title: Verification of 'learning credits' by GP appraisers.
abstract: BACKGROUND
  The RCGP CPD Learning Credits system aims to enable GPs to demonstrate knowledge and skills relevant to their daily practice. Credits are self-assessed and will form part of the 'evidence' necessary for successful revalidation. At an appraisal, GP appraisers verify the credits in terms of the time spent on the CPD activity and its impact on the GP's practice. The purpose of this study was to examine the extent to which GPs (as appraisees) are able to self-assess their own learning and, as appraisers, verify credits in a standardised way.
  
  
  METHODS
  All 17 GP appraisers in NHS Lanarkshire were invited to participate in a study, which triangulated three sources of evidence on credits: self-rating, peer-assessment and workshop discussion. The resultant data were analysed on an Excel spreadsheet. Outcomes included self-assessed credit value, peer-assessed mean score (range) and free text.
  
  
  RESULTS
  Of the 17 appraisers, 15 completed the paperwork and 13 attended the workshop. GPs' self-assessed learning credits were equivalent to peer-assessed score in 5/15 cases, but considered overestimates in 4/15 and underestimates in 6/15 cases. The most extreme variance was for an oncology module, where the variance ranged from 28% to 200% of the self-assessed score.
  
  
  CONCLUSIONS
  GPs have a variable understanding of how to award themselves learning credits and of how to judge the credits of potential appraisees. Without adequate resources for appraisal training, validated instruments, calibration and reliability, verification of the learning credit system will be flawed by its subjective and arbitrary nature.
authors.affiliation: NHS Education for Scotland/NHS Lanarkshire. jill.murie@nhs.net
authors.forename: Jill
authors.initials: J
authors.lastname: Murie
authors.forename: Judy
authors.initials: J
authors.lastname: Wakeling
mesh_terms: D003406:Credentialing / Q000592:standards*; D004502:Education, Medical, Continuing; D004650:Employee Performance Appraisal / Q000592:standards*; D005260:Female; D058006:General Practice / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012606:Scotland; D012647:Self-Assessment