Continuing Professional Development Jill ILIFFE Executive Secretary Commonwealth Nurses Federation
What is CPD? There are MANY different names for the same thing CPD: Continuing professional development CNE: Continuing nursing education CPE: Continuing professional education CME: Continuing medical education CE: Continuing education LLL: Life long learning ISE: In-service education SD: Staff development
Why have a CPD requirement? One of the shared ethical mandates for health professionals is a commitment to competence. Becoming competent and maintaining competence requires ongoing, lifelong learning as new knowledge, understanding and experience require new ways of doing things. The credibility of a profession is based on the willingness of each professional to embrace new skills, knowledge and experience. Life long learning is a hallmark of committed and competent health professionals. Ongoing learning, both formal and informal, is required to maintain clinical competence and acquire new knowledge and skill.
Who is responsible? employers (public or private) regulatory bodies professional associations governments individuals
Who is to be covered by your CPD program? Whoever the regulatory council has Responsibility for
How is CPD to be linked to licensure? What is Registration: what is Licensure There are different meanings for the same thing Your name is entered on the register when you complete your initial qualification as a nurse or midwife and you are issued with a license to practice.
How is CPD to be linked to licensure? Life long registration and no requirement for renewal of your license to practice. Initial registration and renewal of your license to practice annually (or each 3 years or 5 years) with or without a requirement for mandatory or voluntary CPD. Some countries also have practice requirements so many hours of practice over a set period (2-5 years) or require recency of practice, that is, you have practiced in your profession within the last 2-5 years.
A process for establishing CPD 1. Prepare your arguments and your brief. 2. Develop and implement a communication strategy. 3. Develop your CPD policy. 4. Develop your CPD framework. 5. Make any legislative change. 6. Take small steps moving forward toward your goal. 7. Remember: the process should be reasonable, achievable, fair, accessible, transparent, flexible, and inclusive. 8. CPD should be relevant, current, available, accessible and affordable.
What should go in your Act Make it as broad as possible giving the regulatory authority the power to adapt the CPD requirements from time to time without having to change legislation.
Vision or Mission Statement You might want to insert a vision or mission statement at the beginning of your framework
VISION STATEMENT Nurses, midwives and nursing assistants in Lesotho will provide high quality, competent, evidence-based, legal and ethical care to patients, clients and the community through their involvement in continuous professional development and their commitment to lifelong learning. The Lesotho Nursing Council, through their mandate to protect the public and as the responsible body for nurses, midwives and nursing assistants, will implement, support and monitor a national program of continuous professional development for nurses, midwives and nursing assistants.
Introduction Establish the mandate of the regulatory council to require involvement in CPD activities. The knowledge needed to function effectively as a health professional continues to expand and change while consumer demand and expectations continue to increase. Registered health practitioners have a professional obligation to maintain their competence and to aim for continuous improvement in the standard of service they provide.
Definitions There are many different definitions in the literature. Find or develop one that suits you. CPD can be defined as the conscious updating of professional knowledge and the improvement of professional competence throughout a person s working life. It is a commitment to being professional, keeping up to date and continuously seeking to improve. CPD is the purposeful maintenance and improvement of a professional s knowledge and skills to remain competent in their chosen profession for the benefit of themselves, their patients or clients and the wider profession.
Purpose or Rationale Explain why? Many individuals will already be involved in CPD. Why now? Make your arguments as to why the regulatory council is imposing a CPD requirement.
What are the principles of CPD? CPD is a continuous process and actively seeks to improve skills, knowledge and performance. Learning needs should be defined and agreed in collaboration with line manager but owned and managed by the individual learner. CPD should be based on a rigorous and continuous analysis of professional learning needs. CPD activities should be planned in advance through a personal development plan, and should reflect and be relevant to current and future professional practice and performance.
What are the principles of CPD? CPD acknowledges varying learning styles and includes a wide range of formal and informal learning activities. The key principles of CPD are that it is self-directed; that it is based on learning needs identified by the individual; builds on an individual s existing knowledge and experience; links an individual s learning to their practice; and includes an evaluation of the individual s development. CPD requires professionals to identify their learning needs based on an evaluation of their practice against recognised professional standards; develop a learning plan based on the needs identified; participate in CPD activities which meet these learning needs; and reflect on the value of these activities to their practice.
What are the principles of CPD? relevant, current, available, accessible, and affordable adult learning principles evidence-based
Voluntary or mandatory? Governments, regulatory bodies, employers, and professional associations all have a responsibility to ensure services Provided are safe and protect the public. They have to demonstrate accountability. Individuals have an ethical responsibility to their patients and clients, their professions, and themselves to practice competently and safely. CPD should be an integral part of their professional life whether voluntary or mandatory. Difficult to apply sanctions for non-compliance without legislative support.
