Module 6: Tricky situations

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This module contains the preparation for the face to face meeting planned at the end of the distance learning course.

A number of scenarios are given, you are asked to write brief notes as to what you would do in each situation. These notes will be used to stimulate discussion at the face to face event. Please complete and bring these to the event

  1. An appraisal folder is presented to you and there are very few electronic entries within it. It contains 10 certificates of attendance, an audit that was performed by a junior doctor on the team and 15 letters from patients expressing satisfaction and gratitude. This is the second time the folder has been submitted (the first time it did not contain the patient’s letters). What do you do?
  2. You review a doctor's entries on MARS, there are over 100 different pieces of information. There seems to be no organisation to these. There are the usual certificates of attendance but no information regarding the meetings. There is an audit that has many errors in calculation. There are two significant events which have not been fully addressed. You feel overall that the information presented is of poor quality. What do you do next?
  3. You review a doctor's information which appears to be well organised. There is evidence of attendance at many meetings both local and national. There is a publication in a peer reviewed journal appended. The activity easily exceeds 50 CPD credits. There is an audit that meets the standards set. There is however no commentary on any of these items, there is no evidence that the educational meetings attended have led to change. How would you approach this appraisal?
  4. You have prepared for an appraisal using information supplied by a doctor. The information is just sufficient. At the appraisal the doctor seems distant and is monosyllabic in his responses to your questions. You ask him which pieces of information he wishes to discuss and the reply is “I have produced all the stuff required, can’t we just finish this off and I can get back to work”. What is your response to this?
  5. A doctor produces an audit which has led to no change despite there being several criteria that fall below national accepted standards. She wants you to agree that it is sufficient for revalidation. You discuss the requirements of revalidation and you feel that this audit does not meet them. At this point she raises her voice and disputes the case. How will you respond? What would the next step be?
  6. During an appraisal a doctor raises personal stress as an issue. They then go on to tell you that they are having an affair with one of the nurses on your ward. What is the appropriate way to deal with this during the appraisal?
  7. During an appraisal a doctor tells you that some of the information in the folder is incorrect. There is one certificate for a meeting that he was sent by mistake and an audit that they were not involved in. What issues does this raise? What do you do next?
  8. A doctor includes in their appraisal information a sentence that says “he has missed two diagnoses of appendicitis and a bowel cancer” when you challenge her on this she reveals that the senior consultant on the team has been causing her concern. She refuses to take this through performance processes. What is your position here? What would you do?

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