Motivations to engage with CPD - The precursors of effective CPD - Healthcare

It is important to consider your own motivations for engaging with CPD. The vast majority of health and care professionals are positively motivated by maintaining a high standard of professional competence. Also, there is a positive peer pressure amongst professionals that drives them to want to present a professional image, and enhance their professional status in the field.
Other drivers to engage with CPD are economic. At one level, registered professionals must be able to evidence their CPD activities to maintain their registered status. Beyond that CPD is an important platform on which to achieve promotion and higher levels of financial reward.Time for reflection
Take the time to talk with colleagues or peers to discuss your motivations for engaging with CPD


The precursors of effective CPD
A considerable amount of research has been undertaken in a range of disciplines to determine the range of factors that determine whether the learner is able to transfer their learning from CPD into practice (Blume et al., 2010). An awareness of these precursors can help to learners to understand how the process of CPD can be optimised. The factors can be divided into three groups

Characteristics of the learnerA range of studies suggest that the learner’s cognitive ability (e.g. the learner’s ability to understand complex ideas, adapt to new environments and learn from experience), their level of self-efficacy (the learner’s perceived judgment of their ability to perform a given task), personal motivation (e.g. their intensity, direction and determination of effort to learn) and their sense of whether the CPD has a high utility (i.e. the CPD is relevant in terms of its content and its link to their job role) influence learning.
Design of the CPDIn order to encourage learning transfer into practice it is suggested that CPD should display the characteristics of behavioural modelling. Behavioural modelling is a set of learning principles that includes clearly defined explanations of the behaviours to be learned, opportunities for learners to practice new skills and clear feedback on their learning. It is also suggested that CPD that contains ‘error management’ is effective in encouraging transfer of learning to practice; error management allows learners to understand, as part of their learning, what can go wrong and how to correct the problem (e.g. using simulation as part of the learning). Additionally, it is proposed that the learning environment should be realistic; either on-the-job learning, or in environments that simulate realistic aspects of the work environment.
Workplace environmentThe work environment in which the learner attempts to apply their newly learnt knowledge, skills and attitudes is a critical factor. The ‘transfer climate’ depends on whether, for example, learners are encouraged to use their learning at work, peers and managers provide positive feedback for the application of the learning and learners may be rewarded in various ways (e.g. praise, more responsibility, financially) for the use of their learning as part of their job role. Supervisor and peer support to deploy the learning is vital; for example, before the CPD event supervisors should set achievable goals for how the learning will be used at work, and after training supervisors should set short-term and long-term goals for applying the new competencies in the workplace. A lack of management support is cited in many studies as a frequent barrier to the transfer of learning to work. As a related observation, learners need to be provided with time and frequent opportunities to use the learning at work, preferably very shortly after the CPD event. Supervisors should also make time to engage the learners in feedback sessions to debrief them on their application of the learning.
Given that research informs us of the critical ingredients of the recipe for successful CPD, we can use this to our advantage. For example, you should consider whether a CPD course is really relevant to your learning needs (i.e. does it have a high utility?), or if a CPD course contains opportunities to practise new skills or whether it is purely didactic, such as ‘chalk and talk’ lectures (e.g. there is evidence purely instructional CPD does not lead to transfer of learning to practice), and whether you are able to involve your line manager in the planning of your CPD agenda to ensure you will be supported to have repeated opportunities to refine your learning in the workplace shortly after the CPD programme.Time for reflection
Consider a recent CPD learning activity you have undertaken. Based on the identified precursors for successful CPD consider the ways in which the learning could have been more effectively designed and transferred to practice.


Types of CPD: What counts as CPD?
It is not an overstatement to say that CPD opportunities are everywhere. It would certainly be a mistake to think that CPD can only occur in a formal learning setting, such as a classroom at a university. Formal learning such as a Masters degree can be a very important aspect of career-wide learning but the informal learning that takes place every day at work, for example from observing senior colleagues or receiving feedback from your line manager, can be core components of learning to be a highly effective practitioner.
As many health and care professions have moved towards becoming graduate-only, an emphasis and value has been placed on formal learning, such as accredited university programmes. These accredited programmes generally incorporate a formal assessment, such as a written exam or objective structured clinical examination (OSCE). Accordingly, each learner can be shown to have reached the required standard and certification will be provided to reassure current or future employers and service users of the professional’s qualification. This is seen by most as a welcome development in increasingly complex work settings where clear standards must be maintained, and the risk of litigation is high if processes and quality standards are not enacted and met.

However, it may be argued that an unintended consequence has been that the perceived value of informal learning, often work based, has been diminished. This is very concerning as a significant body of evidence across many fields suggests that work-based learning is a highly valuable component of any approach to CPD (Flanagan, Baldwin and Clarke, 2000).
Another consideration around the types of CPD you may seek to engage with are how you balance your specialist learning needs (e.g. CPD that specifically pertains to a technical component of your role, such as how a piece of specialist medical equipment is operated) and generalist needs (e.g. CPD that helps you to understand key changes to health and care in its broadest sense, such has how pharmaceutical medications and forms of treatment are assessed by the National Institute for Health and Care Excellence [NICE]). It could be argued that the general context in which you operate as a professional is equally as important as specialist knowledge and skills. However, the latter may seem more appealing when seeking to perform in a specific role, or differentiate your skill set in a competitive job market. Yet without an overview of the landscape in which you work it may not be possible to be a successful specialist practitioner in the longer term.
Healthcare professional regulators divide CPD into a range of different types. For example, HCPC differentiates between work-based learning, professional activity, formal education, self-directed learning and other types.
Work-based learning includes CPD activities such as learning by doing, case conferences, coaching from peers or senior colleagues, work shadowing, secondments, job rotation, journal clubs, supervising students or colleagues, visiting other departments (both within and beyond your employer) and reporting back, analysing watershed events, or undertaking a specific project.

