Appraisal in post and NHS appraisal: Functions and terminology

Appraisal has been put forward as the key to ensuring optimum opportunity for educational development. The aim of this report is to establish the contribution of Start-Middle-and-End (SME) of post appraisal to senior house officers (SHOs) in general practice (GP) training. This paper looks at the scheme in the Wessex Deanery area which introduced SME appraisals into each GP training SHO post. Recent reforms such as the Calman report in 1993 have introduced and developed appraisal within the NHS. Appraisal has been advocated as good educational practice and has been part of education in training posts in Wessex since 1996. A survey of the educational content of hospital-based training posts was carried out using the SHO Educational Audit Project (SEAP) questionnaire. This questionnaire was designed, piloted and assessed for validity and reliability, and applied at the end of each training post from 1996. Participants were SHOs in GP training posts from the Wessex Deanery area. Overall there were 666 questionnaire responses with at least 600 responses to each question on appraisal. Results indicated that both educational supervisor support and post satisfaction were significantly linked to this SME appraisal system. This study also highlights problems with appraisal terminology. From this study it is proposed that the introduction of SME appraisal within a post is associated with support and post satisfaction. SME appraisal is a formative model; this study provides evidence to suggest that introducing SME appraisal will contribute to the quality of medical education.