Planning Continuing Professional Development

Frankie Todd

• Publisher: Taylor & Francis
• Year: 2020
• eBook ISBN: 9781000639629
• Edition: 1
• Topic: Business
• Subtopic: Business General
• Index: Business

Continuing professional development (CPD) aims to maintain or improve the quality of professional performance. So far, it tends to have been designed for specific professional groups such as teachers, doctors, architects or engineers. Approaches, as a result, have often been local, separatist or idiosyncratic in nature. This book, first published in 1987, argues that CPD designers should consider strategies used for professional groups other than their own. This title will be useful to anyone with a responsibility for developing and implementing courses and also to practitioners themselves, as well as to students of business studies.

SECTION I:

PROFESSION-HIDE STRATEGIES

This section covers strategies of identifying continuing educational need and implementing education programmes that address professional groupings as a whole.

The profession-wide approach is usually of necessity a quantitative one, drawing on techniques from educational and social research such as representative sampling and statistical analysis for the identification of educational need.

This quantitative approach is the natural strategy to follow in circumstances where an education designer is working with large numbers of professionals from the same group and has little in the way of mediating organisations (employers, for instance) with which to work. The three papers in this section describe attempts to identify educational need respectively for five different professional groupings in the state of Pennsylvania, USA (accountants, architects, clinical dieticians, clinical psychologists and gerontic nurses); for general practitioners in the province of Limburg, the Netherlands; and for nurses in the United Kingdom. The size of the “whole” under consideration may vary (in these instances from around 400 to 400,000 practitioners) as may the definition of the “whole” (a state, a province, a country) but what these papers have in common is that they each deal with aggregated groupings of a specified profession.

When dealing with a large group it is clearly too unwieldy, too time-consuming and too costly an exercise to approach each member of the profession on an individual basis. Each of the studies in this section utilised representative sampling techniques at some point, a technique which permits findings gained from a small number of practitioners to be applied to the professional group as a whole.

Having drawn up a representative sample of practitioners, there is then the question of how to discover their continuing education needs. One strategy is simply to ask them: what they would be interested in, what relates to their work, what gives them problems. Peter Bouhuijs describes taking such perceived needs as a starting point and goes on to document the grounds for his ultimate dissatisfaction with the method — that in the end free-choice professional education does not necessarily improve professional practice.

Another strategy would be to monitor practice itself and base a curriculum around the prevention of demonstrated practice deficiencies. This is difficult to put into operation and Donna Queeney describes instead the development of simulation exercises that act as surrogates for practice. The performance of a sample of practitioners on these exercises (rated by panels of experts from the profession) is taken as indicative of what practitioner performance would be in the field. The deficiences that are found in the samples then guide the curriculum for the profession as a whole.

Yet another approach, particularly where there is little systematic information on CPD in a profession, is to try to establish what is happening currently. Using this information as a baseline, consideration can be given to deficiences not in professional practice but in existing patterns of provision and uptake of provision in that profession. This is the approach outlined by Jill Rogers in her paper. It supports recommendations about the overall design of a CPD system for nurses in the UK rather than, as in the other two cases, decisions about curriculum content in relation to the needs of practice.

Yet another way of getting a bearing upon the educational requirements of practice is to ask experienced and respected practitioners to reflect on what they see as important curriculum areas that should be addressed by CPD for their profession. In one way or another, at one stage or another, such recommendations from profession experts were used to guide CPD curriculum content for each of the groups discussed in this section. Expert professionals’ recommendations may be a valuable source of guidance on commonly found practice deficiences and on what good practitioners should be able to do.

The need to address aggregates of practitioners arose in each of these cases from the starting position of the education designers and the brief agreed for them, in effect, from the type of relationship that the education designers had with the professional group. Here we see education-providing institutions taking as a unit for analysis the accountants or dieticians in the state of Pennsylvania, the GPs in Limburg province, the nurses who take up CPD in the UK. Interestingly these writers are in agreement about the need to set up some kind of local infrastructure to support the continuation of CPD (or to exploit such structures that already exist).

The methods used to identify educational need can be seen as attempting to get as close as possible to real-life practice. In just the same way the involvement of local organisations or divisions of a professional body is a way of closing the gap between the provider and the practitioner. This may be particularly important where professionals practise independently rather than within an employing organisation, or when they form a large group that is always on the move with no ready means to track practitioners from one post to another. This section includes instances of each of these possibilities.

Donna Queeney’s chapter describes an innovative project which had at its heart the aim of orienting continuing professional education directly towards the needs of practice. The Continuing Professional Education Development Project, based at Pennsylvania State University and sponsored by the W.K. Kellogg Foundation, worked between 1980 and 1985 with five professions or professional specialities — accounting, architecture, clinical dietetics, clinical psychology and gerontic nursing to develope practice-oriented educational programmes.

The Project was guided by “The Practice Audit Model”, a model which had grown out of Pennsylvania State University’s earlier work with the pharmacy profession, carried out in the late 1970s. The model required an initial decision that there were fruitful possibilities for collaboration between the University and a professional group, based on the satisfaction of clearly defined criteria. A substantial amount of work went into this selection process, culminating in a firm commitment to the Project from appropriate decision-makers within both the University and the professional associations.

