Background: The health services are facing many new challenges, including a growing number of elderly patients, and an increasing use of technology in the work place. These challenges might require flexible and reflective conversations with the employees. Aim: This study examines whether some performance appraisals (PAs) are more efficient and more effective than others. The study also shows how some performance appraisals are more suitable for home care and nursing homes in municipal health services. Methods: Two datasets are used: 1) a questionnaire was distributed to a representative sample of 600 health personnel in Norway; and 2) a questionnaire was distributed to a representative sample of 60 employees (test-group: 10 groups; control-group: 30 employees), in pre-test, post-test 1 and post-test 2. SPSS. Findings: Managers are the only ones who receive training in PA techniques (factory perspective). Nurses versus auxiliary nurses experience more frequent dyadic relationships and exchanges in PAs (family perspective). PAs for employees from nursing homes are fairer than those administered to home care employees (jungle perspective). In organizations closest to carnival perspectives, employees participating in group-PAs are more active in the conversations than employees who have individual conversations in PAs. Conclusions: Health personnel involved in PAs experience different effects of the conversational, and employees working as a member of a team in the organization need to experience a high quality of relationships (family), justice (jungle), and participation in group-conversation (carnival) during performance appraisals.
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