Tomorrow's Pharmacist October 1999 p61-63
Edited by Pamela Mason

Professional development

Continuing professional development

Not an optional extra, continuing professional development is a vital part of your professional life. Your time as a student provides an opportunity to lay down foundations for your future practice and CPD.

In the 1990s, continuing professional development (CPD) has emerged as a major issue for pharmacy as it has for all professions. It is also a feature of current government policy for the NHS. In its consultation document, "A first class service: quality in the new NHS", the Government has put forward a policy on clinical governance which includes the need for programmes of CPD aimed at the needs of individual health professionals and the service needs of NHS organisations. The two perspectives of CPD are clear within this policy. On the one hand CPD is aimed to meet an individual's need while on the other it is seen as the delivery of programmes to meet organisational needs. The government policy is intended to ensure that all healthcare professionals are competent throughout their careers and that the NHS delivers relevant services of a high quality.
This dual nature of CPD is seen within the Society's current activities. An increased level of support and guidance is being given to help pharmacists meet their individual CPD needs alongside activity to ensure the realisation of the vision for pharmacy practice expressed in the "Pharmacy in a New Age" initiatives. In response to government policy and the "new age" proposals, the centres for pharmacy postgraduate education in the UK provide workshops and distance learning material to support developments in pharmacy practice.

What it is

CPD can be defined as "the process through which pharmacists continuously enhance their knowledge, skill and personal qualities throughout their professional careers". It is not a new concept but is derived from the pharmacist's obligation within the Code of Ethics to "keep abreast of the progress of pharmaceutical knowledge in order to maintain a high standard of professional competence relative to his or her sphere of activity". In earlier years the emphasis was on continuing education through participation in evening meetings, study days, conferences and courses. Indeed, those pharmacists who did not participate in such activities were perceived as not keeping themselves up to date.
Now, however, there is recognition that many of these pharmacists were making effective use of learning activities within their day-to-day practice to maintain and enhance their knowledge and skill. This mode of learning is now being included within recommended learning activities for CPD. Within this CPD framework, pharmacists are being encouraged to identify their learning and development needs through critical questioning and reflection on their practice and personal performance, to identify, and prioritise, those needs and to identify appropriate means to meet those needs. These could include the effective use of the learning potential in day-to-day activities, learning from the practice of other pharmacists through discussion or working with them, together with other less formal ways, in addition to participation in meetings, study days and courses. After implementing the planned learning, pharmacists are being encouraged to evaluate their learning by confirming the extent to which it has met their intended outcomes.

CPD for students

But how relevant is all of this to undergraduate and preregistration trainees? As you might expect, it is very relevant. Indeed, your professional development began when you decided to qualify as a pharmacist. That decision would have been based on a number of reasons but would almost certainly have included a desire to learn more and more in areas of science that both interested you and which you enjoyed. In addition you would have had an interest in applying your knowledge and skill directly or indirectly within the health service. These will be key factors in your CPD. Without a continued enjoyment and satisfaction from questioning practice, from engaging in learning activities and from providing quality services there will be little incentive for CPD.
Your undergraduate and preregistration years will provide you with a wide range of knowledge and skill for your future practice. Of particular value, and generally overlooked in assessment procedures, is your growing awareness of pharmacy practice and your ability for self-directed learning and learning through working with a group of your peers. In respect of pharmacy practice you will be impressed by some pharmacists and their practice and critical of others. You will have the opportunity to read professional journals, attend Society branch meetings and discuss initiatives such as those within the "new age" agenda. You will also identify some pharmacist or pharmacists as role models for your future practice. This growing awareness of pharmacy practice is important for your future CPD in that it will help shape the future direction for your practice and the standards that you will set over and above those officially laid down.

Learning

In respect of your learning, its direction and depth is largely set by the degree syllabus and preregistration requirements and by your lecturers and preregistration tutor. However, you also have a responsibility to set limits yourself within project work and the opportunity to develop self directed learning skills in such work as well as in the formally set problem based and self directed learning within your course. These abilities are clearly critical for your future CPD where you will take full responsibility for that development, and its success will rest firmly on your own shoulders.
A further valuable skill that you develop in your preregistration year is that of identifying and, in particular, recording evidence of your competence. Although pharmacists are efficient in maintaining Controlled Drug registers, they are poor at recording their practice and development activities. There is therefore difficulty in confirming just what they do achieve and contribute in practice, and they lose a valuable opportunity for reflection on their practice. Your enhanced skill in recording such activity should prove invaluable in future years.

