocol, multisource feedback tool, and coaching approach were developed and piloted.
• Peer coaches were recruited, trained, and facilitated in debriefings.

Main Results:

• A two-hour peer-to-peer coaching session based on appreciative inquiry and solution-focused coaching was implemented.
• Sessions were highly motivating, development-oriented, and valuable, with peer coaches deemed suitable.
• The system successfully balanced accountability and professional development, allowing physicians control over disclosure.

Conclusions:

• Effective physician professional development requires an appreciative appraisal process, trustworthy coaches, and physician control over disclosure.
• The peer-to-peer appraisal system was positively evaluated for its motivational and developmental aspects.
• Longitudinal research is needed to investigate the effects of this system on physician professional development.