Feedback

Scottish Medical Appraisal & Revalidation Toolkit Role specific additional considerations Sessional GPs Supporting Information

Both "Feedback from Colleagues" and "Feedback from Patients" are required once in a 5-year cycle (though not necessarily in the same year).

This is a requirement of all doctors practicing in the UK if they wish to renew their licence.

It is recognised that sessional doctors may have greater difficulty in completing these feedback surveys, and we advise that you should ask a practice manager to assist you. If possible try to do the survey in a place where you have worked before, and where other doctors, nurses and staff will know you.

If you did not partake in MSF or have no formal Patient Feedback, consider the reflection questions prompted in the "Working with Colleagues" and "Patient / Carer Involvement" templates instead.

Patient Survey Questionnaire (PSQ)

PSQ is perhaps the most difficult area in which the sessional doctor needs to gather evidence for appraisal.

Different arrangements exist currently in different boards and there is (at present) no provision of a single approved model for national use. Doctors who see few patients may experience difficulty in getting sufficient replies, and some settings are by their nature difficult (prison service or other secure environments for example).

In all cases you will need to prepare in advance. The first step is to liaise with your health board admin team to identify which tool you should use that would be acceptable to your responsible officer for revalidation purposes.

It is suggested also suggested that you contact the practice manager to organise admin support from the reception staff to assist you by:

Handing out questionnaires to patents before they see you
Providing them with pens
Collecting them after they leave your consulting room

You may find it helpful to offer to share the results of the survey with the practice at a later date.

Other examples of feedback QIA

Communication Skills

Formative observation proforma working with a sessional doctors' group:
- using role play
- audio records of consultations
Working with a colleague in the out of hours service: you could use recordings of telephone consultations
Approved video - this needs a practice's agreement, equipment, and probably extra time for your consultations, so potentially a longer surgery - as well as a trained observer to give you feedback (see the more detailed advice below)
Use of a patient enablement questionnaire or the CARE measure

Formative observation proforma

This obviously requires a collaborator, preferably one who is trained in the techniques of observation and feedback. However, if no-one is available to you in this role, you may wish to consider trying the technique as part of a sessional doctors' group.

It is better for a small group of you to work on this than to work in pairs: the feedback will be more objective and there is less likelihood that you will avoid giving constructive but possibly critical feedback. Remember, if you decide to undertake work of this type and you are new to it, it is helpful to work on the basic principles:

The observed person is invited to state what went well.
The observed person is invited to state what could have been done differently.
The observer is invited to state what went well.
The observer is invited to state what could have been done differently.
The observed person is allowed to reflect and respond, noting lessons learned.

You may be able to get help from your local postgraduate centre for activities like this, and it is always worth asking.

Approved video

It will probably be difficult to set up video opportunities in practices where you work infrequently, but practices with whom you have an ongoing relationship might consider this as a useful educational facility. Many training practices already have consulting rooms with fixed video equipment and you may be able to negotiate their use. You might even be lucky and get feedback on your video as part of an in-house teaching session.

Remember that it is very important to observe guidance on permission and confidentiality.

Provide leaflets for patients to explain in advance that the doctor will be asking them for permission to video the consultation for private educational purposes, that it will be treated with strict confidentiality and that it will be destroyed after use
Ask permission and ensure a written signature from the patient before recording
Confirm at the end of the consultation that the patient is still happy for you to keep a record
Make sure that your video is stored securely and erased after use

A sample video consent form is available for download below.

If you have recently completed vocational training you may have your registrar videos available. However, the intention is that this appraisal topic allows you to learn something new. If you provide video material that has already been used for summative assessment, there may be few new lessons to learn from it.

If you want to use video material, please consult with your appraiser first.

Telephone consultations

Handling requests for advice or help on the telephone may be part of your locum work. On most occasions the caller will not be known to the doctor. Accurate, effective and empathetic communications are particularly important. It is also very important to ensure that the outcomes are clearly understood.

Some organisations record all telephone conversations and they provide a rich resource for reviewing skills in this activity.

Observing guidelines on confidentiality, you could:

Obtain samples of your telephone consultations
Review them against a structured reflective template
Share them with a small study group (preferably facilitated by a trainer with experience of this)
Reflect on the feedback you receive

An example of a structured template is available for download below.

Our advice

Whenever possible, try to form an association with a practice, practices or group of peers. In these groups it will usually be possible to use tools and examples designed for group work, which have the clear advantage of allowing you to reflect with colleagues, learn with them, and get an external feedback on the quality of what you are doing.