The Practice Audit Model was then followed with these selected professions through each of its main phases. These are: organising a profession team made up of academic and professional representatives; developing a practice description, or delineation of roles carried out by practitioners within the profession; developing materials to assess practitioner performance within key roles from this listing; using these materials to run Practice Audit sessions with groups of practitioners selected to represent the whole profession; evaluating practitioner’s performance on these exercises so as to establish areas of weakness; designing and planning appropriate continuing professional education programmes to improve performance in these areas; and, finally, implementing the programmes and evaluating their effectiveness. The evaluation included an assessment by participants, six months after the programme, of the extent to which they had used programme content in their practice (with reports of favourable results).

Although the Project itself has concluded, an Office of Continuing Professional Education continues Pennsylvania State University’s involvement in this field and is extending and adapting the application of the Practice Audit Model to new groups.

The strategy used in this Project to link continuing professional education to real-life practice rests upon four key elements. These are (a) the definition of practice roles, (b) the use of simulation exercises to provide an objective definition of performance standards, (c) the use of a sample of practitioners whose performance is deemed to be representative of standards in the profession as a whole, and (d) the use of self-report by practitioners participating in the programme as a means of evaluating its longer-term effects on everyday practice.

Some of these elements are also found in Chapter Two, describing Peter Bouhuijs’ work with general practitioners in the Netherlands. This is a case study of the planning and implementation of continuing medical education (CME) with a substantial proportion of the 436 registered general practitioners (GPs) in the province of Limburg.

The initial strategy in this study was to carry out a survey of GPs’ educational needs as they themselves perceived them, using a two-stage questionnaire. First 40 GPs were asked to list ten suitable topics for CME to address, then all GPs in the province were asked to assess the 68 topics on a four point scale. Here an interesting problem arose, in that analysis found an inverse relationship between, on the one hand, those topics that frequently occurred in a GP’s practice or those topics of general importance to GPs, and, on the other, topic areas where GPs encountered problems. The researchers found an ingenious way of utilising this anomaly to aid their design of courses.

But are the problem areas perceived by practitioners the whole story? The chapter goes on to discuss the limitations of a “perceived needs” approach, drawing particularly on two studies which found little beneficial effect on quality of practice arising from “free-choice CME”. It was concluded that a better way of linking CME to quality of care would be the construction of a systematic curriculum reflecting important aspects of the work that GPs do.

The paper describes the construction of such a curriculum, themes from which were then offered to GPs in the province, each theme over a three month period, three themes per year.

A varied mix of educational formats was used to cover these themes, including course books, self-assessment materials, case studies for small group work and face-to-face events — even co-temporaneous coverage in a professional journal.

The provision of opportunities and materials for individual study and for self-help groups is an important feature of this work as is the involvement of GPs in organising the implementation of the curriculum. The need for a local system of support to service and maintain such an initiative is a clear recommendation from the study.

In Jill Rogers’ paper we move to a different order of magnitude. In 1986 there were 400,000 qualified nurses listed on the new United Kingdom professional register, with around 40,000 new admissions to the register in 1985 alone. Jill Rogers points out that the issue is not simply the size of the profession. This group is also “geographically spread and educationally diverse”. When one takes into account recent changes in the profession’s structure, in the management of the National Health Service and in health care needs and trends, it becomes clear that there can be no easy answers to the question of CME provision for this large and diverse group.

The certification records for post-basic nursing qualifications showed that between 1973 and 1983 a small proportion of qualified nurses (around 10 per cent) possessed this kind of additional qualification. For a variety of reasons little was known of the use made by nurses of this involvement with CPD. Why did they undertake it, and how did it affect their careers? The study Jill Rogers describes set out to answer such questions using a questionnaire to survey a large (3,000 respondents) stratified sample of the nurses who had followed such courses. In the context of the size and geographical spread of this profession it is not surprising to find around 300 certificate courses run in course centres ranging from hospitals to colleges of education to schools of nursing. The logic behind this research was to examine the use made of these existing CPD programmes in order to move on to make coherent recommendations for the future.

To someone outside the profession one of the most striking points to emerge from this study was that almost 70 per cent of these nurses left their employing health authority to follow such a course, becoming instead temporary employees of the health authority running the course, but with no guarantee of a post after the course ended. Given that there is no increase in salary associated with these qualifications this puts rather a different complexion upon the 10 per cent participation (cited above) in these courses for the profession as a whole. The picture that emerges of these CPD participants is of a geographically mobile group committed to a particular clinical speciality and prepared to accept a degree of risk in order to improve their skills in that area — with enhanced promotion prospects quite a strong motive. It is interesting that the General Intensive Care course was seen by participants as having applications to several specialisms and was used by them as a way of rounding off basic training.

This survey is important because it shows the need for a wide-reaching system of CPD for nurses in the UK involving many more people than currently participate. Open learning systems, flexibility and a uniform system of accreditation to facilitate mobility are among Jill Rogers’ recommendations.

1 THE PRACTICE AUDIT MODEL: A NEEDS ASSESSMENT/PROGRAMME DEVELOPMENT PROCESS

Donna S. Queeney

Background

Professions by nature are complex configurations. It is easy to forget that a profession is not a single en...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Acknowledgements
• Contents
• Introduction
• SECTION I: Profession-Wide Strategies
• SECTION II: Organisation Based Strategies
• SECTION III: Practitioner Based Approaches
• Afterword
• Notes on Contributors
• Index