Appraisal – the World’s Cost-Effective Management Tool?

How much time, money and effort does a practice spend on building and promoting a website, buying the latest equipment or learning a new skill?  Of course, every forward-thinking practice will consider these as investments, not a cost to the business.  To be successful, it is essential that a practice continues to invest in in improving its assets.

The practice’s most significant asset is its human resources – the team of people who work there.   The team are also the practice’s most significant cost.  It follows that even a small improvement in a team member’s performance will have a significant effect on the quality and quantity of care it can deliver. Appraisal

Appraisal is widely regarded as an effective way of promoting small, incremental improvements in person’s performance.  It’s part of the Philosophy of Marginal Gains that has had such a profound effect in all walks of business and sporting life .   And since the team member is already being paid, it is unlikely to cost the practice any more either.  Add to that the benefits of greater self-esteem and more integrated team working and it surely makes Appraisal the most cost-effective way to improve your practice.

However, how many practice managers have had training in appraisal? How often does an appraisal simply descend into a monologue of ‘do’s and don’ts’ from the practice manager?  At the same time, the team member awaits their opportunity to leave the room and go back to doing things the way they’ve always done them.

Appraisal is a series of skills and techniques that are worth investing in.

What is the appraisal process?

The main purpose of appraisal is to give a team member  the opportunity to reflect on their work and learning needs in order to improve their performance.  This can be achieved through discussing their development and providing feedback on their job performance in a way that is constructive and motivational.  It should result in an effective personal development plan.

An appraisal should focus mainly on how to improve so it is important not to spend too much time reviewing past performance.  An effective appraisal involves the team member fully in the discussion rather than lecturing at them, so that they can get the maximum benefit from the appraisal.

Ideally an appraisal should be:

  • A piece of two-way rather than one-way communication.
  • A process rather an event.
  • A tool for development as well as for assessing performance.

It is also important to be clear on what an appraisal is not.  Appraisal is not a disciplinary process or a disciplinary discussion.  There are other separate processes for addressing serious issues to do with conduct or capability, which should be followed and used appropriately. 

They are also intended to ensure that people are kept updated with the latest developments and inform them of the skills they need to develop in order to address change positively.

Appraisal is part of  Reflective practice.  Reflective practice is a process of examining strengths and weaknesses in order to learn and develop.  Undertaking planned reflection demonstrates a commitment to professionalism and future development.

“Professionalism can be defined as the manner in which one reflects on and reconciles different aspects of professional practice, which demonstrates acceptance of professional responsibility and accountability”

(Ref: Zijlstra-Shaw et al 2013)

So how does this impact on the day-to-day working of a DCP?  It is argued that if dental nursing is to be recognised as a profession, dental nurses need to be engaged in critical thinking, professional reflection and the examination of self in terms of personal core capabilities and capacity. 

The Dental Business Academy has recently added Appraisal and Recruitment modules to its popular Level 4 Diploma in Dental Practice Management.  These modules have been written by Janet Goodwin and Andy Toy, using their many years of practice and academic experience in the world of dentistry. 

The diploma is designed to help you make a difference from day one, with assignments based on your own practice.  It also allows you to ‘earn while you learn’, without taking precious time away from the practice.  Here’s some of our recent feedback:

“The course was very difficult but very worthwhile. I thoroughly enjoyed learning. My assessor Miranda was a fantastic support for me! I will definitely be recommending the DBA to my colleagues. A lot of time and effort has been put into the course. The content really makes you want to learn more about the role. For me the course came at a great time, we had just taken over a practice and had inherited a bit of a disaster but with my coursework I was able to sort everything out from a managerial point of view. Gaining this qualification has also given me confidence that I can achieve in my job role. Thank you once again for all the support I received!”

Members of ADAM receive a generous 30% discount on the cost of completing the diploma.  The modules are also available as stand-alone CPD.  Go to our dental courses page to find out more, or email on

i. Syed, Matthew  Black Box Thinking: Marginal Gains and the Secrets of High Performance John Murray, London 2016

ii. Zijlstra-shaw, S; Roberts, T E; Robinson, P G.  Perceptions of professionalism in dentistry – a qualitative study British Dental Journal; London215.9 (Nov 8, 2013): E18.

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