Inside Tomorrow's Pharmacist (2003)

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Continuing professional development — what it will mean for you

Continuing professional development — what it will mean for you by Douglas Hancox

As undergraduates and preregistration trainees you are acquiring a wealth of knowledge and skill to prepare you for your future career in pharmacy. However, completion of your degree and your preregistration training is only the start of your ongoing learning and development. There will be many advances during the next 40 or more years: new treatments, new technologies, further evidence of effectiveness or adverse effects of medicines and further understanding of disease processes and of drug actions will emerge. Your own personal role will evolve too. You have a lifetime of learning and professional development ahead of you.

At university as well as during your preregistration training the content and direction of your learning and professional development will have been largely determined by others within a framework laid down by the Royal Pharmaceutical Society. After your registration, however, this will increasingly become your personal responsibility.

Within the next two years continuing professional development (CPD) will become mandatory within the profession. All pharmacists, certainly all pharmacists wishing to work in the traditional areas of community and hospital practice, will need to provide evidence to the Royal Pharmaceutical Society of acceptable CPD activity.

What is CPD?

CPD has been defined as "the process through which pharmacists continuously enhance their knowledge, skill and personal qualities throughout their professional careers".

Keeping up to date has always been a key responsibility. For many years the emphasis in respect of meeting this responsibility lay in continuing education (CE). Pharmacists were encouraged to attend evening meetings and study days, to participate in short courses and to complete distance learning packages. The Society recommended that pharmacists undertook a minimum of 30 hours CE activity each year.

In the early 1990s it became clear that an emphasis on CE had serious shortcomings. For one thing, the learning and development that arises from day-to-day practice was not being recognised. Alternative ways of addressing learning and development needs were being neglected. Appropriate workshops and courses were not always available to meet pharmacists' needs and there were many cases where pharmacists attended workshops and courses simply because they were available and interesting rather than because they met their real needs. Furthermore, there was rarely any assessment of the success of the CE activities in promoting learning or enhancing daily practice.

To counter these shortcomings the Society introduced the concept of continuing professional development, CPD. Within this concept pharmacists are encouraged to adopt a structured approach of:

• Reflection

• Planning

• Action

• Evaluation.

Reflection

In the reflection phase of the CPD cycle pharmacists are encouraged to identify their personal learning and development needs through a process of reflection upon their practice that is based on an appropriate mix of self-assessment, professional audit and appraisal by their line managers and peers.

Planning

Having identified and prioritised their needs pharmacists are then encouraged to identify the most appropriate ways of meeting those needs from the wide range of learning and development activities available to them. These include not only the traditional CE activities but also such opportunities as shadowing other pharmacists with the required expertise, self-study using relevant review articles and other information sources, and being part of a study group with other pharmacists.

Action and evaluation

The action phase speaks for itself, while in the evaluation phase pharmacists are encouraged to assess the outcome of the activities in terms of their impact upon practice.

CPD in practice

The CPD concept has another important component. It recognises that significant learning and development occur from pharmacists' engagement in day-to-day practice, from finding solutions to everyday problems, from reading The Pharmaceutical Journal and other professional journals and from attending conferences and meeting of the various pharmacy organisations. Pharmacists are therefore encouraged to recognise this contribution, to make learning, development and reflection a part of their daily practice and to integrate this within their structured approach to CPD.

The CPD cycle has been designed to ensure pharmacists are able to fully meet their professional and service responsibilities. There is no syllabus, no required mix of activities and no minimum time requirement. CPD is a personal process and a continuing process. It will probably be desirable for pharmacists to make a major review of learning and development needs every year and to incorporate minor reviews arising from day-to-day practice when necessary. A further major reflection will also be needed whenever roles and responsibilities change or a change to career direction is sought.

With the introduction of mandatory CPD pharmacists will be required to adopt these recommendations. In addition they will need, every three to five years, to submit a record of their CPD activity to the Society to provide evidence that the CPD process has been satisfactorily addressed.

While all this may sound very demanding the only extra activity for many pharmacists will be keeping the required documentation of their CPD activity. All that is being asked of pharmacists is full acceptance of their professional responsibility to maintain and enhance the knowledge, skills and competencies relevant to their professional role. While CPD is a personal responsibility, significant support is available from the Centres for Pharmacy Postgraduate Education, the College of Pharmacy Practice, the National Pharmaceutical Association, the major community pharmacy employers and from the NHS.

Start now

Although designed for practitioners the CPD process is equally applicable to preregistration trainees and undergraduates. As you near the end of your preregistration training you should put time aside to reflect on your achievements.

• What tasks did you do well?

• What tasks did you find difficult?

• How do you rate your competence and confidence in specific areas of practice?

• What knowledge, skill and competence do you need to enhance?

• What are the specific needs for the post you will be taking up on completion of your preregistration year?

• What post do you want to have in five years time?

In answering these questions you will be making a number of self-assessments. Evidence shows that self-assessment is difficult and, at times, inaccurate. You should therefore balance it with the considered judgement and opinion of others. Reflect on the appraisals you have been given during your preregistration year. It may also be helpful to share your reflections with friends or with more senior pharmacists whom you respect.

After putting together these various assessments and judgements it will be possible to tease out the various specific learning and development needs and to rank them both in order of their importance and in terms of the time scale needed to address them. Some will be easy to achieve within a short time scale; others will be more difficult and take longer.

Having identified your personal needs you should then draw up an appropriate action plan. This will reflect the urgency and importance of the needs and identify the most appropriate way to address them. Remember that there is a wide spectrum of learning and development opportunities. Finally, having completed specific parts of your action plan take time to reflect on their success and their impact on your practice.

The above description of the CPD process will apply to many of you. However, for some pharmacists their employers will require completion of specific training programmes or a postgraduate qualification. In such cases it will be good practice to reconcile the expected outcomes of these CE activities with the personal learning and development needs that you have identified.

Those of you who are undergraduate pharmacy students can adopt a similar process. Before taking up your preregistration placement complete a similar self-assessment to identify your immediate learning and development needs and reconcile these with the expected outcome of your preregistration training and experience.

How has CPD come to be mandatory?

The issues of mandatory CE and CPD and periodic assessment of competence have been debated within the profession for at least the past 20 years. However, more recent concerns over the quality of health care provision and of incompetent and poorly performing health practitioners have dented public confidence and have led the Government to require improved self-regulation by health professional bodies.

This has led to the current modernisation of the Royal Pharmaceutical Society and to the decision to move to a requirement for pharmacists to provide evidence of satisfactory CPD. Over the past four years the Society has developed a CPD scheme and conducted a series of pilots. The scheme is currently being rolled out to a further 5,000 pharmacists. Within the next two years we can expect the scheme to be finalised and regulations to be introduced to link the CPD requirements with re-certification and continued eligibility to practice. Pharmacists, who are unable to provide satisfactory evidence of CPD, after being given appropriate guidance and support, can expect to be denied the right to practise.

It is anticipated that the requirement for CPD will provide public reassurance that pharmacists are remaining competent and fit-to-practice within their specific area of practice. While engagement in CPD does not guarantee competence, the only alternative approach would be that of competence assessment. Combinations of written and observational techniques could assess competence but at a high cost to all concerned. In addition, only a few of the many competencies required of individual pharmacists could be assessed. Although they are not direct measures of competence, satisfactory CPD records are the most practical way to provide the necessary public assurance of fitness for practice.

Pharmacy plays a major role in the provision of health care and faces the brightest of futures. Your competence in lifelong learning and CPD will be strongly linked to the quality of the services you deliver, the success of your career and the satisfaction you derive from being a pharmacist.