Continuing professional development (CPD) - Healthcare

Introduction

Global health and social care economies are affected more than ever by rapid – and frequently unpredictable – political, economic, sociological, technological, environmental and legal change. No single registered health professional can confidently forecast the future, other than to say that it will be subject to profound upheaval.
The commitment to remain open minded, continually learn and apply that learning – across a career that for many professionals now entering the workforce may last for around half a century – for the benefit of service users will be one of the key difference between individuals and organisations that succeed and those that do not. The stakes around continuing professional development (CPD) are high, therefore, for patients, the careers of professionals that care for them, and the employers of these health and care professionals. An effective approach to CPD is one of a set of critical success factors that must be addressed by health and care professionals who are intent on driving significant, valuable and potentially radical changes, to ensure that the health and well-being of the communities they serve are improved.
It is vital that all health and care professionals have far more than a cursory understanding of CPD, an understanding, in fact, that extends well beyond the basics. For example, an understanding of the ‘amount’ of CPD required over a certain time period to maintain their registration if they are to maximise their job satisfaction, respond to the needs of employers, deliver exceptional patient care – and ultimately optimise their career-long employability.



Objectives
This chapter seeks to demystify CPD for those who are current pre-registration health and care students or who are registered practitioners in the early part of their career.
Outline guidance on how to plan and enact a meaningful CPD portfolio that results in the transfer of learning into practice is provided later on in this chapter and is deliberately not a ‘painting by numbers’ guide to CPD. Sadly, CPD is conceived of by some professionals and their employers as a chore to be completed, or a ‘tick box’ exercise, where the minimum to achieve continued registration or revalidation is considered satisfactory. Those professionals with an understanding of how to think about, plan and execute an approach to CPD that underpins their growth as a provider of exceptional care will be far better placed to take ownership of their career trajectory, and by association enjoy a more fulfilled career. Consequently, the chapter will help the reader to understand:
What CPD is, and its link to employability.
The types of learning that underpins the most effective types of CPD.
The variety of forms CPD takes, particularly the importance of a CPD mix that maximises the use of informal (work-based learning) and formal educational programmes.
Levels of CPD, specifically credit-bearing and non-credit-bearing CPD.
An approach to judging the impact of CPD, specifically whether learning has been transferred to practice.
How to overcome the barriers to accessing CPD, particularly limited time and funding.
A practical outline guide to planning and undertaking effective CPD.
It should be noted that whilst the chapter is relevant to all health and care disciplines, it does not exhaustively list the procedures required by healthcare professional regulatory bodies to complete their individual CPD requirements. This is because these requirements vary over time and are subject to change (e.g. forthcoming revalidation requirements). Up-to-date details of the amount (if specified, in hours or perhaps as CPD points) of CPD required over a certain period, the types of CPD permitted in a portfolio and the forms of evidence required to document their completion can be found on the web site of the relevant regulatory body. It is advisable to check the CPD pages of your regulatory body at least a couple of times each year to ensure you are aware of any proposed changes (remembering that if you work internationally the requirements will vary quite considerably from what you may have previously experienced). Usually, CPD requirements will be clearly specified; if not, a call or e-mail to their helpdesk will normally result in a quick answer to specific queries.
Throughout this chapter we will consider CPD as a vital pillar of your career development and employability, alongside regularly practicing as a clinician and the mandatory training that your employer will require you to complete.


The terminology of CPD

The continuing professional development field is awash with terminology, an alphabet soup of abbreviations. Throughout this chapter the term continuing professional development (CPD) will be used. However, there are a plethora of variants, including continuing education (CE), continuing professional education (CPE), continuing professional and personal development (CPPD), post-registration education, learning beyond registration, professional education, lifelong learning – and others are emerging all of time.
It is interesting and important to note that the word ‘training’ is absent from most of the current nomenclature pertaining to professional development. This may be because training has historically implied the acquisition of a rather rigid and contained set of skills to perform a specific set of tasks, without necessarily understanding the underpinning theory. In a rapidly changing world there is a perceived danger that trained skills may well become outmoded and the trained individual unable to adapt to their new circumstances.
However, some graduate employers now claim that university students are ‘overeducated’ in the underlying theory but ‘under trained’ in the workplace application of their knowledge (Archer and Davison, 2008). This highlights the need for balance between knowledge acquisition and the capacity, and necessary opportunities, to apply that learning. Any approach to CPD that is unbalanced – with a continued overemphasis on either pure education or narrow task-focused training – is unlikely be successful in the medium-to-long term.

