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The key role of self-assessment

Plans for improvement and development are always strengthened if there is individual ‘ownership’. One of the cornerstones of modern theories of human motivation is that people like to have a say in decisions that affect them. So, in terms of appraisal, anything the appraisee can observe, say or decide for themselves is going to have a stronger impact on them achieving positive change than if you say it for them. This is why appraisers should be looking to ‘develop the ask-don’t-tell habit’ (Downey, 1999). In this way they can try to use questions to help the doctor to self-appraise. Compare the following evaluative statement with the question that follows it.

  • ‘You’ve got to be sharper and take a lot more care when taking patient histories. Mistakes or areas missed can really jeopardise the chances of an accurate diagnosis.’
  • ‘Tell me about your use of patient histories as part of diagnosis?’

If the appraisee responds by saying something like, ‘well, that’s an area where I’ve run into a few difficulties’, you can then ask, ‘what sort of difficulties?’ followed by ‘talk me through an example?’ Before you know it the doctor will be working towards solutions and proposing improvements that they’ve identified for themselves. And what’s more, they will probably be far better and more personally appropriate solutions than any you could suggest for them. You still have a role, of course, adding your own observations, where useful, and helping them to select and refine the improvement proposed, but this is much more a coaching role than that of a directive manager. As a coach your main role is to ‘listen’.

It is worth keeping in mind here the four ‘ifs’ of self-evaluation:

  1. If I see it for myself, I know it for myself
  2. If I say it for myself, I understand it for myself
  3. If I commit to it myself, I’ll change it for myself
  4. If I improve it myself, I’ll go on learning for myself.

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