McKay John, Shepherd Annabel, Bowie Paul, Lough Murray
Department of Postgraduate Medicine, Division of Community-based Sciences, University of Glasgow, Glasgow, UK.
Med Educ. 2008 Dec;42(12):1210-7. doi: 10.1111/j.1365-2923.2008.03235.x.
A model of independent, external review of significant event analysis by trained peers was introduced by NHS Scotland in 1998 to support the learning needs of general practitioners (GPs). Engagement with this feedback model has increased over time, but participants' views and experiences are largely unknown and there is limited evidence of its educational impact. This is important if external feedback is to play a potential role in appraisal and future revalidation.
The study aimed to explore aspects of the acceptability and educational impact of this external feedback model with participating GPs.
Semi-structured interviews were carried out with nine GPs. Participants were sampled to reflect their level of learning need (low, moderate or high) to gain a range of views and experiences. Transcribed interviews were analysed for content.
This system of external peer feedback is generally acceptable to participants. It complemented and enhanced the appraisal process. External feedback had positive educational outcomes, particularly in imparting technical knowledge on how to analyse significant events. Training issues for peer reviewers were suggested that would further enhance the educational gain from participation. There was disagreement over whether this type of feedback could or should be used as supporting evidence of the quality of doctors' work to educational and regulatory authorities.
The findings add to the evidence for the acceptability and educational impact of external review by trained peers. Aligning such a model with the current national appraisal system may provide GPs with a more robust demonstration of participation in reflective learning.
1998年，苏格兰国民保健服务体系引入了一种由受过培训的同行对重大事件分析进行独立外部审查的模式，以满足全科医生的学习需求。随着时间的推移，对这种反馈模式的参与度有所提高，但参与者的观点和经历在很大程度上尚不为人所知，而且其教育影响的证据有限。如果外部反馈要在评估和未来重新认证中发挥潜在作用，这一点很重要。
该研究旨在探讨这种外部反馈模式对参与的全科医生的可接受性和教育影响方面。
对9名全科医生进行了半结构化访谈。对参与者进行抽样，以反映他们的学习需求水平（低、中或高），从而获得一系列观点和经历。对转录的访谈内容进行分析。
这种外部同行反馈系统总体上为参与者所接受。它补充并加强了评估过程。外部反馈产生了积极的教育成果，特别是在传授如何分析重大事件的技术知识方面。提出了同行评审员的培训问题，这将进一步提高参与带来的教育收益。对于这种类型的反馈是否能够或应该用作向教育和监管当局证明医生工作质量的支持证据，存在分歧。
这些发现增加了关于受过培训的同行进行外部审查的可接受性和教育影响的证据。使这种模式与当前的国家评估系统保持一致，可能会为全科医生提供更有力的参与反思性学习的证明。