A definition of CPD

The Health and Care Professions Council in the United Kingdom (HCPC) defines CPD as:
‘a range of learning activities through which health care professionals maintain and develop throughout their career to ensure that they retain their capacity to practice safely, effectively and legally within their evolving scope of practice’
The care sector organisation Skills for Care defines CPD as:
‘planned learning and development activity that develops, maintains or extends knowledge, skills, understanding or performance’.

The American Nurses Association (ANA) defines CPD as:
‘a lifelong process of active participation by nurses in learning activities that assist in developing the maintaining their continuing competence, enhance their professional practice, and support achievement of their career goals’
These definitions share some similarities. All consider CPD to be a process. In this chapter we will explore this process, so that early-career professionals can optimise their approach to CPD.
Each of the three illustrative definitions places the responsibility for undertaking CPD directly on to the healthcare professional; ultimately, this is unarguable, one essential requirement of professionalism is to demonstrate a personal commitment to learn and appropriately apply that learning to practice. However, it is important that this should not be confused with CPD being an individual and isolated process. For example, learning in groups or teams (e.g. a group of colleagues who work together) is often an effective way of engaging with CPD. Furthermore, employers should ensure that the CPD of their employees joins up to address important strategic targets.
Significantly, each of the definitions makes reference, explicit or implied, to the link between CPD and patient safety. They each suggest that CPD is a critical part of ensuring that health and social care professionals are safe to practice. CPD is an important part of ensuring that avoidable errors and adverse events are avoided and that, more broadly, CPD plays a vital role in ensuring service users are provided with the best available and most contemporary treatments, care and advice.
Likewise, as you would expect, they each stress the notions of career-long ‘continuing’ learning, tacitly implying the need for regular engagement with CPD. The centrality of maintaining previously acquired competencies and professional development, growth and improvement are also common elements to the definitions.
The HCPC definition, as might be anticipated from a regulatory body, mentions the requirement to work within the law. A vital consideration particularly, for example, as the role boundaries of health professionals continue to grow and increase in complexity.
All of these components of the definitions are important to informing our understanding of what CPD should be about as early career practitioners. However, it could be argued that some important elements are missing or are underemphasised, particularly for early-career practitioners seeking to maximise their employability.
Whilst the Skills for Care definition highlights the need for planning of the CPD agenda, perhaps insufficient emphasis is placed by the definitions on the need for professionals to take stock – by regularly looking forwards and backwards – at their CPD mix. Clearly, practitioners must be prepared for their day-to-day job role in the short term. However, they must also consider the knowledge, skills and attributes they are likely to require in future roles – linking their CPD agenda to the career trajectory to which they aspire. These varied requirements suggest that any meaningful CPD mix is likely to contain an assortment of different types of learning opportunities.
None of the definitions describes what types of CPD should be undertaken. We shall explore this in more detail later in the chapter.
In addition to personal responsibility, however, CPD should be considered as a partnership of learning between the healthcare professional and their line manager, which, in turn, is aligned to the priorities of the employing organisation. The line manager’s and the employer’s roles are essential in the sense that they must support the professional to deploy and develop their learning in the workplace to ensure that patients benefit optimally from the investment in CPD.
Surprisingly, given the requirement by most regulatory bodies to keep appropriate records of CPD undertaken, it is interesting that none of the definitions specifically set out this requirement. It is essential that all students and graduates familiarise themselves with the CPD record keeping required by their regulatory body, and put in place an approach to respond to this need.
The ANA definition also extends to link CPD to the achievement of career goals. This may encompass goals such as achieving specialist qualifications, or perhaps hoped for promotions to increased levels of responsibility and seniority. However, it is possible to extend this further to consider the role CPD can play in job role and career satisfaction. The personal and professional fulfilment that can be obtained through making the transition from novice to expert in a field of interest, or sustainably improving the performance of a clinical area can, in part, be unlocked by well-designed and well-timed CPD programmes. The virtuous circle of job satisfaction leading to higher workplace performance and, hence, greater employability is clear.