- Email: [email protected]
Continuing Professional Development—is it beneficial?
Physiotherapy 90 (2004) 174–175
Editorial
Continuing Professional Development—is it beneficial? Continuing Professional Development (CPD) is recognised as a necessary part of professional responsibility and accountability, and is fundamental to professional and organisational success. There is a growing quantity of information relating to CPD being produced and an increasing volume of literature published. There are several descriptions of CPD, most of which emphasise a planned process recognising that, through increased professional performance, this should benefit individuals, organisations and the wider society [1]. The interpretation of ‘wider society’ in the healthcare context includes the patient. Invariably, most activities focus on the care given and the therapy deliverer. The accepted purpose of undertaking CPD is to enhance the outcome of patient care by improving practice, through activities like reflection, evaluation and consideration of the evidence base. Thus patients should expect to receive treatment which is effective, based on sound evidence and up-todate. There are, however, different models of CPD; input versus outcomes [2], sanctions versus benefits [2] and obligatory or mandatory [3]. The Chartered Society of Physiotherapy (CSP) has adopted an obligatory policy on CPD, enforced through the Rules of Professional Conduct, which is based on outcomes and focuses on benefits to the individual and other stakeholders [4]. As organised and structured CPD is still a relatively recent concept, yet to be fully assimilated into professional activities, many issues require further consideration and resolution. Two of these key issues include the responsibilities of the organisations involved in CPD and the effectiveness of the activities included in CPD, asking the question ‘does it impact on quality of care?’
Responsibility Who should be responsible for undertaking CPD and its effectiveness? Current debates relate to individuals, the organisations for which they work, and to professional and statutory organisations. The relative responsibilities for the
CPD of those involved in patient care is an issue that requires to be addressed in greater detail. Several organisations are involved in the promotion of CPD. These include: • Government place CPD at the heart of improving patient care through initiatives like the agenda on lifelong learning, clinical governance and modernisation. • Professional organisations have to demonstrate that their members are accountable, efficient and effective through CPD. • Statutory organisations have a duty to protect the public and are introducing mechanisms to demonstrate that registrants are up-to-date. • Employing organisations need staff with appropriate skills and knowledge to deliver a first class service. Within the context of the NHS and major private healthcare organisations, patients do not seek out individual therapists for their treatment. Instead, a patient engages with the organisation and trusts that it will provide a certain standard, quality and consistency of care. In this case, it is proposed that the emphasis on providing an appropriate level of CPD, in terms of time and finance, to meet the quality of care within that service should fall to the organisation. This situation contrasts to those working in the private, independent sector. In this environment, patients may seek out specific therapists for their treatment. Those individuals are wholly responsible for the quality and standard of care and must therefore bear all of the implications for their CPD. Alongside this is the recognition that all individuals should contribute to their CPD for career advancement. One of the key principles of CPD is that the individual professional is responsible for planning and undertaking their own CPD, ensuring that it is relevant to their current practice and future career development. This is one fundamental aspect of professionalism based on judgement and trust, safeguarding the interests of the patient. Employers may however choose to use this argument as a means of abdicating responsibility and may fail to provide support in the form of time, funding or appropriate staffing for individuals to keep upto-date. In contrast to this situation, CPD requirements have been introduced by some professional bodies and, in addition,
0031-9406/$ – see front matter © 2004 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.physio.2004.10.002
Editorial / Physiotherapy 90 (2004) 174–175
the Health Professions Council will be linking evidence of CPD to continued registration from 2005, introducing monitoring requirements. As CPD will become a condition of employment, employers will need to ensure that staff fulfil any statutory requirements. It is arguable whether CPD can be both externally imposed and be part of the internalised ethic of being a professional. The purpose of CPD is to develop the abilities of the individual and, through this development, change and improve practice and service provision. Obligating physiotherapists to provide evidence of their CPD should include documenting the activity and the identification of demonstrable benefits to the patient. There is a danger that this will result in a massive bureaucracy, which is expensive and time-consuming to administer and where the process of monitoring is judged rather than the CPD activity and outcomes. The responsibility for CPD lies with a range of different partners, all with different agendas which may not necessarily be synonymous. However, the common outcome should be that CPD benefits the patient.
175
its complexity create barriers which may prevent some from implementing it effectively. This may affect the individuals’ inability to assimilate the effects of new knowledge and its impact on the patient.
The way forward There is agreement that assessment of CPD is challenging for all stakeholders. There are a plethora of models and frameworks adopted by employers, professional organisations and statutory bodies. The challenge for the individual therapist is to keep up-to-date and provide high quality effective care. The challenge for the CSP is to continue to support its members through a period and process of change rather than feeling pressurised to police them, which in turn increases the stress on individual members. The challenge for the Health Professions Council is to develop robust standards with transparent assessment criteria. However, the greatest challenge for all is to ensure that the focus of CPD is the improvement in patient care.
