Julian Archer1, Sam Regan de Bere, Suzanne Nunn, Jonathan Clark, Oonagh Corrigan. 1. Dr. Archer is National Institute for Health Research Career Development Fellow, senior clinical lecturer, and director, Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, United Kingdom. Dr. Regan de Bere is lead for medical humanities and deputy director, Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, United Kingdom. Dr. Nunn is research fellow, Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, United Kingdom. Mr. Clark is lecturer in sociology, Plymouth University, Plymouth, Devon, United Kingdom. Dr. Corrigan is honorary fellow, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, United Kingdom.
Abstract
PURPOSE: To analyze prevailing definitions of revalidation (i.e., a recently instituted system of ongoing review for all physicians in the United Kingdom), the circumstances of their origin, and proposed applications, after a protracted and sometimes difficult decade in development. This was to support a more consensual approach to revalidation policy before its launch in 2012. METHOD: In 2010 and 2011, the authors carried out a critical discourse analysis of interviews with 31 medical and legal revalidation policy makers. These individuals represented the main stakeholder bodies, including the General Medical Council, Academy of Medical Royal Colleges, British Medical Association, National Health Service Employers, and the departments of health from across the United Kingdom. RESULTS: The authors identified two overarching discourses: regulation and professionalism, held together by patients as "discursive glue." Regulation frames revalidation as a way to identify "bad apples," requiring a summative approach and minimum standards. Professionalism looks to revalidation as a process by which all doctors improve, requiring evolving standards and a developmental model. CONCLUSIONS: These two discourses were not mutually exclusive; indeed, most interviewees used them interchangeably. However, they are in some regards at odds. Their coexistence has been supported by a shared discursive formation around patients. Yet the authors found little patient-centered policy in revalidation in its current form. The authors concluded that patients need to be recognized, making them present with an active voice. They also stressed the importance of established and ongoing evaluation of medical regulation as a policy and process.
PURPOSE: To analyze prevailing definitions of revalidation (i.e., a recently instituted system of ongoing review for all physicians in the United Kingdom), the circumstances of their origin, and proposed applications, after a protracted and sometimes difficult decade in development. This was to support a more consensual approach to revalidation policy before its launch in 2012. METHOD: In 2010 and 2011, the authors carried out a critical discourse analysis of interviews with 31 medical and legal revalidation policy makers. These individuals represented the main stakeholder bodies, including the General Medical Council, Academy of Medical Royal Colleges, British Medical Association, National Health Service Employers, and the departments of health from across the United Kingdom. RESULTS: The authors identified two overarching discourses: regulation and professionalism, held together by patients as "discursive glue." Regulation frames revalidation as a way to identify "bad apples," requiring a summative approach and minimum standards. Professionalism looks to revalidation as a process by which all doctors improve, requiring evolving standards and a developmental model. CONCLUSIONS: These two discourses were not mutually exclusive; indeed, most interviewees used them interchangeably. However, they are in some regards at odds. Their coexistence has been supported by a shared discursive formation around patients. Yet the authors found little patient-centered policy in revalidation in its current form. The authors concluded that patients need to be recognized, making them present with an active voice. They also stressed the importance of established and ongoing evaluation of medical regulation as a policy and process.
Authors: Kieran Walshe; Alan Boyd; Marie Bryce; Kayleigh Luscombe; Abigail Tazzyman; John Tredinnick-Rowe; Julian Archer Journal: J R Soc Med Date: 2017-01-13 Impact factor: 5.344
Authors: Abigail Tazzyman; Jane Ferguson; Kieran Walshe; Alan Boyd; John Tredinnick-Rowe; Charlotte Hillier; Samantha Regan De Bere; Julian Archer Journal: Acad Med Date: 2018-04 Impact factor: 6.893
Authors: Carolin Sehlbach; Marjan J B Govaerts; Sharon Mitchell; Truus G J Teunissen; Frank W J M Smeenk; Erik W Driessen; Gernot G U Rohde Journal: Health Expect Date: 2019-11-20 Impact factor: 3.377
Authors: Abigail Tazzyman; Jane Ferguson; Charlotte Hillier; Alan Boyd; John Tredinnick-Rowe; Julian Archer; Sam Regan de Bere; Kieran Walshe Journal: BMC Health Serv Res Date: 2017-11-21 Impact factor: 2.655