Peer group activities are part of the requirement to review and reflect on practice.  Peer review groups meet regularly to discuss case management and clinical problems, with the aim of improving the performance of individuals within the group. 

A minimum of 6 hours of peer review group activities must be performed each year.

Rules

  • At least three doctors will be present and participating.  
  • At least one person present will be an RNZCUC Fellow or senior registrar. The Education Committee may waive this rule for registrars working in a location where a RNZCUC Fellow or senior registrar is not available. 
  • The group discusses urgent care cases or clinical challenges with the aim of improving clinical performance. 
  • RNZCUC accepts video conference peer group meetings but meetings should be in-person if possible. 
  • Peer review must take place in an environment conducive to the confidentiality of the patients being discussed, and the privacy of the doctor whose work is being reviewed. 

Examples 

As long as the rules above have been satisfied, examples of peer review might include: 

  • difficult or interesting cases
    • Clinically challenging
    • Those where there was a challenge providing culturally appropriate care*
    • Those where achieving an equitable health outcome was challenging*
  • learning points from the training programme 
  • journal articles relevant to a recent case 
  • joint review of cases 
  • critique of a video review of consultation.

*when the peer group activity covers cultural safety or health equity (a high-value activity), an additional point for each hour may be claimed as triennial CPD points, but the minimum requirement of 6 hours per year of peer group activity remains.

For clinicians, peer review does not include the following, which may, instead, be claimed as triennial CPD activities: 

  • practice management 
  • matters relating to practice premises or systems 
  • non-clinical research 
  • non-clinical education 
  • participation in College or other committees that are not of a clinical nature 

 Finding a peer group 

A list of peer groups in NZ is available here. 

Registrars should check first with their supervisor for their recommendation for a peer group. When access to an RNZCUC Fellow or senior registrar is not possible, registrars should communicate with the Director of Clinical Training to seek dispensation. 

Getting the most from the peer group 

Many doctors report that the best discussions only eventuate after several meetings when participants become comfortable with the group and feel free to be frank. Some keys to facilitating this atmosphere are: 

  • An attitude that all members of the group are equals (peers). 
  • No direct criticism or threatening attitudes. 
  • Keep time limits. 
  • Encourage participation by all members. 
  • Encourage and plan for socialisation. The end of the meetings is a good time for this. 

Guidance on peer review in ED 

Any RNZCUC registrar working in an ED with no RNZCUC Fellow or senior registrar should first seek dispensation. 

ED often run training events or symposia with multiple foci.  Peer review may be part of this.  If the event includes feedback, guidance, or critique of your clinical performance and is in a group format, it may be classed as peer review for the purposes of RNZCUC recertification.  Record your peer review activities on ePortfolio using the template below. 

Examples of ED activities include: 

  • Those listed above 
  • interactive radiology conferences 
  • mortality and morbidity meetings. 

Otherwise, it may be claimed as an educational or triennial CPD activity.  Whichever option you choose, you cannot claim both peer review and CPD points for the same activity (ie no “double-dipping”). 

Recording 

Nominate one person to be responsible for writing minutes and sharing them with everyone present.  An example of meeting minutes is shown below. This table can be downloaded as a word document here. 

RNZCUC allocates points for interaction time only, not preparation. 

Currently (March 2019) individuals enter their peer group activity on their personal ePortfolio. RNZCUC has requested a tool to allow minutes to be uploaded to ePortfolio, in the meantime individuals should keep a copy of the minutes in case of audit.