How much is enough? There should be a minimum requirement, but there is no maximum. Requirements for health professionals vary globally from the equivalent of 20 hours annually to 50 hours annually sometimes spread over 2-3 years. CPD requirements must be: reasonable, achievable, fair, accessible to all (includes cost considerations), transparent, flexible, and inclusive (avoid monopoly).
CPD points or CPD hours? Awarding CPD points for learning activities requires the development of a formal process which involves personnel, time and cost. Specifying a minimum number of hours of CPD activity is a satisfactory first step. In some programs, one hour of active learning = one CPD point. In other programs, different types of CPD activities have different values eg one hour of formal learning might attract 3 points whereas one hour of informal learning might only attract one point.
REQUIREMENT Nurses, midwives and nursing assistants recognised by the Lesotho Nursing Council will be expected to obtain a minimum of 12 CPD points each year prior to renewing their practising license. CPD points will only be allocated on completion of the CPD activity. The CPD points will be allocated according to the CPD table. One hour of active learning will attract 1, 2 or 3 CPD points depending on the activity. A record in the log book, available from the LNC, of the CPD undertaken must be kept by the nurse, midwife or nursing assistant which is verified by the provider of the CPD. CPD activities will include both formal and informal learning.
REQUIREMENT Nurses registered with Swaziland Nursing Council will be expected to undertake at least 10 hours of continuing professional development each year prior to renewing their practising license. One hour of active learning will equal one point of CPD so each nurse will be required to accrue 10 CPD points each year. CPD points will only be allocated on completion of the CPD activity. A record must be kept by the nurse of the CPD undertaken which is verified by the provider of the CPD. CPD activities will include both formal and informal learning.
What constitutes CPD? What is the scope? formal educational programs short courses (face to face or online) experiential (presenting at or attending conferences; seminars or workshops; supervised practice for skills development; conducting research; developing policies, protocols or guidelines; acting as a mentor or preceptor; participating in committees eg quality improvement, occupational health and safety) self-directed (reading professional journals and books; keeping a self reflection journal; publishing articles)
CPD TABLE - Registered Nurses and Midwives 1 hour = 1 point 1 hour = 2 points 1 hour = 3 points Reading professional journals and books (SD) Keeping a self-reflection journal (SD) Attending conferences, seminars, workshops or in-service education (SWI) Active membership of professional body and its committees (SD) Working with a mentor to improve practice (EX) Participating in case studies, clinical audits, clinical meetings, focus groups or peer review (EX) Acting as a mentor or preceptor if not part of job description (EX) Attending short courses distance or online with a minimum of 3 hours of active learning each week (SDO) Presenting at conferences, seminars, workshops or in-service education (SWI) Participating in committees eg quality improvement, occupational health and safety (EX) Lecturing, teaching or doing assessments if not part of the job description (EX) Planning or running a seminar or workshop or in-service (SWI) Formal education programmes leading to a qualification (FL) Attending short courses 3-6 months duration face to face with a minimum of 15 hours of active learning each week (SF) Writing articles for publication in journals or books (SD) Developing policies, protocols or guidelines (EX) Conducting research as principal investigator (EX) Planning or running a short course face to face, distance or online 3-6 months duration (SF or SDO) FL = Formal learning SF = Short course face to face SDO = Short course distance and online SWI = Seminars, workshops, in-service EX = Experiential learning SD = Self-directed learning
CPD TABLE - Registered Nurses and Midwives 1 hour = 1 point 1 hour = 2 points 1 hour = 3 points Participating in a professional reading or discussion group or journal club (SD) Observation at disciplinary hearings (EX) Voluntary work relevant to practice (SD) Project work if not part of job description (EX) Supervising staff or students if not part of job description (EX) Supervised practice for skills development (EX) Skills development in IT, numeracy, communications, problem solving and working with others (SD) Investigating disciplinary cases if not part of job description (EX) Participating in research as a team member (EX) Reviewing educational materials, journal articles, books (SD) Project management if not part of job description (EX) FL = Formal learning SF = Short course face to face SDO = Short course distance and online SWI = Seminars, workshops, in-service EX = Experiential learning SD = Self-directed learning
Documentation What evidence should each nurse and midwife provide? In what form? Log book, diary, professional portfolio
Accredit or not? It would be difficult to accredit all CPD activity as CPD activities should embrace both formal and informal (self-directed and experiential) learning. Accepting only accredited CPD activities diminishes the value of self-directed (reading journals, presenting at conferences, publishing articles) and experiential learning that takes place in the workplace (supervised clinical learning). Both accredited and non-accredited CPD activities should be encouraged and valued.
