Middlemass Jo, Siriwardena A Niroshan
West Lincolnshire Primary Care Trust, Lincoln, UK.
Med Educ. 2003 Sep;37(9):778-85. doi: 10.1046/j.1365-2923.2003.01469.x.
All general practitioners (GPs) are expected to have an appraisal from 2002 and the first cohort will experience revalidation in 2005. Although there is a link between appraisal and revalidation, this has yet to be clarified.
To investigate the knowledge, attitudes and beliefs of GPs towards revalidation and appraisal.
Cross sectional survey.
Lincolnshire, UK.
General practitioners.
In 2000 a self-administered postal questionnaire survey was sent to all 343 GP principals on the list of Lincolnshire Health Authority. The questionnaire consisted of 47 attitudinal statements on appraisal and revalidation. It also included open questions on concerns about appraisal and revalidation and questions on attributes of responders.
Of the 343 GPs sent questionnaires, 272 (79%) replied. Lincolnshire GPs had more positive attitudes towards appraisal than towards revalidation. They welcomed appraisal provided that it had local ownership and took into account their views and concerns on the process. Other factors that correlated with a positive attitude towards appraisal included agreement that the purpose of appraisal is educational and that it should result in an agreed development plan. Those who had a positive view of appraisal were more likely to agree set objectives. Previous experience of appraisal either as an appraiser or appraisee was associated with a positive attitude towards appraisal. General practitioners who felt they had more control over the process tended to be more positive. General practitioners who were in favour of appraisal were also more likely to be in favour of revalidation and agree that appraisal formed part of the revalidation process. They were less likely to feel that there was a hidden agenda on the part of government and more likely to agree that revalidation would provide evidence of acceptable care being provided to patients. Time involved and lack of resources were the two main concerns.
A better understanding of knowledge, beliefs and attitudes towards appraisal will ultimately help in setting up a successful appraisal system for GPs. The current emphasis on appraisal as an educational tool will help to foster positive attitudes. The relationship between appraisal and revalidation needs to be clarified. Concerns relating to lack of time and resources for appraisal and revalidation need to be addressed by primary care organisations.
自2002年起，所有全科医生（GP）都需接受评估，第一批人员将于2005年经历重新认证。尽管评估与重新认证之间存在联系，但尚未明确。
调查全科医生对重新认证和评估的知识、态度及信念。
横断面调查。
英国林肯郡。
全科医生。
2000年，向林肯郡卫生局名单上的所有343名全科医生负责人发送了一份自填式邮政问卷调查。问卷包含47条关于评估和重新认证的态度陈述。还包括关于对评估和重新认证的担忧的开放式问题以及关于应答者特征的问题。
在343名收到问卷的全科医生中，272名（79%）回复。林肯郡的全科医生对评估的态度比对重新认证的态度更积极。他们欢迎评估，前提是评估具有地方自主性，并考虑到他们对评估过程的看法和担忧。与对评估持积极态度相关的其他因素包括同意评估的目的是教育性的，并且评估应产生一份商定的发展计划。对评估持积极看法的人更有可能同意设定目标。以前作为评估者或被评估者的评估经历与对评估的积极态度相关。认为自己对评估过程有更多控制权的全科医生往往更积极。支持评估的全科医生也更有可能支持重新认证，并同意评估是重新认证过程的一部分。他们不太可能认为政府有不可告人的目的，更有可能同意重新认证将提供向患者提供可接受护理的证据。涉及的时间和资源短缺是两个主要担忧。
更好地了解对评估的知识、信念和态度最终将有助于为全科医生建立一个成功的评估系统。当前将评估作为一种教育工具的重点将有助于培养积极态度。评估与重新认证之间的关系需要明确。基层医疗组织需要解决与评估和重新认证缺乏时间和资源相关的担忧。
