Barriers and attitudes influencing non-engagement in a peer feedback model to inform evidence for GP appraisal

We conducted semi-structured interviews with a sample of west of Scotland GPs who had yet to participate in the peer review model. A thematic analysis of the interview transcriptions was conducted using a constant comparative approach.13 GPs were interviewed of whom nine were males. Four core themes were identified in relation to the perceived and experienced 'value' placed on the topics discussed and their relevance to routine clinical practice and professional appraisal: 1. Value of the appraisal improvement activity. 2. Value of external peer review. 3. Value of the external peer review model and host organisation and 4. Attitudes to external peer review.GPs in this study questioned the 'value' of participation in the external peer review model and the national appraisal system over the standard of internal feedback received from immediate work colleagues. There was a limited understanding of the concept, context and purpose of external peer review and some distrust of the host educational provider. Future engagement with the model by these GPs is likely to be influenced by policy to improve the standard of appraisal and contractual related activities, rather than a self-directed recognition of learning needs.Since 2003, general practitioners (GPs) in the United Kingdom (UK) have been contractually obliged to engage in a peer appraisal of their professional practice [1]. This involves an externally nominated peer colleague (appraiser) reviewing specific aspects of an individual GP's (appraisee) professional practice on an annual basis. Feedback to aid professional development is provided in a 'non-judgemental' and formative manner. The appraisal interview remains a confidential interaction between the appraiser and appraisee, unless issues arise during discussions that give cause for serious concerns about the well-being of the doctor or patients.There is an expectation that the combined evidence from five consecutive annual appraisals would substantially inform