Challenging Appraisal Situations Training

This module by NHS Education for Scotland delves into potential challenges faced by appraisers during medical appraisals and offers strategies to navigate through difficult situations, emphasizing awareness of pitfalls and effective approaches. Topics include dealing with doctor issues, preparing for appraisals, managing difficult attitudes, and addressing performance and conduct issues.

• Training
• Medical
• Appraisal
• Challenges
• Strategies

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1. New Appraiser Training Medical Appraisal Scotland Challenging Appraisal Situations Module 06 This PowerPoint has no audio nor animations. The audio has been transcribed in the Notes section for your reference. 1

2. NHS Education for Scotland List of Modules Appraisal Overview Supporting Information Personal Development Plan & Introduction to Form 4 Appraiser Skills Using a Coaching Approach in Appraisals Challenging Appraisal Situations Appraisal in Trainer Roles 2

3. NHS Education for Scotland Aims of this module Explore potential challenges for an appraiser and what could be done to deal with these situations Raise awareness of potential pitfalls as an appraiser 3

4. NHS Education for Scotland Learning outcomes Have considered what situations may make an appraisal challenging and have explored some approaches to use in these situations Be aware of potential pitfalls for an appraiser and how to avoid them 4

5. NHS Education for Scotland Consider your thoughts on What situations you would find challenging in an appraisal? How you would deal with them? What you might do that could be counterproductive in an appraisal? How you could prevent that from happening? 5

6. New Appraiser Training Medical Appraisal Scotland Doctor issues 6

7. NHS Education for Scotland What doctor problems could make an appraisal difficult? (1/2) Preparation Too much or too little documentation, supporting information or reflection Attitude Arrogant/cynical/dependent/disengaged 7

8. NHS Education for Scotland What doctor problems could make an appraisal difficult? (2/2) Special (rare) cases Poor performance Conduct issues Illness Whistleblowing 8

9. NHS Education for Scotland Strategies you may use Contact doctor prior to appraisal to discuss Use appraisal to discuss what supporting information you would expect to see for the next appraisal Discuss the reasons for their behaviour from a position of curiosity Seek advice from Appraisal Lead prior to or after appraisal 9

10. NHS Education for Scotland Your role with concerns Being able to identify them Making a judgement about seriousness Know where to seek advice and help as an appraiser Know where to sign post doctors for further help Capture concerns accurately in summary and include actions in PDP Know when to stop an appraisal 10

11. NHS Education for Scotland Suspending the appraisal Very rare Evidence of a previously unknown serious performance concern threatening patient safety Attendance at interview in a seriously depressed/distressed state or under influence of drugs/alcohol 11

12. NHS Education for Scotland Preparation: time to postpone the appraisal? Potential conflicts of interest (allocate a different appraiser) No pre-appraisal documentation/illegible documentation Late receipt of pre-appraisal documentation with no time to prepare No previous summary of appraisal or PDP from last year s appraisal Inadequate supporting information Unsuitable venue or lack of protected time 12

13. NHS Education for Scotland Special cases Try as far as possible to crystallise: Are patients at risk? Should the appraisal continue? What action are you going to take? How you can signpost clearly the next steps to the doctor? Sometimes it is appropriate for the appraisal to continue but for the appraiser to take action in the way that the appraisal is written-up 13

14. NHS Education for Scotland Preparing for difficult medical appraisals Identify potential areas of difficulty Understand the possible causes for these difficulties Develop strategies for dealing with difficult appraisals 14

15. NHS Education for Scotland Summary reality is complex In practice, doctors do not conform to stereotypes (unless they are choosing to play a single role) Difficult appraisals will usually involve a mixture of some of these attitudes and behaviours The high flying doctor may also produce too much meticulously organised paperwork and then reveal that it is all fuelled by alcohol as a stress reliever Being an appraiser is a privilege but it is not always easy and in many situations there are no perfect answers 15

16. New Appraiser Training Medical Appraisal Scotland Appraiser issues 16

17. NHS Education for Scotland Pitfalls What potential pitfalls do you recognise for yourself as an appraiser? How might you avoid these traps? The people pleaser The elder statesman The rescuer The head teacher The judge The perfectionist The task oriented The diffident The doctor The money oriented The over- involved/colluder 17

18. NHS Education for Scotland Being self-aware Acknowledge that personal stumbling blocks exist Do not let them get in the way of delivering an effective appraisal Rehearse alternative strategies within an appraisal support group or network Reflect on and discuss difficult appraisals after they have occurred (in terms of process, not specific content) to gain useful insights 18

19. NHS Education for Scotland Before each appraisal Be self-aware Be doctor-aware What are my personal pitfalls to beware? What issues of preparation or attitude might I have to challenge here? If there are no apparent issues, how can I add value to this appraisal? 19

20. NHS Education for Scotland Serious concerns The requirement to suspend an appraisal discussion because of a serious concern is not new It is exceptionally rare for such a serious concern to arise during the appraisal discussion that the appraiser needs to take off the appraiser hat and move into other processes 20

21. NHS Education for Scotland Local processes and specialty specific issues Appraisal leadership and support Appraisal policy Occupational health and poor performance procedures Whistle-blowing policies What does your designated body advise? What does your royal college or faculty advise? Are you clear about how this links to the GMC requirements for revalidation? Any other issues? 21

22. NHS Education for Scotland Next steps Complete other mandatory modules Place allocation Microsoft Teams 22