What do doctors really think about the relevance and impact of GP appraisal 3 years on? A survey of Scottish GPs

Background The aim of appraisal is to provide an opportunity for individuals to reflect on their work to facilitate learning and development. Appraisal for GPs has been a contractual requirement since 2004 in Scotland, and is seen as an integral part of revalidation. Aim To investigate the outcomes of GP appraisal in terms of whether it has prompted change in medical practice, education and learning, career development, attitudes to health and probity, how GPs organise their work, and their perception of the overall value of the process. Design of study A cross-sectional postal questionnaire. Setting GP performers in Scotland who had undertaken appraisal. Method The questionnaire was based on the seven principles outlined in Good Medical Practice, a literature review, and previous local research. The survey was conducted on a strictly anonymous basis with a random, representative sample of GPs. Results Fifty-three per cent (671/1278) responded. Forty-seven per cent (368/661) thought that appraisal had altered their educational activity, 33% (217/660) reported undertaking further education or training as a result of appraisal, and 13% (89/660) felt that appraisal had influenced their career development. Opinion was evenly split on the overall value of appraisal. Conclusion Appraisal can have a significant impact on all aspects of a GP's professional life, and those who value the process report continuing benefit in how they manage their education and professional development. However, many perceive limited or no benefit. The renewed emphasis on appraisal requires examination of these findings and discussion of how appraisal can become more relevant.