Impact on practice References CPD is seen as a way of responding to the challenges raised in the healthcare environment. However, the results of research in this area on the relationship between CPD, professional practice and clinical outcomes are inconclusive [5–7]. This is due, in part, to the difficulty of assessing the impact of CPD on practice. Formal learning can be assessed, but the impact of informal learning is more problematic, relying to some degree on subjective assessment. Most practitioners believe that CPD affects their practice in some way but find it hard to articulate how or why [8]. Most can link CPD to an activity and are able to identify the resulting increase in knowledge or skill, but find it more difficult to connect this with improvements in practice. Most can recognise the personal benefit and the benefits to their patients, colleagues and employers. Thus, the impact of learning on a superficial level is apparent. Deep learning takes place over time and reflective practice has been widely acknowledged by the health professions as a process to integrate learning and practice. It also leads to learning that alters the professional’s perceptions and consequently engenders changes in behaviour. Whilst reflective practice is recognised as an essential element of CPD among physiotherapists, its vagueness as a concept and
[1] Woodward I, editor. CPD: issues in design and delivery. London: Cassell; 1996. [2] Madden CA, Mitchell VA. Professions, standards and competence. a survey of continuing education for the professions. Bristol: University of Bristol; 1993. [3] Friedman A, Davis K, Durkin C, Phillips M. Continuing professional development in the UK: policies and prgrammes. Bristol: PARN; 2000. [4] Chartered Society of Physiotherapy. Policy statement on continuing professional development. London: CSP; 2003. [5] McCormick G, Marshall E. Mandatory continuing professional education: a review. Aust Physiother 1994;40(1):17–22. [6] Beggs C, Sumsion T. After the workshop: a model to evaluate long-term benefits of continuing education. Physiother Can 1997;Fall:279–91. [7] Cervero R. Continuing professional education in transition, 1981–2000. Int J Lifelong Educ 2001;20(1/2):16–30. [8] O’Sullivan J. Unlocking the workforce potential: is support for effective continuing professional development (CPD) the key? J Res Post-Compulsory Educ 2003;8(1):107–22.
Julia O’Sullivan The Chartered Society of Physiotherapists London WCIR 4ED, UK E-mail address: [email protected]
Editorial
Continuing Professional Development—is it beneficial? Continuing Professional Development (CPD) is recognised as a necessary part of professional responsibility and accountability, and is fundamental to professional and organisational success. There is a growing quantity of information relating to CPD being produced and an increasing volume of literature published. There are several descriptions of CPD, most of which emphasise a planned process recognising that, through increased professional performance, this should benefit individuals, organisations and the wider society [1]. The interpretation of ‘wider society’ in the healthcare context includes the patient. Invariably, most activities focus on the care given and the therapy deliverer. The accepted purpose of undertaking CPD is to enhance the outcome of patient care by improving practice, through activities like reflection, evaluation and consideration of the evidence base. Thus patients should expect to receive treatment which is effective, based on sound evidence and up-todate. There are, however, different models of CPD; input versus outcomes [2], sanctions versus benefits [2] and obligatory or mandatory [3]. The Chartered Society of Physiotherapy (CSP) has adopted an obligatory policy on CPD, enforced through the Rules of Professional Conduct, which is based on outcomes and focuses on benefits to the individual and other stakeholders [4]. As organised and structured CPD is still a relatively recent concept, yet to be fully assimilated into professional activities, many issues require further consideration and resolution. Two of these key issues include the responsibilities of the organisations involved in CPD and the effectiveness of the activities included in CPD, asking the question ‘does it impact on quality of care?’