Accredit or not? Accreditation of CPD content requires the development of a formal process, establishing accreditation criteria and ongoing evaluation of applications which involves personnel, time and cost. Likewise, the accreditation of providers of CDP learning activities requires the development of a similar formal process. Is it the responsibility of a regulatory body to accredit CPD activities or encourage the development of an external body to undertake this function?
ACCREDITATION: FORMAL LEARNING Nurses undertaking formal undergraduate or postgraduate education (FL) at a school of nursing, college or university (either face to face, distance or online) leading to the award of a certificate, diploma, advanced diploma, degree, post graduate certificate, post graduate diploma, masters or PhD, may claim CPD points in each year they are undertaking the course. Documentary evidence should be provided in the form of a transcript of subjects undertaken and successfully completed or any other relevant documentation which verifies the number of hours of active learning, including clinical learning.
ACCREDITATION: SHORT COURSE CONTENT A short course face to face (SF) is one with a duration of between 3-6 months with a minimum of fifteen hours of active learning in each week and may consist of theory and clinical components. A short course distance or online (SDO) is one with a minimum of three hours of active learning in each week and may consist of theory and clinical components. Documentary evidence must be kept in the log book outlining: Learning objectives, Course content, Relevance to current or future work, Hours of active learning, Brief description of what has been learned. Documentary evidence must be verified by the CPD course provider by supplying their name, designation, contact details and signature.
ACCREDITATION: SEMINARS, WORKSHOPS AND IN- SERVICE To claim CPD points for seminars, workshops and in-service education (SWI), the activity must be of at least one hour of continuous active learning. Documentary evidence must be kept in the log book outlining: Learning objectives, Course content, Relevance to current or future work, Hours of active learning, Brief description of what has been learned. Documentary evidence must be verified by the CPD provider by supplying their name, designation, contact details and signature.
ACCREDITATION: EXPERIENTIAL LEARNING Experiential learning (EX) is learning that occurs by active participation in a practical activity either in or outside the workplace and which is not a part of the usual job description. Documentary evidence, verified by the employer, supervisor, manager, educator or other relevant person, must be provided in the log book outlining: Learning objectives, Description of activity, Relevance to current or future work, Hours of active learning, Brief description of what has been learned. Documentary evidence must be verified by the CPD provider by their supplying name, designation, contact details and signature.
ACCREDITATION: SELF-DIRECTED LEARNING Self-directed learning (SD) is when the individual takes initiative to participate in an active learning activity which is not part of the usual job description. Self-directed learning usually takes place outside the workplace. Documentary evidence must be kept in the log book outlining: Learning objectives, Description of activity, Relevance to current or future work, Hours of active learning, Brief description of what has been learned. Some self-directed learning may be verified by the employer, supervisor, manager, educator or other relevant person (eg sharing with your employer a journal article you have just read and what you learned from it). Such verification must include their name, designation, contact details and signature. Self directed learning which cannot be verified by an external person must not comprise more than 25% of the minimum required CPD points each year.
QUALITY STANDARDS FOR CPD PROVIDERS AND FACILITATORS Providers and facilitators of CPD in Lesotho (short course face to face; short course distance or online; seminars, workshops or in-service) are required to meet the following quality standards: Be familiar with and adhere to the Lesotho CPD framework. Ensure CPD is provided by teachers who use effective teaching and learning strategies matched to content and the level and type of learners. Use valid and reliable assessment methods that provide feedback on whether the learning objectives have been met. Document and retain information about program design and content; number of contact hours; names and contact details of participants; and evaluation outcomes. Secure storage must be provided for this documentation. Understand the need to minimise any conflicts of interest related to commercial supporters and willingly disclose any conflicts of interest to participants at the beginning of the CPD activity.
ACCREDITATION - FORMAL LEARNING Nurses undertaking formal undergraduate or postgraduate education at an accredited institution of learning, school of nursing or university (either face to face, distance or online) leading to the award of a certificate, diploma, advanced diploma, degree, post graduate certificate, post graduate diploma, masters or PhD, may claim CPD points in each year they are undertaking the course providing: they have undertaken at least ten hours of active learning during the year that CPD points are being claimed, they have successfully completed course requirements for the year in which CPD points are being claimed, and the course is directly relevant to the nurses current or future professional practice. Nurses claiming CPD points for formal learning must be able to provide an academic transcript of subjects undertaken during the year in which CPD points are being claimed as well as their assessment results or academic certificate at the conclusion of their course.
