title: Impact of revalidation on appraisal in primary care: an initial evaluation of the experience of Welsh GPs.
abstract: BACKGROUND
  While appraisal is a well-established process and has been a contractual obligation for GPs in Wales since 2004, revalidation is a new requirement for all doctors practising in the UK. Appraisal is an essential component of revalidation. However as appraisal is developmental, and revalidation is summative, there is concern over the potential impact revalidation may have on the appraisal process itself.
  
  
  METHODS
  This study, carried out among GPs in Wales, aimed to capture participants' perspectives of the initial impact of revalidation on appraisal. The study was commenced by conducting a basic literature review, building on existing research in this area. We employed a mixed method approach (an online survey and focus groups). The online survey was disseminated via Bristol Online Survey. Focus groups were carried out to examine the perspectives of both GP Appraisers and GPs on the study subject matter.
  
  
  RESULTS
  The majority of respondents felt that revalidation had had a medium-sized effect on the appraisal process. Respondents were fairly evenly divided on the nature of that impact. Some reported collecting GMC-specified information had increased time costs. Others found that collecting this information had sparked reflection and changes to their practice. GPs were fairly evenly divided on the precise extent to which the GMC data collection offered an accurate picture of their work and learning. The majority felt that it did, with 20-23% reporting a negative impact.
  
  
  CONCLUSIONS
  The study participants reported that revalidation had impacted on appraisal, bringing increased time and costs alongside some increased individual reflection and Quality Improvement (QI) activity. The impact was felt more by appraisers than appraisees. Overall, of those GPs revalidated in 2013, 62% reported it was a positive experience.
authors.affiliation: a Wales Deanery, Cardiff University.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Williams
authors.affiliation: b School of Postgraduate Medical and Dental Education , Cardiff University , Cardiff , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Holmes
authors.affiliation: a Wales Deanery, Cardiff University.
authors.forename: Katie
authors.initials: K
authors.lastname: Laugharne
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004650:Employee Performance Appraisal / Q000379:methods*; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D011320:Primary Health Care / Q000592:standards; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014852:Wales
keywords: Revalidation; Wales; appraisal; general practice; primary care