SMART, SMARTER, SMARTEST: The influence of peer groups compared to practice visits on the quality of action plans

Background: It has been reported that appraisal by peers can be effective. Aim: To investigate whether feedback from a peer group (PG) compared to that by a staff member during a practice visit (PV) is as effective in improving the quality of action plans. Methods: Seventy-three general practitioner (GP) trainers randomized into either a PG or PV were instructed to draw up action plans using the SMART criteria to realize the goals set in their personal development plans (PDPs). To improve action plans, feedback was given in either PG or PV. Quality of baseline and follow-up action plans, operationalized as the SMARTness with which plans were formulated, was assessed using a study-specific instrument. Results: Response rate for submitting both baseline and follow-up action plans was 89% in the PG versus 79% in the PV. It was feasible to determine scores on all SMART criteria, except for the criterion 'Acceptability'. Significant improvement was made on the remaining four criteria irrespective of the feedback setting. Conclusions: PGs cost less and seem equally effective in improving the SMARTness of the action plans. Moreover, they also seem to stimulate GP trainers more to write a PDP. Therefore, they may be favoured over PVs