Abstract

Background 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.
Objective: To investigate the knowledge, attitudes and
beliefs of GPs towards revalidation and appraisal.
Design: Cross sectional survey.
Setting: Lincolnshire, UK.
Participants: General practitioners.
Method: 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.
Results: 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.
Conclusions: 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.