Processing your evidence for NHS appraisal

Sara Chambers continues her two-part article on collecting evidence for NHS appraisal on-the-go. The first part was featured in June 2017 edition of The Sessional GP magazine.

Collect your learning needs and ideas on the move

  • So now you’ve decided on which collection method, be it pen and paper or a note-taking app, try it for a month. Is it working for you?
  • The idea is that, next time, you have a nagging doubt or a moment when you think “I wish I knew how to do this better...”. Have your chosen collection device ready to capture that thought as quickly as possible before it evaporates.
  • At the collection stage, think of yourself as a squirrel gathering acorns and burying them away in specific locations for future use. Once you’ve captured the learning need, you don’t have to stress about what to do with it at that moment. It’s taken care of. All you have to do is remember the location and come back to it when you’re ready for the next step.

Turning your learning needs into appraisal evidence and useful knowledge

  • Sit down with your calendar and build in time to go over all the places you’ve buried your acorns, I mean, collected your learning needs (your notepads, Evernote etc) and decide how you want to handle them.
  • Allow enough time to make notes and record any learning outcomes; an hour a fortnight could be a starting point.
  • Keep this important “appraisal appointment” with yourself, or your note collection will get out of control and you’ll start to feel that appraisal anxiety again.
  • Filter through and immediately discard those that, on reflection, seem less relevant and can go straight in the bin with no further action.
  • For each of your other learning needs, start a record of the need you have identified and why it’s important to you and patients. Decide and record how you intend to address the learning need. This is the part of the reflection process that appraisers are keen on. NASGP’s AppraisalAid comes in handy here.
  • Be as specific as possible about what you intend to do next with each learning need. Being vague can mean that when you revisit the learning need later, you lose the plot and have to repeat spending more valuable time trying to remember what the problem was and what you intended to do.
  • The NASGP AppraisalAid CPD section has templates from different learning settings. You could log your learning need by starting to complete a template and leave yourself specific pointers about what the next step e.g. reading and research, finding a suitable course, discuss with a colleague and make it into a case review, carry out a condition-based review.
    • Top tip | NASGP templates are available in Google Doc format and if you’re using Google Drive, using one of these will automatically store it in your Drive
  • Use your chosen filing system to organise the learning needs you have dealt with and completed, and those that you want to come back to. See example in box 1

Getting your learning activities completed on the move

  • Treat your @Action folder like a To Do list. Have all the items in there ready with a specific next step e.g. the link to a new guideline, or the contact to set up a course.
  • Another helpful tip is to include the time you think it will take to complete the task in the name of the document eg; Brushing up on asthma (30)
  • Whenever you get any spare time, scan down your list and see which one you have time to complete
  • You may never have an empty @Action folder but don’t panic, that’s not the idea. You’re probably achieving far more learning than you did before and you’ve got loads of ideas what to do next. You will never run out of CPD credits or be stuck for appraisal again!

Reviewing your progress

  • Every 1-2 months, treat yourself to a whole session where you can review how you are getting on and keep your “appraisal brain” well-oiled.
  • You might grumble about lost income and not enough time but try to approach this as a positive time. We spend so much time frantically dealing with the increasing demands of patients in a stretched healthcare system that we need moments to lift our noses from the grindstone and remember why we want to be doctors and maybe feel energised by learning something new.
  • How is your note collection and filing system working? Any changes you want to make?
  • Get general maintenance and housekeeping of your notes and files up to date - even work on getting some transferred across to your appraisal toolkit to save last minute panic.
  • Tally up your CPD credits. Are you on target for the minimum average of 50 per year? Remember you’re already nearly halfway there if you’ve been spending you hour a fortnight on thinking and planning your learning actions - and recording it!
  • Any longer term bigger projects you want to plan? Decided to do a diploma in sports medicine? Want to work abroad?

Box 1

For instance, during one of your “appraisal appointments”, you have time to complete some research and learning on the best practise management of Bell’s palsy.

Another of your learning needs notes was a PUNS & DENS after you saw an 8 year old child with asthma on a low dose ICS inhaler. Her asthma was poorly controlled and you wanted to step up her treatment but weren’t sure how best to manage this and adequately counsel her carers.

  • You open a PUNS & DENS template.
    • You record the non-identifiable patient details to remind you of the case.
    • You record your specific questions e.g.
      • What do the latest BTS guidelines say about stepping up asthma treatment in children of this age?
      • When should patient be reviewed?
      • What effect do any higher doses of ICS have on growth?
      • How often should growth be measured?
      • What should I tell parents about this?
    • You even look up the BTS asthma guideline link and copy it into the template for future use.
    • You name your PUNS & DENS form “Childhood asthma (1 hour)” and store it in your @Action folder.
    • Next time you have a spare hour or have some CPD time set aside, you can go straight to your @Action folder.
    • Your previous notes lead you straight into a productive time of answering your specific learning needs.
    • You are able to complete your PUNS & DENS form and move it to your CPD folder.
    • You’ll be able to access this new information in future consultations and it will be easy to find when it’s time to compile your appraisal evidence.

Appraisal time

No last minute panic for you. All your appraisal evidence is sitting in your folders and simply needs transferring to your chosen appraisal toolkit for sharing with your appraiser - depending on what system you’re using - this may be a copy and paste exercise or uploading your completed learning templates.

Tip

My appraiser liked the formatting of the NASGP templates and found them much easier to read than the toolkits - so all I had to do was upload my templates into the relevant sections of the toolkit - no other typing necessary.

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