Presented by Prof David Watters, as part of the Wiley Professional Learning seminar, 'Across the Professions'. For info visit http://wileyprolearning.wordpress.com or follow us @WileyProLearn
Case Study: Continuing Professional Development in Specialist Medical Colleges - Prof David Watters
1. Continuing
Professional
Development
Specialist Medical Colleges
Professor David Watters S
Royal Australasian College of Surgeons
2. Presented at the Wiley seminar
Professional Development
Across the Professions
Melbourne, 1 March 2012
#pdmelb
wileyprolearning.wordpress.com
3. Continuing Professional
Development
S Why do CPD?
S Principles of CPD
S What do medical colleges do?
S What’s new?
S Compliance, Verification and Professional
registration
5. Elements of Professionalism
S Putting patients first
S Managing conflicts of interest
S Honesty and confidentiality
S Disclosing errors
S Self-regulation
S Advocacy
Gruen, Watters and Hollands. Surgical Wisdom. BJS 2011
6. The Social Contract in Medicine
Society Profession
expectations
Patient obligations Physician
Professionalism
Cruess R & Cruess S
Linda Snell, 2012
7. Professionalism - expectations
Social contract
Autonomy Assured competence
Self regulation Altruistic service
Monopoly Morality, integrity, honesty
Trust Accountability, transparency
Role in public policy Respect for patient autonomy
Rewards … Promotion of the public good ..
Linda Snell 2012
Tricollege consensus, 2012,
Cruess et al, McGill, 2005
8. What is expected with CPD?
S Commitment to Lifelong Learning
S Continuous improvement in performance
S Maintenance of Competence
9. Learning Management
Strategy
S Transitions and Stages of a career
S Competency-aligned
S Aligned to scope of practice and context of practice
S Capable of Assessment
S Based on contemporary learning principles
S Adult learning
S Self-referenced/reflective
S Work-based
S E-learning tools
RACS, RACP, RCPSC consensus, Feb 2012
10. Modern Principles of CPD
S Educational principles
S Promoting quality not quantity
S Learning and Development mapped to
competencies
S Performance assessment
S Improving performance
11. Educational Principles
S Adult learning
S Reflective practice
S Variety of Learning styles and preferences
S Self directed and individually tailored
S Lifelong learning
12. Evidence for Facilitating
Professional Learning
S The learner is motivated
S The learning is self directed
S Learning is matched to recognised learning needs
S The process encourages active participation
S Learning involves reflection
S Evaluation of what has been learned
Pam Montgomery, Council papers 2009
Continuing Professional Development – does it work?
13. Competency based CPD
S Use practice information to identify learning priorities
S Develop and monitor CPD (learning) plan
S Access information sources for new evidence or
innovations
S Establish a personal knowledge management
system
S Use tools and processes to measure competence
and performance
S Improve practice Campbell C et al. Medical Teacher 2010;32:657-662
14. Effective CPD
What do we want to achieve?
S For all surgeons
S Compliance is mandatory but easy to document and
verify
S Documentation and verification
S Reflection rewarded and reinforced
S Learning addressed to needs
S Professional Development Plan aligned to
competencies
15. Workbased Assessment tools
S Direct Observation
S Multisource feedback
S Audit and feedback
S Simulation
S Reflective learning portfolios
18. Assessing Performance
S Observable behaviours
S Performance
markers/descriptors
S Based on workplace
and real practice
situations
S Aligned to
competencies
21. Performance Assessment
mapped to competencies
S Multisource feedback tool
S Based on the 9 competencies and 27 patterns of
behaviour
S Promotes reflection
S Opportunities for improvement can be recognised
S A learning/development plan can be devised
S Improved performance can be evaluated
25. CPD Points
Annual and Triennial
S Conferences,Workshops and
Courses
S Audit and Peer review
S Practice visits
S Multi-source feedback
S Teaching, Journals and Research
S Clinical governance
S On-line learning modules
26. 8 Categories of CPD
compliance 2010 - 2012
No Category Annual requirement
1 Surgical Audit and Peer Review Both required
ANZ Audit of Surgical Mortality
2 Credentialed at a hospital Letter of appointment
3 Clinical Governance and Evaluation of Care 30 pts
4 Maintenance of knowledge and skills 210 pts for 4-7
5 Teaching and Examination
6 Research and Publication
7 Other professional development
8 Medico-legal Workshop or Peer review
27. 2010-2012 CPD
Types of Surgical Practice
S Surgical practice in hospitals and day centres
S Surgical procedures only in rooms
S Surgical consultation only
S Medicolegal (personal injury) – non clinical
S Medicolegal (negligence) – non clinical
S Research, Administration – non-clinical work
S Locums & Surgical Assisting
28. My CPD - RACP
S Lifelong Learning
S A continual process of reflection
S Assessment
S Learner centred approach
S Learner identifies needs
S Ensures means of change
S Diary, Learner Log,
S Integrated learning navigator
30. Anaesthetists
S Participate on-line or off
line
S CPD plan every 3 years
S record activities
S Write reflections
S Write an evaluation
S Produce statements for
registration and re-
credentialing
35. Design Principles for CPD
S Transitions and Stages of a career
S Competency-aligned
S Aligned to scope of practice and context of practice
S Capable of Assessment
S Based on contemporary learning principles
S Adult learning
S Self-referenced/reflective
S Work-based
S E-learning tools
RACS, RACP, RCPSC consensus, Feb 2012
36. Summary
S CPD is expected of us and is part of our social
contract with the patient, society and the profession
S CPD is required by the regulatory authorities but
they have delegated verification to the Colleges (at
present)
S CPD can contribute positively to our professional
lives and ensure we continuously improve through
learning
S We will know where we are at (self-referenced) and
how we are doing
Notas do Editor
Commitments and obligations in return for privileges
Change in red
One might reasonably ask why did we choose to have nine not seven. However, for a surgical college it was thought that medical and technical expertise were different, and surgery is most certainly a procedural specialty and deserved a competency devoted to it. Also the decision to operate or not to operate, the decision to treat or palliate is so essential to surgery that clinical decision making and judgement were added to the Can Meds seven. CanMeds most certainly lacks the judgement competency so important to all medical specialties.There is also overlap between the comptencies which is displayed on the figure although obviously each competency can overlap with many of the others.
Each competency is described by three patterns of behaviour. There is no special order to the patterns of behaviour. One does not lead to another but there is often considerable overlap.
The assessment tool developed uses a 4 point leikert rating scale – poor, marginal, good, excellent. The behavioural markers are used to describe illustrative behaviours to guide the rating.Some examples of the different patterns of behaviourare shown in the following slides. Each pattern of behaviour is rated, making 27 patterns of behaviour to be assessed.
There is the option to make free text comments for each competency, combining comments for each of the three patterns of behaviour for that competency.