CONTINUING PROFESSIONAL DEVELOPMENT: A TOOL FOR QUALITY HEALTHCARE, PRESENTED BY THE REGISTRAR OF THE MDCN, DR. A. A. IBRAHIM, mni.
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1 CONTINUING PROFESSIONAL DEVELOPMENT: A TOOL FOR QUALITY HEALTHCARE, PRESENTED BY THE REGISTRAR OF THE MDCN, DR. A. A. IBRAHIM, mni. AT THE 11TH INTERNATIONAL CONFERENCE ON MEDICAL REGULATION (9TH 12TH SEPTEMBER, 2014) IN LONDON, UNITED KINGDOM.
2 OBJECTIVES: Attempt would be made to: Introduce the topic Define CPD Historical Context International CPD Model/Current Trends Nigerian CPD Model Consider a case study from MDCN Benefits, Challenges and Impact of CPD Conclusion References
3 INTRODUCTION: The care of the patient should be the first consideration of medical professionals. CPD/CME: These form of continuing learning has been adopted by most regulatory bodies in registering and/or Licensure of practitioners. The twenty first century doctor has come to realize that without making conscious effort at updating his knowledge and skills he soon become rusty and obsolete. Quality healthcare depends on the knowledge and skill of the medical doctor which he obtains over time and available equipments which must be up to date. No medical doctor can give what he does not have and that is why it is often said that Whenever a doctor cannot do good, he must be kept from doing harm. To remain relevant in the medical profession a good doctor must continually update his knowledge and skills through the CPD programmes. DEFINITION Continuing Professional Development (CPD) is a process of ensuring that knowledge is continually updated. It is aimed at ensuring that practitioners are in tune with the current trends in the practice of medicine with a consequential benefit imparted on the patient. There have been several definitions of what CPD means, but all appears to agree they are educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationship a physician uses to provide services for patients, the public or the profession.
4 HISTORICAL CONTEXT CME is not a new concept. From essentially the beginning of institutionalized medical instruction (medical instruction affiliated with medical colleges and teaching hospitals), health practitioners continued their learning by meeting with their peers. Grand rounds, case discussions, and meetings to discuss published medical papers constituted the continuing learning experienced. In 1950s through to the 1980s, CME was increasingly funded by the pharmaceutical industry. Concerns regarding informational bias (both international and unintentional) led to increasing scrutiny of the CME funding sources. This lead to the establishment of certifying agencies such as the society for Academic Continuing Medical Education which is an umbrella organization representing medical association and bodies of academic medicine from the USA, Canada, Great Britain and Europe. The Pharmaceutical industry has also developed guidelines regarding drug detailing and industry sponsorship of CME, such as the Pharmaceutical Advertising Advisory Board (PAAB) and Canada s Research-Based Pharmaceutical Companies
5 INTERNATIONAL CPD MODEL/CURRENT TRENDS There appears to be a wide variation across systems for CPD in different countries and healthcare systems, there are some features: most are based on an hours related credit system, in which hour educational activity equates to one credit; educational activities. Surveys in 18 countries in Europe shows the diversity of systems operating within the territory. No European country has followed the US model of exam for recertification. Only the Netherland has legislated recertification system. Recently the UK has introduced compulsory revalidation or recertification.
6 NIGERIA CPD MODEL: MDCN is empowered by an Act. Its mandate includes the determination of the knowledge and skills of practitioners and ensure that practitioners subscribe annually for a practicing license. The Council in 2008 made the attendance of CPD activities mandatory. ln 2011 it began its enforcement and went a step further to ensure that annual registration for licensure was tied to the issuance of its license to practice. The MDCN accredits CPD providers from both private and public institutions which includes; educational institutions, hospitals, clinics and professional associations. Doctors are mandatorily expected to obtain a minimum of 20 credit Units. The credit Units are expected to be obtained from at least three different CPD activities spread within three quarters in a CPD year. Some categories of practitioners are exempted from CPD by the Council due to their constant engagement in academic activities; they include resident doctors and intern doctors. CPD activities: Scientific Conferences, Workshops and Seminars, Grand rounds, Clinical meetings/discussions/demonstrations, researches, telemedicine, Medical ethics, Hospital Management and administration.
7 CONTINUING PROFESSIONAL DEVELOPMENT AS A TOOL FOR QUALITY HEALTHCARE Parameters assessed. Compliance to CPD activities CPD activities of most interest to doctors Cases of Professional negligence reported to the council Conferenc es/worksh ops Conferenc es/ workshop s CASE STUDY Responses from 100 doctors were randomly selected and analyzed from the total number of 28,000 financial members who applied each year from 2008 to The study aimed to detecting: 1. Compliance to the CPD guidelines 2. Which CPD activity interest practitioners the most 3. Relationship between attendance of CPD activities and the number of cases of professional negligence brought before the Council s IP and DT before and after CPD was enforced. Conferences/w orkshops Ground rounds Conferences/W orkshops Ground rounds Conferences/W orkshop Ground rounds On line programmes Conferences/worksh ops Grand rounds Telemedicine On line programmes Researches
8 ANALYSIS From the table above the following can be deduced: The level of compliance of doctors to CPD increased from 2008 to 2013 due to enforcement by the MDCN The type of CPD activities attended by doctors also increased due to awareness and enforcement The total number of cases reported by the public increased steadily from 2008 to 2013, despite the introduction of CPD, possibly due to increase awareness of the public to the mandate/activities of the MDCN Enforcement/compliance with attendance of CPD has not in any way reduced medical negligence.
9 BENEFITS/IMPACT OF CPD Improved patient care Mentorship Improved knowledge and skills of practitioners Improved infrastructural development and collaboration with Diaspora doctors and institutions Improved compliance to regulations Improved revenue generation for both the NMA and MDCN Increased patient/public awareness of activities of the Council CHALLENGES OF CPD PROGRAM Acceptability by Practitioners CPD Exemption Compliance with CPD rules Unaccredited CPD Providers
10 CONLUSION CPD has compelled doctors to improve their personal knowledge and skills and in turn give their best to the patient has greatly impacted positively on the healthcare delivery. What doctors learn at medical school and during postgraduate training needs to be updated throughout their careers to reflect changes in practice. Similarly, in their daily practice, doctors should reflect changes in the needs and attitudes of modern society as a whole. REFERENCES Ahmed K, Ashrafian H (October 2009) Life-Long learning for physicians Cathy peck, director of cpd, Martha Mccall, executive officer and tai rotem, research assistant. BMJ. Feb 12, CME for Licensure Reregistration State Medical Licensure Requirements and Statistics. American Medical Association Code of Medical Ethics in Nigeria Guidance on CPD (2007). The General Medical Council (GMC). London England. Website: Ibrahim Mohammed Inuwa : 3 rd Component in the Perpetual trilogy of Medical Education Institute of medicine,2001; Medical and Dental Council of Nigeria Guidelines on Registration as a Medical or Dental Practitioner in Nigeria Medical and Dental Council of Nigeria, Practitioners Act. Cap M8, LFN, 2008 Standards for Commercial Support: Standards to ensure independence in CME Activities Accreditation Council for CME. 2012
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