career - CPD assessment
by Ursula Arens Freelance dietitian
Learning about CPD
A few months ago, about 170 dietitians were in a mild panic; they were amongst the first to have been randomly selected from the total list of about 7,000 dietitian registrants, required to submit their continuing professional develop- ment (CPD) portfolios to the Health Professions Council (HPC) assess- ment panel. Bleak futures threat- ened those whose reflective ram- blings were deemed inadequate; appeals could be made against assessment decisions, but the ulti- mate sanction could be removal from the professional register. As someone who has only just found out that reflective writing did not mean holding a laptop against a mirror, I thought, what better way to demonstrate CPD, than to write a feature on it? Does feature writing count as reflective practice? What, in a nutshell, do the HPC want when they assess CPD? They want evidence and a description of the meeting of five standards that, overall, promote reflective profes- sional practice and a commitment to lifelong learning. The HPC con- cede that, for some of the profes- sions, the requirement to write in a reflective way about CPD activities was not well received, but regard- less, the HPC believe that over time the professions will be persuaded of the benefits of the reflective nature of the CPD standards that have been defined. The aims of the standards are to promote reflec- tive practice and to foster greater emphasis on the outcomes of CPD activity rather than just a demon- stration of hours-collection schemes. Of the 14 professions that the
HPC regulate, dietitians have come last into the audit requirement, so in many ways we have the benefits of being able to observe how things have gone for the forerunner pro- fessions. The first HPC CPD annual report was published in March 2010 and provides outcomes and discus- sion of the audits of the first four professions to be audited in 2008-9: chiropodists/podiatrists, operating
NHDmag.com Aug/Sept '10 - issue 57
department practitioners, orthop- tists and paramedics.
Conclusions of the first report In my view, the outcomes of the first audit cycle are astonishing. I am further concerned that the conclu- sions of the report do not ‘reflect’ the obvious issues that arise from the data. There has been one immedi- ate change as an outcome of the first audit procedures: because some of the profiles submitted were strik- ingly similar and investigations estab- lished that they had been produced on the individuals’ behalf by a third party, an amended wording was approved for standard 5. The previ- ous version was, ‘present a written profile containing evidence of their CPD upon request.’ The amended wording is now: ‘upon request, pres- ent a written profile (which must be their own work and supported by evidence) explaining how they have met the standards of CPD.’ The first cycle has also confirmed the HPC’s decision to reduce the audit size from 5.0% of registrants to 2.5%. Of the 650 chiropodists/podia- trists selected for audit, nearly 80 percent had their profiles accept- ed. Although none were removed from the register, about one in six of those selected for audit chose not to continue registration, against a reference of about one in 13 typically expected not re-register every cycle. Of 650 chiropodists/ podiatrists captured by audit snap- shot, not one single individual was ‘assessed’ as unable to reach the defined five standards of the CPD hurdle, but 103 professionals, an ex- cess of about 50 from the expected number, were lost to the services of foot health. Perhaps this ‘self- selection’ of lapsers has perfectly identified incompetent and inca- pable colleagues who should not be let near a corn or a bunion. This is far from proven by the HPC’s as- sessment, and another view could be that perhaps it represents a very unfortunate outcome of audits, resulting in an unnecessary loss to a profession, of experienced and
capable colleagues. The nonchalant view expressed, that the twice-the-level expected of non re-registration indicates that this may have been influenced by selection for CPD audit, indicates little concern for further analysis of this leakage from the profession of foot healers, other than a comment that a larger number of lapsers were over the age of 50. The conclusion is not so simple, as the largest numbers of those selected for audit were in the age range 50-60 years, and the largest single age band of lapsers were 40-44 year-olds.
The due-to-audit lapser rates
were lower in the other professions assessed and lowest in the para- medics, where 3.4% did not re-reg- ister compared to expected levels of 2.7% - however numbers involved are too small to draw conclusions. So, of all the four professions audited, coming to a total of 1,528 registrants, how many complied with the procedures to submit a portfolio, which was then assessed as inadequate? The answer is astonishing: zero. Not one single submitted portfolio has been given an F-for-Fail. A few registrants have failed to meet the CPD standards, but in all cases, this is because they failed to submit a profile, not because what was submitted was considered insufficient to demon- strate professional reflection and learning. Can 1,500+ health profes- sionals really all be learning whiz kids, or could the whole CPD proce- dure not really be capturing what it was set up to? The very glib and non-reflective audit summary states that this ‘indicates that the guid- ance and communication provided by us [HPC] is enabling registrants to complete their CPD profiles in a way that demonstrates that they meet the CPD standards.’ This self- congratulatory pat-on-the-back is undeserved, and a more critical analysis is really needed to address the leakage of perhaps competent professionals and the contrast of the astonishing ‘100 percent pass rate’ of those who submit profiles.
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Ursula has spent most of her career in industry as a company nutritionist for a food retailer and a pharmaceutical company. She was also a nutrition scientist at the British Nutrition Foundation for seven years. Ursula guides the NHD features agenda as well as contributing her regular column, ‘Lookout’.
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