Continuing Professional Development CPD National Podiatry Survey

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Continuing Professional Development
(CPD)National Podiatry Survey

• Keith G McCormick

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Introduction
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Clinical Governance

• Development and implementation of clinical
  guidelines and protocols
• Evidence based clinical practice
• CPD for all staff
• Developing clinical leadership skills and
  managing the performance of colleagues
• Risk management
• Accreditation of hospital and community
  departments
• Learning from complaints

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CPD and AHPs

• An initial qualification is not enough to
  maintain competence over a lifetime of practice
  (Fraser et al 2000)
• In a survey of 192 podiatrists 94 considered
  regular professional updating important (Pavey
  1998)
• The most significant individual element of
  lifelong learning is CPD (BMA 2000)
• CPD activities within the PAM are uncoordinated,
  uni-disciplinary and not accredited (NHS
  Executive 1998)

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Pushing the Boundaries

• Developing new skills and new roles (Partnership
  for Care 2003)
• Extended roles based on competence and
  qualifications (e.g. Diabetes and Surgery)
• Documented and accredited CPD
• Protocols for standards and reporting of adverse
  events (National Patient Safety Agency NPSA)
• Improving Safety for Patients in Scotland
  (Quality Improvement Scotland (QIS) 2003)
• The only limit to clinical practice is competence
  and political barriers

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CPD and State registration

• Health professions Council (HPC) aims to link CPD
  with registration (DoH 2001)
• Learning Together (1999) set a deadline of Dec
  2000, for roll-out of Personal Learning Plans
  (PLPs)
• Courses must ultimately make a difference to
  patient care and improve outcomes
• Interactive workshops are more likely to improve
  clinical practice than Lectures (Thomson, OBrien
  et al 2001)

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CPD and State registration

• Doctors have a periodic evaluation of their
  registration
• SALT - 10 sessions of CPD p.a.
• Dietitians - 5 hrs plus an additional activity or
  an appropriate academic course
• Nurses - PREP system (since 1990) 5 days study
  in 3 yrs to re-register
• Physio - no specific requirements
• The Institute of Personnel and Development (IPD)
  suggest 35 hrs of recorded CPD p.a.

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Who is Responsible and How Much ?

• IPD places emphasis on individual responsibility
  for learning
• CPD for all staff in the NHS is the
  responsibility of the employer
• Learning Together (1999) recognises that
  investment varies widely between professions
• Fraser et al (2000) suggest that allocation of
  funding for CPD bears no relationship to the
  requirements of different professions

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Aims
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Aims

• To evaluate Continuing Professional
• Development (CPD) activity in National
• Health Service (NHS) Podiatry in Scotland,
• and make recommendations for the future
• post registration training and development
• of Podiatrists

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Objectives
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Objectives

• Identify the professional requirements for the
  post registration education and training of
  Podiatrists
• Identify what CPD is currently undertaken by NHS
  Podiatrists in Scotland
• To evaluate the type, level and appropriateness
  of CPD in NHS Podiatry in Scotland
• Develop guidelines for the future post
  registration training and development of
  Podiatrists in Scotland

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Methods
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Methods

• Local Management Support (FVPC)
• Support from PAM CRAG Clinical Effectiveness
  Project leaders
• Funding Trust Bursary and Learn Direct Scotland
• Ethics Letter from Multi-centre Research Ethics
  Committee, and successful application to ethics
  committee (QMUC)
• Questionnaire design / Pilot
• Distribution of questionnaire to Health Board
  area via CE representatives

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Results
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Results

• In total 760 questionnaire were delivered to NHS
  Podiatrists in Scotland
• 259 questionnaires were returned by 28th Feb 2002
  (33 return)
• Compared to other similar studies, this was
  deemed to be a reasonable return

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Qu. 1 - State Registration
Median 12 yrs
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Qu. 2 - Grade
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Qu. 3 - Age
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Qu. 4 - Sex
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Qu. 5 6 - Qualifications
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Qu. 7 - Other Qualifications
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Qu. 8a - Employment Status
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Qu. 8b - Health Boards

• It was agreed with the PAM CRAG Clinical
• Effectiveness Project Leaders, that
• information on specific Health Board Areas
• would not be disclosed in the final report.
• However this information is available on
• request.

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Qu. 9 - Specialist remit
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Qu. 10 - CPD days
N 238 Mean 2.16 Median 1.0 42.2 had 0
CPD Days
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Qu. 11 - PLP
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Qu. 12 - Adequate Training
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Qu. 13 - Podiatric Surgery
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Qualitative Comments

• 22.5 of respondents included comments in the box
  provided. These comments were divided into 4 key
  areas, based on their primary theme Resources
  (time/money), Podiatric Surgery, General Training
  and Personal comments to researcher

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Qu. 14 - CPD Activities
26.1 did not report any CPD activities in the
last 3 years
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Qu.14a-b - Title Duration

• CPD activities were grouped into like categories
• CPD activities were split into short courses (2
  weeks or less) and long courses (gt 1 month)
• 91.4 were short courses
• 8.6 were long courses

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Qu. 14c - Funding Short Courses
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Qu. 14c - Funding Long Courses
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Qu. 14d - Time Short Courses
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Qu. 14d - Time Long Courses
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Qu. 14e - Assessment

• In general short courses were attendance only
  (83.9)
• Longer courses involved examination (43.9) and
  course work (41.5)

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Qu. 14f - Accreditation

• Short courses were generally accredited by a
  professional body (49.3) or by employer (16.2)
• Longer courses had more involvement with the
  University sector (48.7)

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Qu. 14g - Relevance
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Qu. 14h - Multi-Disciplinary
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Conclusion Recommendations

• The training development of NHS Podiatrists, in
  Scotland, is a priority for all stakeholders
• Prepare for the introduction of mandatory CPD
• Additional resources will be required to fulfil
  the requirements of 30hrs CPD p.a.
• All Podiatrists should have a PLP
• Clinical networking, skill mix and a
  multi-disciplinary approach are pivotal

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Specialist Clinicians

• Visible career structure for Specialist
  Podiatrists
• Podiatric triage to cut waiting lists
• Work based professional qualifications/ exams
• Validation by appropriate professional body
• Rotation through Hospital departments and a
  pupilage for clinical specialists

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Service Re-organisations
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Podiatric Triage

• Direct open referral system
• Podiatric general assessment
• Appropriate access to medical records
• Limited prescription rights
• Immediate treatment if appropriate
• Referral for specialist assessment or community
  care
• Treatment from a foot care assistant

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Specialist Assessment

• Peripheral Vascular disease
• Diabetic foot disease
• Muscular skeletal service
• Podiatric Surgery
• Biomechanics
• Rheumatology
• Orthopaedics
• Podo-Paediatrics
• Sports Podiatry

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Quality Standards
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Podiatry needs Funky Business!!
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Develop Us!

• If you want to attract and retain the best people
  you have to train them
• What people look for in an employer is a
  continuous investment in their career
• With employee education growing far faster than
  academia, the workplace is becoming a campus
• Leadership is about contaminating and being
  contaminated with knowledge
• It is the job of leaders to create new leaders

Ridderstrale and Norstrom (2000)
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Continuing Professional Development
(CPD)National Podiatry Survey

• Keith G McCormick