Responsibility Who should be responsible for undertaking CPD and its effectiveness? Current debates relate to individuals, the organisations for which they work, and to professional and statutory organisations. The relative responsibilities for the
CPD of those involved in patient care is an issue that requires to be addressed in greater detail. Several organisations are involved in the promotion of CPD. These include: • Government place CPD at the heart of improving patient care through initiatives like the agenda on lifelong learning, clinical governance and modernisation. • Professional organisations have to demonstrate that their members are accountable, efficient and effective through CPD. • Statutory organisations have a duty to protect the public and are introducing mechanisms to demonstrate that registrants are up-to-date. • Employing organisations need staff with appropriate skills and knowledge to deliver a first class service. Within the context of the NHS and major private healthcare organisations, patients do not seek out individual therapists for their treatment. Instead, a patient engages with the organisation and trusts that it will provide a certain standard, quality and consistency of care. In this case, it is proposed that the emphasis on providing an appropriate level of CPD, in terms of time and finance, to meet the quality of care within that service should fall to the organisation. This situation contrasts to those working in the private, independent sector. In this environment, patients may seek out specific therapists for their treatment. Those individuals are wholly responsible for the quality and standard of care and must therefore bear all of the implications for their CPD. Alongside this is the recognition that all individuals should contribute to their CPD for career advancement. One of the key principles of CPD is that the individual professional is responsible for planning and undertaking their own CPD, ensuring that it is relevant to their current practice and future career development. This is one fundamental aspect of professionalism based on judgement and trust, safeguarding the interests of the patient. Employers may however choose to use this argument as a means of abdicating responsibility and may fail to provide support in the form of time, funding or appropriate staffing for individuals to keep upto-date. In contrast to this situation, CPD requirements have been introduced by some professional bodies and, in addition,
0031-9406/$ – see front matter © 2004 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.physio.2004.10.002
Editorial / Physiotherapy 90 (2004) 174–175
the Health Professions Council will be linking evidence of CPD to continued registration from 2005, introducing monitoring requirements. As CPD will become a condition of employment, employers will need to ensure that staff fulfil any statutory requirements. It is arguable whether CPD can be both externally imposed and be part of the internalised ethic of being a professional. The purpose of CPD is to develop the abilities of the individual and, through this development, change and improve practice and service provision. Obligating physiotherapists to provide evidence of their CPD should include documenting the activity and the identification of demonstrable benefits to the patient. There is a danger that this will result in a massive bureaucracy, which is expensive and time-consuming to administer and where the process of monitoring is judged rather than the CPD activity and outcomes. The responsibility for CPD lies with a range of different partners, all with different agendas which may not necessarily be synonymous. However, the common outcome should be that CPD benefits the patient.
175
its complexity create barriers which may prevent some from implementing it effectively. This may affect the individuals’ inability to assimilate the effects of new knowledge and its impact on the patient.
The way forward There is agreement that assessment of CPD is challenging for all stakeholders. There are a plethora of models and frameworks adopted by employers, professional organisations and statutory bodies. The challenge for the individual therapist is to keep up-to-date and provide high quality effective care. The challenge for the CSP is to continue to support its members through a period and process of change rather than feeling pressurised to police them, which in turn increases the stress on individual members. The challenge for the Health Professions Council is to develop robust standards with transparent assessment criteria. However, the greatest challenge for all is to ensure that the focus of CPD is the improvement in patient care.
Impact on practice References CPD is seen as a way of responding to the challenges raised in the healthcare environment. However, the results of research in this area on the relationship between CPD, professional practice and clinical outcomes are inconclusive [5–7]. This is due, in part, to the difficulty of assessing the impact of CPD on practice. Formal learning can be assessed, but the impact of informal learning is more problematic, relying to some degree on subjective assessment. Most practitioners believe that CPD affects their practice in some way but find it hard to articulate how or why [8]. Most can link CPD to an activity and are able to identify the resulting increase in knowledge or skill, but find it more difficult to connect this with improvements in practice. Most can recognise the personal benefit and the benefits to their patients, colleagues and employers. Thus, the impact of learning on a superficial level is apparent. Deep learning takes place over time and reflective practice has been widely acknowledged by the health professions as a process to integrate learning and practice. It also leads to learning that alters the professional’s perceptions and consequently engenders changes in behaviour. Whilst reflective practice is recognised as an essential element of CPD among physiotherapists, its vagueness as a concept and
[1] Woodward I, editor. CPD: issues in design and delivery. London: Cassell; 1996. [2] Madden CA, Mitchell VA. Professions, standards and competence. a survey of continuing education for the professions. Bristol: University of Bristol; 1993. [3] Friedman A, Davis K, Durkin C, Phillips M. Continuing professional development in the UK: policies and prgrammes. Bristol: PARN; 2000. [4] Chartered Society of Physiotherapy. Policy statement on continuing professional development. London: CSP; 2003. [5] McCormick G, Marshall E. Mandatory continuing professional education: a review. Aust Physiother 1994;40(1):17–22. [6] Beggs C, Sumsion T. After the workshop: a model to evaluate long-term benefits of continuing education. Physiother Can 1997;Fall:279–91. [7] Cervero R. Continuing professional education in transition, 1981–2000. Int J Lifelong Educ 2001;20(1/2):16–30. [8] O’Sullivan J. Unlocking the workforce potential: is support for effective continuing professional development (CPD) the key? J Res Post-Compulsory Educ 2003;8(1):107–22.
Julia O’Sullivan The Chartered Society of Physiotherapists London WCIR 4ED, UK E-mail address: [email protected]