As will be apparent from these noted work-based activities, these kinds of CPD can range from the relatively straightforward, such as taking the lead over selecting a journal article to discuss and critique with colleagues over a 30 minute session, through to the complex planning of a job rotation programme that may involve extended rotations either within or between health and social care employers.
When looking at a future or current employer it is important to analyse the breadth of work-based learning opportunities it offers to its employees.Time for reflection
Think about the workplaces you have recently experienced. What evidence of work-based learning have you observed? Could more be done?
Developing a range of professional activities – such as lecturing or teaching, mentoring, giving a presentation as part of your employer’s seminar series, becoming involved in a research project or becoming part of an internal or external working parties and groups – is a crucial part of the CPD mix. All of these activities will challenge you to think about your practice, consider the most contemporary evidence-based approaches and change your approach to work for the better. Moreover they will help to grow your internal and external profile and, if done well, will consequently increase your employability.
Formal education includes components such as university delivered courses, courses accredited by a professional body, attending scholarly conferences, writing articles or papers, or developing and delivering a course.
Self-directed learning is a very important component of CPD. Reading articles in peer reviewed journals in your areas of interest, specialist trade press (e.g. magazines, such as Nursing Times, or online publications from organisations, such as the BMJ) or organisations such as the Department of Health, Kings Fund, Healthwatch or the WHO should be a regular activity.
Similarly, it is worth exploring how you can use platforms such as YouTube, TED, Facebook, Twitter, LinkedIn, iTunes U, blogs, and Google Hangouts for your CPD. For instance, are you aware of all of the relevant experts in your field who Tweet? Do leaders in your field write a regular blog or have a YouTube channel? Are there groups on LinkedIn you can join? There is a massive variety of CPD-relevant content available on the Internet; the most challenging task is to keep on top of the most appropriate content for your learning needs.
Time for reflection
Think about your use of social media? How are you using it to support your CPD agenda?
Other broader civic activities, for example becoming a NHS Trust Governor, School Governor, Parish Councillor, or working for a charity may also be considered part of a meaningful CPD portfolio.


Ensuring that different types of CPD are recorded
At all times it is vital that you are collating evidence of your involvement and learning from CPD. In some cases, such as formal university courses with an examination, this is straightforward, as a certificate and grade are provided. However, where the learning is work based and more informal this can be more difficult, but common sense approaches are available.
For example, some CPD, such as case conferences, in-house seminars or reading peer reviewed journal articles, is unlikely to come with any form of certification. However, you can take sensible steps to document your attendance and learning from these events. For instance, case conferences or in-house seminars should have a sign-in sheet (if not create one, clearly capture the title, date and location of the event, ask all attendees to sign it, and ask the most senior person in attendance to sign it off as an accurate representation of those who attended). Scan or photocopy the sign-in sheet and distribute it to attendees so they can add it to their CPD portfolio. Secondly, it is advisable to allow, for example, 10 minutes at the end for attendees to work as a group to make some notes on a flipchart of the key learning from the session. Take a photograph of the flip chart paper using a digital camera on a mobile phone or tablet (obviously in some sessions during breakout groups some records of learning may well have already been captured – be sure to photograph these too). Then e-mail the photographs to attendees for their records. If they are used, also obtain (with the session leader’s permission) a copy of any slides and hand outs (be very careful to anonymise any information that is confidential, such as patient identifiers).
When you are reading a journal paper, obtain a PDF copy, print it out, record the date you read the paper at the top, write notes directly on the paper highlighting your learning and then either keep it safely in a lever arch file, or scan a copy for your electronic portfolio. Alternatively, use one of the many PDF annotation software packages available (some of which can be freely downloaded) to directly write your notes on to the electronic version of the paper. From time-to-time it is important to cluster together journal papers you have read on related themes and bring together the learning, perhaps by identifying common themes in some reflective notes or a sketching out a mind map.
It is vital that you visit your regulatory body’s web site to further consider the types of evidence it will accept as a record of your CPD.


Levels of CPD, credit-bearing or non-credit-bearing CPD
Important issues to address when thinking about your CPD mix is to consider the educational levels at which you have been learning, and whether or not the courses or programmes of study result in recognised awards.Time for reflection
Is it essential that your CPD results in a recognised award, such as a Masters degree? Or can you evidence your CPD in other ways, such as creating a portfolio of your work-based learning?
Sometimes the level of intended learning is specified by CPD providers in terms of a job role (e.g. registered physiotherapist), by NHS Bands (e.g. suitable for Bands 5–7 occupational therapists) or by experience.