From Tick-Box Exercise to Transformation: Rethinking Appraisals in Your Dental Practice

By Jamie MorleyOctober 30, 2025

According to Gallup, only 14% of employees strongly agree their performance reviews inspire them. From what I experience and from what I’ve seen in dental practices I am not sure it is even this high.

Yet, regulatory bodies in the dental sector, specifically the CQC in the UK, dictate that appraisals must be done by all dental practices. This is part of the problem in that the result is it has often become a tick box exercise. Yet, if appraisals are done well and combined into an overall culture of feedback, it can be transformational in developing the performance and success of your dental practice. Read on for 10 key tips to transform your appraisals and also transform your practice. The first 5 tips are more around the concepts and structure, whilst the second batch of 5 tips are about the conversation itself.

Mindset

The first thing that you have to address in doing appraisals is actually your mindset and how you approach them. It is simply to recognise and consider are we doing this as a tick box exercise? Am I feeling this is a complete pain, so I'm just doing it to get it done, or am I seeing it as truly a way to develop and improve the performance of our people and ultimately the practice? This is a critical role for the leadership of any organisation. The first step is that we actually have to always be thinking that this is about helping to improve and develop the performance of our people, not just about satisfying the regulatory body. Part of the reason this happens is because of how in the past people have responded to and become very cynical about appraisals. That is potentially for good reason, because sometimes appraisals can be done very poorly. They can be very harmful and people can really actually end up being demotivated after them rather than helping inspire them to better performance.

Frequency

Common practice is still that appraisals are done every 12 months as a one off. Yet there is significant evidence and research to suggest this is highly ineffective. If you are only talking to people about their performance every 12 months is this really a good way of managing and improving their performance? No! You actually have to see the appraisals as a bringing together of all the conversations and feedback that we have had about that individual's performance throughout that period. It's okay to have a formal appraisal every 12 months, but it's not okay for this to be the first conversation that's been had with that person about their performance! Throughout the year, you must be giving and receiving feedback about both their performance as well as your performance as their manager. You want there to be a consistent open dialogue, giving feedback about them and about the practice and how it's doing.

The appraisal really is just a summary of all that feedback throughout the year. I would personally have a quarterly more formal conversation about performance that summarises all the conversations throughout the quarter when you can still recall them and document them. To repeat, the key is that there is always ongoing dialogue about performance and that you must give people both good and bad feedback consistently as and when you see it.

Who does the appraisal?

I have seen all sorts of different people doing appraisals within dental practices. From the practice principal who does all the appraisals for everybody to the practice manager who does all the appraisals for everybody.

The key point for me is that the person who is doing the appraising has to be able to give effective feedback on an ongoing basis. In order to do that they need to be observing that person in their work as much as possible. Otherwise they are relying on hearsay or the feedback of other people which can be very distorted and biased. It doesn't give you many concrete examples to discuss as evidence of the individual's performance. The person who is managing that individual should also be able to observe the individual in their role. It is this person who should be doing their appraisal. Again, it is not doing the exercise for the sake of doing the exercise, but actually thinking about who can give the most effective feedback and have the best conversations, and that is the person who is observing and seeing the person most in action in their role.

Watch Out for Different Cognitive Bias’

Multiple cognitive biases often come into play when you are doing appraisals. A cognitive bias is a systematic error in thinking that affects how people perceive, interpret, and remember information, often leading to irrational judgments and decisions. Consider the biases that may be at play when you are doing an appraisal and ensure they are accounted for.

Recency bias

Recency bias is where you are biased according to recent events. This is another good reason why just doing an evaluation once a year is not effective in terms of appraisals. If you have seen somebody do something such as perhaps they made a mistake by incorrectly booking in a patient last week, this will bias your judgement of them, for the whole year. The appraisal is meant to be over a whole time period, so you have to look at all the evidence over the entire period when considering the individual's performance.

Group Think

Groupthink is where you are biased according to what the broader group is thinking. Within appraisals, this is can occur because we may be listening to other peoples points of views about that individual who may not be especially popular within the group. You have to separate out the difference between them being popular versus real evidence of them being good or bad at their job. Likewise, they may be popular but not very good at their job. Make sure you're not taken in by the broader group, but again look at the evidence to consider that individuals performance.

Confirmation Bias

Confirmation bias is where you see what you want to see. If you have a view on this person, you will tend only to see the evidence that reinforces this view. You will ignore or delete evidence contrary to this view. This could be either way. It could be you have a positive view of the points of this person over previous years (halo bias) and so you'll only tend to see the good that they do. Or you may have a negative view of this persons performance (horns bias) and likewise see only the bad that they do and the mistakes that they make. Again, it's really important to take a step back and to look at the evidence as to whether this individual has performed to a high level or not without being swayed by your own biases around this person.

Make sure it is a two-way conversation

The conversation should be a two-way conversation, not just you as the appraiser giving your opinion. It is important to have the individual reflect on their own performance, prior to the appraisal before then engaging with USA appraiser to have a conversation around their performance. Genuinely listen to their perspective and their views on their performance at the same time as honestly giving your insights and perspective.

Evidence & Examples

Give clear evidence and examples to the individual based on what's great about their performance and also what's not great about their performance. To gather evidence and feedback from other people is good, as long as it is real evidence. Ask them for examples if they don’t give them. Otherwise, it may be a biased opinion.

Don’t make it all about the rating

It varies as to whether or not people get a rating these days in appraisals. There are pros and cons to giving people a rating. If it becomes all about the rating then actually it detracts from the overall purpose of the appraisal which is to look at performance. What's been good what's been bad and how their performance can be improved. If it's all about the rating then we end up getting into a tit for tat argument about what the rating should be, and this takes us away from thinking about how to improve our performance.

Add in Values

If you have read some of my other articles  you will know that I really strongly believe in the importance of values. The importance of values for dental practice cannot be underestimated. It is not just about having values but actually making sure they all lived. Adding them into appraisals is one way of starting to reinforce values and to look at whether or not people are actually living them. You can ask individuals to come up with specific examples where they have lived those values. You can also discuss situations around where the values haven't been lived.

Personal Development Plan

Personal development plans are a very important part of the performance appraisal. This is where you have a conversation with the individual about how they can develop.

People often feel that this is about putting in where their next role is or how they can get promoted. This is not a personal development plan. A personal development plan is about how can they develop their skills and capabilities. This may be through taking on a different role or some additional responsibility, but it doesn't have to be. It can be about practising a specific skill and working on a specific skill within their role. It can be about getting training or coaching in an area they want to develop. Is about how to develop their skills and capabilities not just not about getting a new role.

Clarity of Objectives

Make sure the objectives for the coming period are clear. The old acronym of them being SMART is a good one to stick to. It will make it much easier when it comes to actually assessing performance. If objectives are very vague and they are not specific measurable, achievable, relevant and time bound it becomes hard to assess performance against those objectives. Having a conversation with the individual to agree the objectives clearly will help you both to assess performance in the coming period. This may seem obvious, but you will see many examples of where objectives are not clear and there is no real idea of what success looks like for that objective.

Conclusion

Appraisals are often demotivating for those being appraised and dreaded by those doing the appraising. The first thing you need to do is to change your mindset about appraisals from dreading them and treating them as a tick box exercise to seeing it as part of a broader system and way of maintaining and developing high levels of performance within your dental practice. Once you've done this, you can look at the practicalities of actually making appraisals effective. You can combine these into broader systems for developing and transforming the performance of the entire team.

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