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Letters to the Editor
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CPD (Continuing professional development)
Bureaucratic pigeonholes
From Mr P. Melnick, MRPharmS
I think we can safely infer from Peter
Wilson’s response to my
letter (PJ, 18/25 December 2004, p881) that the continuing professional
development process is considered more important than the content. It
is a pity that the format in which I have been recording my own voluntary
CPD over the past three years is not acceptable to the Royal Pharmaceutical
Society. But I really thought I was doing this for me, not for the Society.
Let me briefly give two recent examples.
I received a telephone call from a housebound patient to thank another
pharmacist for his help in selecting black cohosh to reduce or eliminate
her post-menopausal flushing. Upon enquiry, I found that he recommends
either this or wild yams, depending on stock availability, for those
who require a non-hormonal product. A little chance reading later and
I found that black cohosh has on occasion been associated with liver
damage. Altogether, this is a simple opportunistic piece of CPD that
corresponds to “action/evaluation” — I will use it
if I get asked and if I do not, then I will not.
At a recent lecture, I learnt that emollients work best when they are
applied to wet skin. This is a useful piece of information which had
immediate application in my practice and one, moreover, which lent itself
to the four-stage CPD cycle.
The Society would have me spend the best part of half an hour on each
writing it up its way and ticking little boxes en route. In practice,
it took me about five minutes and four or five lines of text in an exercise
book to record both. The Society would argue that since it was not written
its way, this only counts as continuing education, not CPD. I would counter
that all CE can be made to fit the CPD glove, but that not all CPD is
CE.
The Society insists that it requires the same rigid structure to fit
two totally different areas of work that makes CPD more onerous and less
comprehensible to the likes of me.
The difference between my methods and the Society’s, at least as
far as CE/CPD is concerned, is that I do not waste valuable time reflecting
on the patently obvious, evaluating the patently obvious or stating the
patently obvious, and I invite Mr Wilson to demonstrate that I am a less
competent pharmacist thereby: stubborn and arrogant, perhaps, but not
necessarily incompetent.
Of more concern is the attitude that the Society will take to cantankerous
old sods such as myself who would simply prefer not to fit some bureaucratic
pigeonhole. There was a veiled threat reported in the Council proceedings
a few weeks ago of a bully-boy strategy being developed, but no one has
yet spelt out exactly what form this star chamber process is going to
take. Is it not time that they did?
Perry Melnick
Ilford,
Essex
| |
PETER WILSON, head of post-registration, Royal Pharmaceutical
Society, replies:
My compliments to Mr Melnick for providing some
examples
of CPD taken from his practice. I do have sympathy with some of
Mr Melnick’s views. However, the Society has to implement CPD.
If we are to do that successfully and monitor compliance in a profession
with over 30,000 practising members, some standardisation is essential.
My advice is for him to give up the exercise books before the task
of transferring his valuable experience into the Society’s
CPD format becomes too big to contemplate. |
Is the challenge being met?
From Mr D. A. Hancox, MRPharmS
Just over two years ago (PJ, 26 October 2002, p607), I made the following
comment on the development of an appraisal system for continuing professional
development records: “The challenge facing the Society is one of
developing an appraisal system for CPD records that recognises the individual
nature of every pharmacist’s practice, provides supportive feedback
to the pharmacist and meets specific requirements that may be laid down
by the Government.” Is that challenge being met?
In the response to Perry
Melnick’s letter (PJ, 18/25 December 2004,
p881) we are told that the quality of CPD records will be judged by comparison
with the good practice criteria in Appendix 6 of the “Plan and
record” document. Examination of those criteria suggests that they
would confirm due process had been applied in respect of learning and
development needs that had been identified by the pharmacist. However,
the CPD documentation does not seem to require a statement regarding
the pharmacist’s roles and responsibilities or of the competencies
he or she deems to be pertinent to those roles and responsibilities.
In the absence of such a statement it would be impossible to confirm
the appropriateness of the CPD activity undertaken by the pharmacist.
In particular, without such an indication, it would be impossible to
confirm the extent to which the range of required competencies was being
addressed.
The need to confirm such appropriateness appears to be embedded in the
revised Statement
on Professional Competence in the Code of Ethics (PJ,
18/25 December 2004, p889). Here the revision states: “CPD records
should contain evidence that practising pharmacists continually review
the skills and knowledge required for their field(s) of practice, identify
those skills or knowledge in need of development or improvement and audit
their performance as part of the review.” The only way to confirm
that this review has taken place is for the pharmacist to outline his
or her roles and responsibilities/required competencies/required skills
and knowledge within the CPD record. The concept and process of CPD was
introduced for two related, and equally important, reasons: one to guide
pharmacists with respect to maintaining and enhancing their competence
and practice, and the other to provide a mechanism to demonstrate their
fitness to practise to the Society and to society at large. Without ensuring
a clear relationship exists between the skills and knowledge required
to meet individual roles and responsibilities and the CPD activities
undertaken, neither of these outcomes will be met.
