McKay John, Pope Lindsey, Bowie Paul, Lough Murray
Division of Community Based Sciences, University of Glasgow, Glasgow, UK.
J Eval Clin Pract. 2009 Feb;15(1):142-7. doi: 10.1111/j.1365-2753.2008.00969.x.
Peer feedback is well placed to play a key role in satisfying educational and governance standards in general practice. Although the participation of general practitioners (GPs) as reviewers of evidence will be crucial to the process, the professional, practical and emotional issues associated with peer review are largely unknown. This study explored the experiences of GP reviewers who make educational judgements on colleagues' significant event analyses (SEAs) in an established peer feedback system.
Focus groups of trained GP peer reviewers in the west of Scotland. Interviews were taped, transcribed and analysed for content.
Consensus on the value of feedback in improving SEA attempts by colleagues was apparent, but there was disagreement and discomfort about making a dichotomous 'satisfactory' or 'unsatisfactory' judgement. Differing views on how peer feedback should be used to compliment the appraisal process were described. Some concern was expressed about professional and legal obligations to colleagues and to patients seriously harmed as a result of significant events. Regular training of peer reviewers using several different educational methods was thought essential in enhancing or maintaining their skills. Involvement of the participants in the development of the feedback instrument and the peer review system was highly valued and motivating.
Acting as a peer reviewer is perceived by this group of GPs to be an important professional duty. However, the difficulties, emotions and tensions they experience when making professional judgements on aspects of colleagues' work need to be considered when developing a feasible and rigorous system of educational feedback. This is especially important if peer review is to facilitate the 'external verification' of evidence for appraisal and governance.
同行反馈在满足全科医疗的教育和管理标准方面能够发挥关键作用。尽管全科医生（GP）作为证据审查者的参与对这一过程至关重要，但与同行评审相关的专业、实践和情感问题在很大程度上尚不为人所知。本研究探讨了在一个既定的同行反馈系统中，对同事的重大事件分析（SEA）做出教育判断的全科医生评审者的经历。
对苏格兰西部经过培训的全科医生同行评审者进行焦点小组访谈。访谈进行录音、转录并分析内容。
对于反馈在改善同事的重大事件分析尝试方面的价值达成了明显共识，但在做出“满意”或“不满意”的二分法判断上存在分歧和不适。描述了关于应如何利用同行反馈来补充评估过程的不同观点。有人对因重大事件而受到严重伤害的同事和患者承担的专业和法律义务表示担忧。使用几种不同教育方法对同行评审者进行定期培训被认为对于提高或维持他们的技能至关重要。参与者参与反馈工具和同行评审系统的开发受到高度重视且具有激励作用。
这群全科医生认为担任同行评审者是一项重要的专业职责。然而，在制定可行且严格的教育反馈系统时，需要考虑他们在对同事工作的各个方面做出专业判断时所经历的困难、情感和紧张情绪。如果同行评审要促进评估和管理证据的“外部验证”，这一点尤为重要。
