CPD & E-LEARNING
Revalidation for doctors, after years of discussion and planning, will finally be implemented in 2012. Kate Ashley reports on findings which suggest the need to acknowledge the existence of bias in patient and colleague surveys.
R
evalidation, which will en- sure that doctors are fit to
continue practising, will involve multi-source feedback from pa- tients, peers and supervisors. But colleague and patient surveys should be treated with caution, re- search suggests, after a ‘systemic bias’ was discovered.
The study, by the Peninsula Col- lege of Medicine & Dentistry in Exeter and published in the BMJ, examined whether there was any bias evident in the assessment of doctors’ professionalism in groups of potential patient, colleague and doctor-related sources.
Data was used from two question- naires completed by 30,333 pa- tients and 17,031 colleagues. 1,065 doctors took part in the study.
Doctors were less likely to receive
if they received their primary medi- cal degree outside the UK or South Asia, if they were working in a lo- cum capacity, if they were working as a GP or psychiatrist, or the col- league did not have regular profes- sional contact with the doctor.
The researchers concluded that there could be “systemic bias” in the assessment of doctors’ profes- sionalism as a result of the char- acteristics of the doctors and their assessors.
favourable patient feedback if their primary medical degree was from a non-European country, if they practised as a psychiatrist, if the responding patient was not white, or if the patient was not see- ing their ‘usual doctor’.
Doctors were less likely to receive positive feedback from colleagues
They suggested: “In the absence of a standardised measure of pro- fessionalism, doctor’s assessment scores from multi-source feedback should be interpreted carefully, and, at least initially, be used pri- marily to help inform doctor’s pro- fessional development.”
GMC chief executive Niall Dick-
son acknowledged that the results of patient and colleague surveys should be “treated with care”.
He said: “Being aware and taking account of how patients and col- leagues view your practice is im- portant for every doctor but it is only one part of the supporting in- formation that doctors will bring to their appraisals.
“It will be considered alongside all the other information about a doc- tor’s practice and is not something which you can ‘pass’ or ‘fail’.
“It assesses an individual doctor’s strengths and areas for develop- ment to help them improve their practice – it is not a way of com- paring doctors with one another.”
TELL US WHAT YOU THINK
opinion@nationalhealthexecutive.com
NHS trusts are in the full throws of getting ready for the implementation of medical appraisal and revalidation in 2012. This includes the development of processes/procedures and the investment in the IT infrastructure required, explains Mark Edmonds, senior account manager at Premier IT.
W
hilst an e-Portfolio based re- validation management sys-
tem is seen as a necessity by most, there are some common concerns being voiced by NHS trusts about implementing such a solution.
These include:
Concern: a revalidation manage- ment system has not been account- ed for in your current budget.
Solution: find a supplier who will implement your system on a buy- now, pay-later basis.
Concern: implementing a new sys- tem will put a stretch on your IT resources.
Solution: select a managed/hosted solution; a SaaS model will take up very little of your existing IT resources.
Concern: there is a lack of clarity on how the system should ulti- mately function and look.
Solution: use a system on a li- censed basis where the supplier has committed to updating it in line with GMC and RST require- ments and guidelines (such as MAG and ORSA).
Concern: you are concerned about 60 | national health executive Nov/Dec 11
compatibility with existing sys- tems e.g. MSF.
Solution: only select a supplier with experience of sophisticated system integration and who can provide evidence of previous inte- gration work.
Concern: you don’t think you need a solution yet.
Solution: don’t underestimate the time it takes to select the right supplier, implement and roll out your system. If like most trusts you want your IT system in place by April 2012, you should be seri- ously considering supplier selec- tion before the year is out.
Concern: you don’t think you need an electronic system at all.
Solution: the resource required to
administer the process of annual appraisals and revalidation using a paper-based system will far out- weigh that required to manage a highly automated electronic system.
If this doesn’t help to alleviate your concerns around implement- ing a revalidation management system, talk to a potential suppli- er, explore your options and make an informed decision armed with all the facts.
Be mindful that many trusts have already committed to an IT system and are well underway with the implementation process. Be care- ful not to get left behind.
FOR MORE INFORMATION
T: 020 7837 2690 E:
revalidation@premierit.com W:
revalidation.premierit.com Tw: @medrevalidation
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