The issue of supportive feedback also needs to be addressed. Every one
of us will benefit from critical appraisal of our CPD records, from suggestions
of other competencies we should address, of alternative ways of addressing
identified needs and of evaluating the outcome of our learning. Is such
feedback to be given by the Society-appointed CPD facilitators during
the construction of our CPD records or by the Society at the time of
the submission and appraisal of our records? The issue of supportive
feedback is important to all of us and not only to those whose CPD records
are seen to be inadequate. Much time, effort and resources have been,
and will be, committed to CPD. Appropriate feedback will ensure full
benefit is derived from that input.
Douglas Hancox
Auckland,
New Zealand
| |
PETER WILSON, head of post-registration, Royal Pharmaceutical
Society, replies:
I am pleased to acknowledge Mr Hancox’s contributions
to the Society’s original CPD working party and his ongoing
interest in the development of the CPD framework. He is right that
the CPD recording process does not request details of a pharmacist’s
roles and responsibilities. We do not accept that this is the only
way to determine if a pharmacist has conducted a review of their
personal practice. We do ask pharmacists how they have determined
their learning needs and also how what they have learnt through
CPD has been applied to their work.
Our work with the original CPD pilots showed that this enabled
an effective review of a pharmacist’s CPD record.
When we consider what we ask pharmacists to record, it is necessary
to keep the context and purpose of CPD in mind. Mr Hancox states
that one purpose is
to “provide
a mechanism for the demonstration of their fitness to practise to the Society”.
This is not the case. CPD provides the Society with reassurance that its members
are maintaining their competence to practise. If we wished to assess fitness
to practise we would need to examine the practice of each pharmacist individually.
This raises the spectre of observations of practice and examinations. That
is not the purpose of the current CPD framework.
The issue of supportive feedback on their CPD for all pharmacists is well recognised.
We have always promised that pharmacists would get feedback on their CPD records
and we have made a lot of progress to develop effective systems to achieve
this. These will be ready for the start of the record review process. Readers
will
be aware of the appointment of facilitators in Britain to support pharmacists’ CPD
through the branch network. |
The Government should pay
From Dr J. K. Cross, MRPharmS
I see that the President reminded the Royal Pharmaceutical Society’s
Council that “mandatory
CPD was a government requirement” (PJ,
18/25 December 2004, p887), in which case surely the Government ought
to pay the costs thereof.
Readers may be interested to know that dentists also have to undertake
CPD for which they can claim £57.35 per hour up to a maximum of
15 hours per year.
John K. Cross
Pharmacist and Dental Surgeon
Skipton,
North Yorkshire
I commend the Society
From Mr P. J. Harrison, MRPharmS
It is scandalous that continuing professional development is only now
being introduced. I graduated in the late 1960s and the idea that I can
still practise as a pharmacist even if I had not opened a book since
then is astounding.
Since my graduation, academic pharmacy education has become much more
balanced. Associated with the recognition of a more relevant and continuing
education, CPD is now being introduced. Whether this justifies the increased
fee, I do not know. Since my fee as an overseas pharmacist more than
doubles, I had a greater shock than many and I do not practise in the
conventional sense since I am not registered in Canada. I was initially
swayed by the spectacle of pharmacists resigning from the Register after
a lifetime of service and locums on the poverty line; even more so when
I recognised the doyens of academia who joined the fray. I hesitated
at the suggestion that competence should be linked to the number of hours
worked. I wonder if in fact that the opposite should be the case, ie,
you could only be a pharmacist if you practised for the requisite hours.
On reflection, however, these are two related issues where I commend
the Royal Pharmaceutical Society. Pharmacists should have a certain competence,
however infrequently they practise and the fee should be the same regardless
of the number of hours worked. Would these part-time pharmacists accept
part-time representation or should patients be satisfied with partial
competence? Your editorial (PJ, 4 December 2004, p802) made a good point
of relative cost. Whether the absolute cost is justified I do not know.
However, I now think that those who will resign because of the introduction
of CPD or because of the increased fee are making the right decision,
although I much regret the reasons for so doing. I say, if you are proud
of being a pharmacist and are pleased that mandatory CPD is finally being
introduced, pay up.
Despite my embarrassment at the antics of the Society over the past 18
months and although there could have been more decorum, I think that
the passion of the debate augurs well for the Society.
Philip Harrison
Montreal, Canada
|
The
Pharmaceutical Journal