Skip to main content
Quality & Safety in Health Care logoLink to Quality & Safety in Health Care
. 2005 Jun;14(3):185–189. doi: 10.1136/qshc.2004.010983

A qualitative study of why general practitioners may participate in significant event analysis and educational peer assessment

P Bowie 1, J McKay 1, E Dalgetty 1, M Lough 1
PMCID: PMC1744028  PMID: 15933315

Abstract

Objectives: To explore the influences and perceived benefits behind general practitioners' willingness to participate in significant event analysis (SEA) and educational peer assessment.

Design: Qualitative analysis of focus group transcripts.

Setting: Greater Glasgow Primary Care Trust.

Participants: Two focus group sessions involving 21 principals in general practice (GPs).

Main outcome measures: GPs' perceptions of the reasons for and benefits of participating in SEA and associated educational peer assessment.

Results: Pressure from accreditation bodies and regulatory authorities makes SEA compulsory for most participants who believe more in-depth event analyses are undertaken as a result. Some believed SEA was not an onerous activity while others argued that this depended on the complexity of the event. SEA that is linked to a complaint investigation may provide credible evidence to patients that their complaint is taken seriously. Writing up an event analysis is viewed as an educational process and may act as a form of personal catharsis for some. Event analyses are submitted for peer assessment for educational reward but are highly selective because of concerns about confidentiality, litigation, or professional embarrassment. Most participants disregard the opportunities to learn from "positive" significant events in favour of problem ones. Peer assessment is valued because there is a perception that it enhances knowledge of the SEA technique and the validity of event analyses, which participants find reassuring.

Conclusions: This small study reports mainly positive feedback from a select group of GPs on the merits of SEA and peer assessment.

Full Text

The Full Text of this article is available as a PDF (68.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benett I. J., Danczak A. F. Terminal care: improving teamwork in primary care using Significant Event Analysis. Eur J Cancer Care (Engl) 1994 Jun;3(2):54–57. doi: 10.1111/j.1365-2354.1994.tb00013.x. [DOI] [PubMed] [Google Scholar]
  2. Bowie P., McKay J., Norrie J., Lough M. Awareness and analysis of a significant event by general practitioners: a cross sectional survey. Qual Saf Health Care. 2004 Apr;13(2):102–107. doi: 10.1136/qshc.2003.006734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bradley C. P. Turning anecdotes into data--the critical incident technique. Fam Pract. 1992 Mar;9(1):98–103. doi: 10.1093/fampra/9.1.98. [DOI] [PubMed] [Google Scholar]
  4. Evans Richard, Elwyn Glyn, Edwards Adrian. Review of instruments for peer assessment of physicians. BMJ. 2004 May 22;328(7450):1240–1240. doi: 10.1136/bmj.328.7450.1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. FLANAGAN J. C. The critical incident technique. Psychol Bull. 1954 Jul;51(4):327–358. doi: 10.1037/h0061470. [DOI] [PubMed] [Google Scholar]
  6. Fraser S. W., Greenhalgh T. Coping with complexity: educating for capability. BMJ. 2001 Oct 6;323(7316):799–803. doi: 10.1136/bmj.323.7316.799. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Henderson Emma, Berlin Anita, Freeman George, Fuller Jon. Twelve tips for promoting significant event analysis to enhance reflection in undergraduate medical students. Med Teach. 2002 Mar;24(2):121–124. doi: 10.1080/01421590220125240. [DOI] [PubMed] [Google Scholar]
  8. Lough J. R. Goals and methods of audit should be reappraised. Regions should define audit strategy. BMJ. 1996 Aug 24;313(7055):497–497. doi: 10.1136/bmj.313.7055.497a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lough J. R., McKay J., Murray T. S. Audit and summative assessment: a criterion-referenced marking schedule. Br J Gen Pract. 1995 Nov;45(400):607–609. [PMC free article] [PubMed] [Google Scholar]
  10. McIntyre N., Popper K. The critical attitude in medicine: the need for a new ethics. Br Med J (Clin Res Ed) 1983 Dec 24;287(6409):1919–1923. doi: 10.1136/bmj.287.6409.1919. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Norcini John J. Peer assessment of competence. Med Educ. 2003 Jun;37(6):539–543. doi: 10.1046/j.1365-2923.2003.01536.x. [DOI] [PubMed] [Google Scholar]
  12. Ramsey P. G., Wenrich M. D., Carline J. D., Inui T. S., Larson E. B., LoGerfo J. P. Use of peer ratings to evaluate physician performance. JAMA. 1993 Apr 7;269(13):1655–1660. [PubMed] [Google Scholar]
  13. Robinson L. A., Stacy R., Spencer J. A., Bhopal R. S. Use facilitated case discussions for significant event auditing. BMJ. 1995 Jul 29;311(7000):315–318. doi: 10.1136/bmj.311.7000.315. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Walshe K. Opportunities for improving the practice of clinical audit. Qual Health Care. 1995 Dec;4(4):231–232. doi: 10.1136/qshc.4.4.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Westcott R., Sweeney G., Stead J. Significant event audit in practice: a preliminary study. Fam Pract. 2000 Apr;17(2):173–179. doi: 10.1093/fampra/17.2.173. [DOI] [PubMed] [Google Scholar]

Articles from Quality & safety in health care are provided here courtesy of BMJ Publishing Group

RESOURCES