An introduction - What is CPD?
 CPD is the acronym for Continuing Professional Development. This is the
education and development after certification and licensure to practice, and it
is arguably the longest, most complex phase of medical education.
For many years, this process almost exclusively involved attending
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meetings
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conferences,
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and annual medleys which were designed to deliver
the latest developments
in various specialties. |
This was what we call the "teacher-driven" process:
"Teacher-driven" process:
in simple terms, the teacher (a consultant or specialist usually) decided the
content and delivered it as they saw fit.
All we could do as attendees was to say at the end (in the evaluation form)
whether we liked it or not. As we were usually passive attenders (apart from the
small minority that would engage with questions seeking specific answers to
problems they encountered), most of what we were spoon-fed was lost from our
memory very quickly.
Most people attend only meetings on topics they have a special interest in,
and routinely avoid topics they feel less comfortable with.
In the best of cases, what we hear is not retained for long: less than 50% is
retained after the first 24 hours, less than 25% after a week, and less than 10%
by a month's time. As the ancient Chinese proverb aptly states:
"He who hears, forgets; he who sees, remembers; he who does, knows"
Active Learning
That is where active learning comes in: we, as practising doctors, define
where the gaps in our knowledge are, and how we are going to meet them.
We may find that patients ask us things we do not know immediately how to
answer (these are called PUNs: Patient Unmet Needs); we can then go away and
read about them.
This way, we have translated a PUN into a DEN (the acronym for Doctor
Educational Need). We can also try various other methods of determining our
learning needs: audit and significant event audit are just two of them.
Where do we find the time to do it, I hear you say...in our busy professional
lives, we are often having to work hard to find a reasonable balance between
personal and professional time. And as active learning certainly takes more time
than passive, lecture-based learning, why would we want to embark on such an
experience?
The answer is different for every individual; for me, these are the
reasons:
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Because I enjoy it: my father was a hard-working gynaecologist in
Greece; in the rare occasions that he was ill and unable to attend work for a
day or so, he was very unhappy. I remember asking him as a teenager why this
was so, and his answer was “because I love what I do; if I ever stopped loving
my work, I would immediately retire. And anything that keeps me from doing
what I love makes me unhappy”. This instilled in me from a very early age this
premise: unless we enjoy what we do, it will eventually lead us to burnout
much sooner.
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Because I believe that quality, not quantity, is what matters:
attending 6 courses on dermatology may make me good at it, but not necessarily
a good GP, unless I equally attend courses in all the other aspects relevant
to my work. And unless I am actively thinking “where are the gaps in my
knowledge?” and do something about addressing most of them, sooner or later
these tend to increase. And it is these gaps that make my general practice
less secure, as far as patient care is concerned.
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Because it gives me a sense of achievement: just as planting some
seeds, seeing a plant develop, feeding it, watering it and weeding it before
you see it grow to its full splendour can make us proud of what we do,
tackling my deficiencies and imrpoving some of them every year makes me feel
better about myself; it gives me a sense of purpose.
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Because it is the adult way of learning: adult learners, by
definition, learn through motivation and experience. They define their own
learning needs, and then seek ways to address them. This way, what they learn
is more relevant to their specific requirements.
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Because it is more fun: I am one of those people who need variety
in my life; doing exactly the same every day makes life dull and uninspiring
for me. I am not against core elements of stability (family/working
environment/religion); on the contrary, I believe these pillars are necessary
to allow the daily variations to happen without danger. But variety allows
flexibility and stimulates the mind. It has a refreshing effect on a
patient-weary soul: after listening to so many patients about death & illness,
being able to do something different fires up my imagination, and somehow
lifts some mental & emotional fatigue off my shoulders.
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Because it is more relevant: To explain this, I will give you an
example: I attended an annual Neurology Study Day in Bristol 2 years ago. The
room was packed with eager GPs, ready to ask questions. Some were watching
tentatively; others were scribbling notes furiously, as the speaker addressed
the 100-strong audience. At some stage, he turned to us all and said “I
suspect you are here to ask me questions about insomnia”, and looked to the
crowd: many nods could be seen around the room, and quite a few verbal
confirmations could be heard. At this point, he said “but what I want to talk
to you today is not insomnia, but somnolence”. The audible “Ahhhh...” of the
disappointment could match that heard at Wimbledon by Henman fans when he
misses a break point he could have easily converted. Since the vast majority
of patients we are faced with suffer from the former, why on Earth would we
want to spend an hour on the latter? This is precisely what can go wrong when
the agenda is teacher (and not learner) driven. |
I could go on and on about the positives; one big potential drawback is
isolation; for in conferences we meet colleagues, socialize and blend in; we
cannot do that in adult learning unless we choose to learn in small groups. Even
learning in a group of 2 is better than learning on our own. This way we avoid
isolation and boredom, and as 1+1 equals more than 2, in terms of sharing new
knowledge, it is well worth thinking about.
Without further chatter from me, welcome to the website's CPD area; we hope
it will be helpful and suited to your needs. The only way we can achieve this is
through your help and feedback, though; so please let us know what you think of
it, what you would like to see included, what you disagree with. We will take it
all constructively and try to address the gaps as they are pointed to us.
Best wishes
Harry Minas
GP Educationalist, Bristol
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