Designing a system for performance appraisal: balancing physicians’ accountability and professional development

Background In many healthcare systems, physicians are accustomed to periodically participate in individual performance appraisals to guide their professional development. For the purpose of revalidation, or maintenance of certification, they need to demonstrate that they have engaged with the outcomes of these appraisals. The combination of taking ownership in professional development and meeting accountability requirements may cause undesirable interference of purposes. To support physicians in their professional development, new Dutch legislation requires that they discuss their performance data with a non-hierarchical (peer)coach and draft a personal development plan. In this study, we report on the design of this system for performance appraisal in a Dutch academic medical center. Methods Using a design-based research approach, a hospital-based research group had the lead in drafting and implementing a performance appraisal protocol, selecting a multisource feedback tool, co-developing and piloting a coaching approach, implementing a planning tool, recruiting peer coaches and facilitating their training and peer group debriefings. Results The system consisted of a two-hour peer-to-peer conversation based on the principles of appreciative inquiry and solution-focused coaching. Sessions were rated as highly motivating, development-oriented, concrete and valuable. Peer coaches were considered suitable, although occasionally physicians preferred a professional coach because of their expertise. The system honored both accountability and professional development purposes. By integrating the performance appraisal system with an already existing internal performance system, physicians were enabled to openly and safely discuss their professional development with a peer, while also being supported by their superior in their self-defined developmental goals. Although the peer-to-peer conversation was mandatory and participation in the process was documented, it was up to the physician whether or not to share its results with others, including their superior. Conclusions In the context of mandatory revalidation, professional development can be supported when the appraisal process involves three characteristics: the appraisal process is appreciative and explores developmental opportunities; coaches are trustworthy and skilled; and the physician has control over the disclosure of the appraisal output. Although the peer-to-peer conversations were positively evaluated, the effects on physicians’ professional development have yet to be investigated in longitudinal research designs.

Hidden speech, private thoughts: a case study in peer conversation and educational choice

The role of peer and friendship-group conversation in educational and career choices is of great relevance to widening participation (WP) practitioners, but has been little studied in recent years. We interviewed young people and WP practitioners in Carlisle, an isolated city in the UK, to interrogate this subject. We found that young people were clearly discussing their future choices, sometimes overtly and sometimes in 'unacknowledged conversations'. However some topics and ambitions were seen as 'too private' to discuss; all of our young people had a plan for the future, but many believed that some of their friends did not, possibly because of this constraint. We also discuss the role of older students in informing choices, the phenomenon of 'clustering' that can lead to young people funnelli ng into certain options, and the role that geographical isolation might play in exacerbating some effects. Finally we give some recommendations for WP practice based on these findings.

Education is Key for Increasing Breastfeeding Duration Among Working Mothers

IntroductionFederal law mandates protections for time and a private place for pumping. However, mothers continue to express feelings of guilt explaining how the return to work ended their breastfeeding journey. Nationwide, there is a significant drop in exclusive breastfeeding rates at the 3- and 6-month marker, which coincides with the return to employment.MethodMothers attended a “Working Moms' Breastfeeding Class,” a hybrid taught by lactation consultants mixed with the peer-to-peer conversation.ResultsAfter attending the class, mothers reported an increase in knowledge concerning the law, pumping, breast milk handling, and childcare feeding practices.DiscussionEducating mothers at the time of their transition back into the workforce is key to increasing maternal self-efficacy to meet their breastfeeding goals.

Let’s Chat - A fresh take on the invaluable role of peer-to-peer conversation in student engagement, participation and inclusion

This session reports on Monash University’s recently developed Let’s Chat program, delivered at three campuses as a modularised, peer learning opportunity for students from first year to PhD. Involving 3,591 student participants and facilitators in 2015 and 2016, the program responds directly to student feedback and recommendations. Let’s Chat maximises opportunities for peer-to-peer interaction with the aim of increasing participants’ confidence and competence in spoken English and intercultural communication. Informed by current trends in student-centred and peer-assisted learning theory, TESOL and intercultural communication, Let’s Chat is quickly establishing itself as an effective approach to supporting student participation, engagement and sense of belonging in diverse teaching and learning contexts and communities. The session presents a snapshot of the genesis of the program; an evaluation of its implementation; and a summary of emerging outcomes. The session also engages participants in a conversation about how this model might be replicated in other settings.

Communication strategy used by Spanish speakers of English in formal and informal speech

Research questions: Are emergent bilinguals sensitive to register variation in their use of communication strategies? What strategies do LX speakers, in casu Spanish speakers of English, use as a function of situational context? What role do individual differences play? Methodology: This within-speaker study compares Spanish second-language English speakers’ communication strategy use in an informal, peer-to-peer conversation and a formal interview. Data and analysis: The 15 hours of informal and 9.5 hours of formal speech from the Nijmegen Corpus of Spanish English were coded for 19 different communication strategies. Findings/conclusions: Overall, speakers prefer self-reliant strategies, which allow them to continue communication without their interlocutor’s help. Of the self-reliant strategies, least effort strategies such as code-switching are used more often in informal speech, whereas relatively more effortful strategies (e.g. reformulations) are used more in informal speech, when the need to be unambiguously understood is felt as more important. Individual differences played a role: some speakers were more affected by a change in formality than others. Originality: Sensitivity to register variation has not yet been studied within communicative strategy use. Implications: General principles of communication govern speakers’ strategy selection, notably the protection of positive face and the least effort and cooperative principles.