Background: Improving the quality of care for people with dementia in general

The mentoring intervention piloted in this study demonstrates a feasible approach to identifying and developing learning needs. Small numbers in the study make it difficult to attribute this specifically to the action learning approach taken. However, the framework presented was recognised as useful by the mentors. Future work will aim to identify if the approach is due to action learning specifically or the more general effect of counselling.

This paper introduces the first stage of the NHS Revalidation Support Team's (RST) proposals to strengthen medical appraisal. It reports on four focus groups held at London Deanery in 2010, with the aim of gauging initial reactions from general practitioners (GPs). The four groups consisted of two groups of appraisers and two groups of appraisees. After presentation of the proposals to strengthen appraisal, participants were invited to make comparisons between existing appraisal, and the new proposals, Interestingly, the matter which attracted most discussion was a proposal to include an element of self-assessment by the appraisee prior to appraisal, and not, as might have been expected, the proposals for assessment of the appraisee's progress towards revalidation by the appraiser. Since these focus groups, the model of strengthened medical appraisal referred to in this paper has been the subject of testing in the pathfinder pilot, a large scale pilot involving 3000 doctors in various settings in England. The evaluation of the pathfinder pilot was published (July 2011). After further refinement of the appraisal process, including taking into account new GMC and Royal College publications and more testing and piloting, the final version of medical appraisal to support revalidation, known as the Medical Appraisal Guide (MAG) is due to be published in March 2012, in time to permit the expected commencement of revalidation in late 2012.

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Simulation has radically changed medical training and is set to continue to do so in the future. The branch of simulation that sees actors playing a role in training and assessment is long-established and well-developed. Typically actors have been used to play the role of patient. This innovation in communication skills teaching sees actors playing doctors (specifically GP trainees or GP appraisees), to enhance the continuing professional development of established GP trainers and appraisers. By using actors, scenarios drawing on typical encounters can be played up or down using techniques which are familiar to hi-fidelity electronic simulation. This flexibility enables the 'challenge' of the encounter to be tailored to the needs of the participants in order to maximise their learning. Feedback from participants at the workshops was positive, noting that the approach is both challenging and revealing of their own practice. More research is needed to develop this approach further and explore it's relevance to other areas of GP training and CPD.