Appraisal: the catalyst of personal development

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Abstract
Appraisal of NHS consultants has been running for two years, and most general practitioners will have their first appraisal this year. If done properly, the process should enhance personal development and learning, but links with revalidation have led to fears about it being used only for assessment. The challenge is to produce a valued appraisal system that ultimately improves patient care Appraisal should be a vibrant educational process. It is a means of preparing the ground for enhancing personal development and contributes to partnership between an individual and the employing organisation. Most importantly for health care, appraisal has been shown to be positively associated with patient care, with the association increasing with the quality of the appraisal.1 For doctors in the United Kingdom, appraisal is also going to be the main method of revalidation.2 We therefore need to be clear what appraisal is, in order to maintain its integrity as an educational tool. This article sets out what appraisal entails for NHS doctors and its potential benefits. It also explores some issues that could adversely affect appraisal and practical steps that will allow it to flourish. Appraisal is 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 a formalised means of helping a professional move through the learning cycle (fig 1).3 Reflection forms the link between experience and the generation of ideas, which results in altered behaviour. Fig 1 Learning cycle (adapted from Kolb3) The existence of the NHS has facilitated the development of a standardised model of appraisal for all doctors. Although separate guidelines exist for consultants and general practitioners and some differences of approach (see bmj.com), the core process and intent is identical.4 …