ACCREDITATION - EXPERIENTIAL AND SELF DIRECTED LEARNING For accreditation of experiential or self-directed learning and recognition by the Swaziland Nursing Council for allocation of CPD points, certain standards and criteria must be met. Experiential and self-directed learning is that which occurs either in the workplace or similar environment or learning undertaken by the nurse outside the work environment. Experiential learning may include: Acting as a mentor or preceptor or supervising nursing students Undertaking supervised practice for skills development Participating in clinical audits, critical incident monitoring, case reviews and clinical meetings Conducting or participating in research Participating in committees such as quality improvement, occupational health and safety, infection control, accreditation or audit committees and other relevant committees Active involvement in professional groups and committees
Self-directed learning may include: Participating in distance education or online short courses Writing or reviewing educational materials, journal articles or books Keeping a self-reflection journal Presenting at conferences, seminars or workshops Developing work related policies, protocols or guidelines Active involvement in professional groups and committees Project work or project management Lecturing or teaching if it is not part of your job description Being an examiner in a health related field Organising journal clubs or other specialist groups Voluntary work if it is relevant to scope of practice
For accreditation, all experiential or self-directed learning must consist of at least one hour of active learning. Nurses claiming CPD points for experiential or self-directed learning must document in log book: The purpose or reason for undertaking the CPD activity. The learning objective(s). The specific content area(s) covered in the activity consistent with the learning objectives. The type of activity. The time spent undertaking the activity. The learning gained from undertaking the activity. The date the activity was undertaken. Verification in the log book from managers, supervisors, inservice coordinator or CPD provider including name, designation and signature.
ACCREDITATION - SHORT COURSE CONTENT For approval and recognition from the Swaziland Nursing Council as quality CPD and allocation of CPD points, certain standards and criteria must be met. For credit points to be granted, all short courses must consist of at least one hour of active learning. One hour of active learning equals one CPD point. An application from a CPD provider should meet the following requirements: A written statement which includes the course description, purpose or reason for offering the CPD, learning objectives, content area(s) and relevance to practice, target group of professionals, type of activities planned and expected outcomes. Content is related to and consistent with objectives and each objective has a corresponding content and expected outcome. Time allocated for content is consistent with objectives and appropriate for content to be presented. Teaching strategies are congruent with the objectives and content to be presented. Principles of adult learning are evident in the selected strategies.
Presenters of the CPD have knowledge and expertise in the content area and take an active part in planning their presentations and shall provide evidence of academic preparation and/or experience in the content area. The evaluation tool used by the CPD provider is based on the learning objectives and the overall purpose of the educational activity. The CPD provider uses evaluation results to plan future offerings and for quality improvement planning. The CPD provider clearly indicates in the application form the number of hours in the course of active learning. Written confirmation of attendance must be provided to participants who successfully complete an educational activity with verification of attendance recorded in their log book. Such verification must include the name of the CPD provider; date of activity; and signature. A certificate of attendance may also be issued.
The provider has an established and maintained record storage system that assures confidentiality, and easy retrieval by authorised personnel. The provider maintains a record of CPD points earned by the participants. The Swaziland Nursing Council will determine the fees it will charge from time to time for processing applications for approval and recognition of short courses for CPD points. Application fees are to be paid by the CPD provider at the time of application for accreditation of a CPD activity or program.
Monitoring compliance? Each nurse or midwife monitored or a meaningful random sample? What evidence should each nurse and midwife provide? Establishing penalties for non compliance and an appeals process and criteria plus criteria for exemptions and deferment.
Monitoring compliance? CPD requirements must be: reasonable, achievable, fair, accessible to all (includes cost considerations), transparent, flexible, and inclusive (avoid monopoly).
Monitoring compliance? CPD offerings must be: relevant, current, available, accessible, and affordable.
How are you going to evaluate your program? Collecting statistics (what CPD was accessed) Evaluating the process (did it work) Measuring outcomes (how many individuals were compliant)
Developing a CPD framework Introduction Definition of CPD Rationale for CPD Principles Whether voluntary or mandatory Requirement (in terms of points or hours) Scope (what activities are acceptable) How are those activities to be recorded How activities are to be assessed How compliance is to be monitored Is there a penalty for non-compliance Is there an appeals process How can exemptions be sought
Establishing CPD is a staged process
A process for establishing CPD 1. Prepare your arguments and your brief. 2. Develop and implement a communication strategy. 3. Develop your CPD policy. 4. Develop your CPD framework. 5. Make any legislative change. 6. Take small steps moving forward toward your goal. 7. Remember: the process should be reasonable, achievable, fair, accessible, transparent, flexible, and inclusive. 8. CPD should be relevant, current, available, accessible and affordable.