Appraisal is an important process in the medical field which essentially allows you stand back from your work and think about how best to improve what you are doing. Another component of this appraisal process is reflective practice where you actually think through what you have learnt and what you will do differently as a result.
Medical appraisal usually begins during the training years and should continue throughout your entire professional career. It is usually done between a doctor and a trained colleague and includes a discussion about areas of your practice—both good and bad, and how to use these learning points to improve in the future.
Even reflecting on your own practice allows you to recognise your own strengths and weaknesses, guide self-directed learning, improve motivation, and ultimately improve the quality of care you are able to provide.
In medicine, reflections are typically done on things that went wrong, as these tend to stay on your mind and force you to ponder about what could have been done differently. Some common examples of events that prompt reflective practice are surgical complications, missed diagnoses, failed procedures, and even dissatisfied patients.
However, reflecting on things that went well can often be more rewarding and are just as useful. It can build confidence and help you to repeat it again on another occasion. For instance, a well-managed medical emergency with a good outcome, a difficult but well performed procedure, or even a thank you card from a patient can all be a learning experience.
In many centres worldwide this is done in a relatively structured way, with dedicated time for appraisal and to discuss your reflections with the appraiser, as well as the use of learning portfolios to document and track your progress and list immediate objectives and goals.
What I am getting at here, is that these well-known processes of performance appraisal and reflective practice are useful in just about any field and essentially encourage improvement in an environment that is hopefully non-confrontational and blame-free.
In addition to being an important part of overall career progression, the ability to actively reflect and gain insight from daily activities form the basis of critical thinking.
Critical thinking is the ability to think clearly and rationally and understand the logical connection between ideas. It requires you to use your ability to reason and makes you an active learner rather than a passive recipient of information.
Even my young daughter who is about to start SEA preparation is now encouraged by her teachers to do things in a critical way as the exam is now structured around analysing and solving problems, and not just learning by rote which is really just mechanical repetition.
Particularly as our country heads to a general election, we now must consider our role in performance appraisal as well as our use of critical thinking. It is up to us to question ideas and assumptions rather than accepting them at face value. After all, even in medicine there are consequences if you fail to show an acceptable level of career progression. Not passing exams or ticking all the other essential boxes will halt any advancement until certain standards are met.
In the UK, there is now revalidation which means you must be appraised annually and show evidence of your ability to reflect and learn and improve, in order to retain your license to practise. Indeed, this can be revoked if certain requirements are not met.
In the end, it is hoped that we can use these skills to determine the importance and relevance of ideas and arguments in a systematic and critical way rather than by intuition and instinct. This will ultimately decide our future growth and development.