CPD pilots

It has been recognised that the adoption of a systematic approach to CPD could prove to be extremely helpful and the Society is currently piloting such an approach with some 500 pharmacists across the UK. Its essential features are those of reflection, planning, implementation and evaluation.
In the reflection phase pharmacists are being encouraged to think critically of their practice and of their performance. In what ways can these be improved, what aspects are not as good or effective as they could or should be? They are being encouraged to audit aspects of their practice to identify areas for improvement. Regular reading of The Pharmaceutical Journal, and related professional journals, and attendance at Society branch meetings, study days and workshops will keep them aware of practice developments and of new knowledge as well as the opportunity to reflect on the incorporation of these into their own practice.
Another technique which pharmacists are being encouraged to employ is that of a SWOT analysis. In this technique they identify their personal or practice strengths and weaknesses, together with the opportunities for further development and the threats to such development. For some pharmacists there will also be the opportunity for reflection on the outcome of appraisals of their performance, while some will have made a decision to seek a new post or a change of direction for their career.
The purpose of this reflection phase is to identify the pharmacist's learning and development needs. This may be in the nature of refreshment of previous knowledge or skill or for the attainment of further knowledge or skill.
It is likely that following reflection a number of needs are identified. Some will be easily addressed, others with more difficulty. Equally, some will need to be addressed early, while others can be deferred for a while.
Examples of identified needs could be to enhance knowledge and skill in palliative care or become more comfortable in dealing with psychiatric patients. Alternatively, there could be a need for further financial or management skills or the ability to interpret conflicting evidence on the use of particular drug treatments. Another could be the need to become a tutor to a preregistration pharmacist or to work more closely with other health care professionals.
When planning their learning and development activities, the advice given to the pharmacist is to prioritise the needs, differentiate between "needs", "wants" and "interests" and to recognise that there are numerous ways to address them. In addition, there is a need to be specific, to identify the objective, to recognise a way of measuring achievement and to be realistic in regard to the time needed to meet the objective.
When addressing identified learning and development needs, pharmacists are being encouraged to choose wisely from the wide range of methods available to them. Being proactive in work situations and learning from day-to-day activities should be high on the list, together with working alongside others in work situations or study groups. Specific workshops, study days, courses or distance learning material are frequently available, while completion of diploma or Masters degree courses will, at times, be appropriate. Pharmacists are also strongly advised to ensure that there is always an appropriate balance in learning activities between those that are work based and self directed and those that are carried out at conferences, study days and courses in company with other learners.
Following their completion of planned learning, pharmacists are being encouraged to evaluate its outcome. Specific purposes for the CPD activities should have been been identified at the start. These may have been to improve practice and personal performance, to gain further knowledge or skill or to become competent in some new area of practice. Were they achieved? To what extent has practice and performance been improved? What can be learned about the approaches taken? Measuring the outcome is itself seen as a learning experience and, when improvement can be demonstrated, to give further self confidence and be evidence of the quality of service being provided. Indeed, at some future date, pharmacists may be required to provide evidence of their CPD as a condition for continued professional practice.
In emphasising systematic planning for professional development, pharmacists are being encouraged to not lose sight of the spontaneous, unplanned, opportunities for learning and development that continually arise. To miss such opportunities would be neglectful, and at times there will be a need to modify planned learning to take advantage of these opportunities.
Much of the advice being given to pharmacists in regard to CPD is clearly relevant to you as an undergraduate or preregistration trainee. You will be using many of the recommended strategies in your current studies and experience. Their wider usage can only be to your advantage.

Conclusion

Whether you are an undergraduate or a preregistration trainee, your CPD has already started. It is not an optional extra but a part of professional life. Your full recognition of the value of all that is contained within your degree syllabus and preregistration training and experience and the enjoyment you gain from your studies and practice experience will provide you with a firm foundation for your future practice and CPD. Its success will depend very much upon how you approach your undergraduate course and pre- registration training and experience, your sustained enjoyment from learning and practice, and the systematic approach to learning that you adopt in future years.

Mr Hancox is a retired pharmacist now living in Auckland, New Zealand. Previously, he was principle education and training pharmacist, South Thames NHSE

Tomorrow's Pharmacist is an annual publication produced within the editorial department of The Pharmaceutical Journal