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First study in 20 years into peer review groups

05 March 2019 | Avant media

Since their inception, peer review groups for psychiatrists have built a reputation for promoting reflective practice as well as providing education and collegial support for participants. This was confirmed by studies at the time.

For the first time since they were set up in the 1990s, a research team will again test that reputation.

Supported by an Avant Foundation Quality Improvement Grant, the research will evaluate psychiatrists’ peer review groups and explore participants’ perception of the role the peer review group has on their practice, professionalism and wellbeing.

“Good peer support is hugely beneficial for practitioners. We are thrilled to sponsor this study, which could promote greater uptake of peer review groups across the medical profession,” Dr Penny Browne, Chair of the Avant Foundation Board, says.

The research team is made up of two psychiatrists who were part of the original development and research of peer review groups in the 1990s, Dr Shirley Prager and Dr Jan Lancaster in Melbourne. They will work with Dr Aspasia Karageorge, a research psychologist and Associate Professor Louise Nash, a psychiatrist (pictured), who are both from the Brain and Mind Centre at the University of Sydney.

The doctors’ experience

The experience doctors have while in training or in practice, during reflection or in times of stress, has been a keen area of interest for Associate Professor Nash throughout her career.

She was instrumental in researching the impact that complaints and law suit processes have on doctors in her pioneering PhD study, also supported by a grant from Avant.

This study investigated the impact medico-legal matters had on the health, wellbeing and practice of Australian medical practitioners, Associate Professor Nash says, “It was something we all knew but it was good to have it documented officially through a research method”.

Her research encouraged greater support for doctors going through a medico-legal matter, such as Avant’s Personal Support Program.

Associate Professor Nash believes peer review groups are hugely beneficial and is grateful to Avant for the quality and safety grant to support this research to test their hypotheses.

Peer review groups and the benefits

Associate Professor Nash is enthusiastic about her peer review group which has been running for decades. “What I say about my peer review groups is; it’s lovely when they agree with me or when they like what I’m doing, but what I really need them to do is to tell me when they don’t agree with me,” she laughs.

Peer review groups were first set up in 1992 by a group of psychiatrists in Melbourne, and are now included in the Royal Australian & New Zealand College of Psychiatrists’ (RANZCP) Continuing Professional Development (CPD) program. This model inspired others such as The Australian and New Zealand College of Anaesthetists, surgical assistants and psychiatrists in Ireland to adopt the same.

Self-selected and self-directed, RANZCP Peer Review Groups’ members choose what and how they discuss items, relating, for example, to clinical, administrative, research, management, leadership or academic work. The college doesn’t impose specific requirements and requests only limited registration details.

Peer review groups can help overcome the isolation for remotely-based psychiatrists, where groups may meet through video conferencing.

The study and the potential

Associate Professor Nash believes a well-running peer review group (PRG) provides educational and collegial support for practitioners, which in turn may improve clinical practice, professionalism and personal wellbeing.

“We know healthcare can be a high-stress profession. Perhaps this peer process is helpful not just to check on your own clinical performance but also to help you manage uncertainty, possibly to help generate new ideas and also from a wellbeing point of view by having support around you that you could ask any question to,' she offers.

“So I’m saying let’s get some more data on this so we can be more specific about what our PRGs achieve,” she adds.

The study will collect the perceptions of psychiatrist members of peer review groups through qualitative and quantitative methods including online surveys, interviews and focus groups.

Associate Professor Nash and her team aim to explore how psychiatrists experience peer review groups by considering:

  • the range of forms that existing PRGs take
  • the range of functions of the group and has this changed over time
  • how PRGs could be improved
  • the purpose of PRG participation from participants' perspective including:
    • review of clinical management
    • networking and benefits of collegiality (reduction of isolation; management of uncertainty; impact on wellbeing).

She says the research could be useful for other specialities, “For surgeons or physicians or any other disciplines to see whether what we do in psychiatry is a model they would consider good for their colleges and members – like the anaesthetists have adopted”.

Similarly, she hopes the Medical Board will be interested in the findings since, “they consider peer review to be one of the pillars of continuing professional development”.

A report of the findings will be delivered to the RANZCP and funding bodies (including Avant). It will also be presented for publication in a peer-reviewed journal and presented at national and international conferences.

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