Continuing Professional Development

Jill ILIFFEExecutive Secretary

Commonwealth Nurses Federation

_______________________________________What is CPD?

There are MANY different names for thesame thing

CPD: Continuing professional developmentCNE: Continuing nursing educationCPE: Continuing professional educationCME: Continuing medical educationCE: Continuing educationLLL: Life long learningISE: In-service educationSD: Staff development

_______________________________________Why have a CPD requirement?

One of the shared ethical mandates for health professionalsis a commitment to competence. Becoming competent andmaintaining competence requires ongoing, lifelong learningas new knowledge, understanding and experience requirenew ways of doing things.

The credibility of a profession is based on the willingnessof each professional to embrace new skills, knowledgeand experience. Life long learning is a hallmark of committedand competent health professionals. Ongoing learning, bothformal and informal, is required to maintain clinicalcompetence and acquire new knowledge and skill.

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Who is responsible?

employers (public or private) regulatory bodies professional associations governments individuals

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Who is to be covered by yourCPD program?

Whoever the regulatory council hasResponsibility for

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How is CPD to be linked to licensure?

What is Registration: what is Licensure

There are different meanings for the samething

Your name is entered on the register when youcomplete your initial qualification as a nurse ormidwife and you are issued with a license topractice.

_______________________________________How is CPD to be linked to licensure?

Life long registration and no requirement forrenewal of your license to practice.

Initial registration and renewal of your license topractice annually (or each 3 years or 5 years) withor without a requirement for mandatory orvoluntary CPD.

Some countries also have practice requirements – somany hours of practice over a set period (2-5 years) orrequire ‘recency of practice’, that is, you have practicedin 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, andinclusive.

8. CPD should be relevant, current, available, accessibleand affordable.

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What should go in your Act

Make it as broad as possible giving theregulatory authority the power to adaptthe CPD requirements from time to timewithout having to change legislation.

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Vision or Mission Statement

You might want to insert a vision or mission statementat 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.

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Introduction

Establish the mandate of the regulatory council torequire involvement in CPD activities.

The knowledge needed to function effectively as a healthprofessional continues to expand and change while consumerdemand and expectations continue to increase. Registeredhealth practitioners have a professional obligation tomaintain their competence and to aim for continuousimprovement in the standard of service they provide.

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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 professionalknowledge and the improvement of professional competencethroughout a person’s working life. It is a commitment tobeing professional, keeping up to date and continuouslyseeking to improve.

CPD is the purposeful maintenance and improvement of aprofessional’s knowledge and skills to remain competentin their chosen profession for the benefit of themselves, theirpatients or clients and the wider profession.

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Purpose or Rationale

Explain why? Many individuals will already be involvedin CPD. Why now?

Make your arguments as to why the regulatory councilis imposing a CPD requirement.

_______________________________________What are the principles of CPD?

CPD is a continuous process and actively seeks to improveskills, knowledge and performance.

Learning needs should be defined and agreed incollaboration with line manager but owned and managed bythe individual learner.

CPD should be based on a rigorous and continuous analysisof professional learning needs.

CPD activities should be planned in advance through apersonal development plan, and should reflect and berelevant to current and future professional practice andperformance.

_______________________________________What are the principles of CPD?

CPD acknowledges varying learning styles and includes a widerange of formal and informal learning activities.

The key principles of CPD are that it is self-directed; that itis based on learning needs identified by the individual; builds onan individual’s existing knowledge and experience; links anindividual’s learning to their practice; and includes an evaluationof the individual’s development.

CPD requires professionals to identify their learning needs basedon an evaluation of their practice against recognisedprofessional standards; develop a learning plan based on theneeds identified; participate in CPD activities which meet theselearning needs; and reflect on the value of these activities totheir practice.

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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 professionalassociations all have a responsibility to ensure servicesProvided are safe and protect the public. They have todemonstrate accountability.

Individuals have an ethical responsibility to their patientsand clients, their professions, and themselves to practicecompetently and safely. CPD should be an integral part oftheir professional life whether voluntary or mandatory.

Difficult to apply sanctions for non-compliance withoutlegislative support.

_______________________________________How much is enough?

There should be a minimum requirement, but there isno maximum.

Requirements for health professionals vary globallyfrom the equivalent of 20 hours annually to 50 hoursannually 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).

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CPD points or CPD hours?

Awarding CPD points for learning activities requiresthe development of a formal process which involvespersonnel, time and cost.

Specifying a minimum number of hours of CPD activityis a satisfactory first step. In some programs, one hourof active learning = one CPD point. In other programs,different types of CPD activities have different valueseg one hour of formal learning might attract 3 pointswhereas one hour of informal learning might onlyattract one point.

REQUIREMENT

Nurses, midwives and nursing assistants recognised by theLesotho Nursing Council will be expected to obtain aminimum of 12 CPD points each year prior to renewingtheir practising license. CPD points will only be allocated oncompletion of the CPD activity. The CPD points will beallocated according to the CPD table. One hour of activelearning will attract 1, 2 or 3 CPD points depending on theactivity. A record in the log book, available from the LNC, ofthe CPD undertaken must be kept by the nurse, midwife ornursing assistant which is verified by the provider of theCPD. CPD activities will include both formal and informallearning.

REQUIREMENT

Nurses registered with Swaziland Nursing Council will beexpected to undertake at least 10 hours of continuingprofessional development each year prior to renewing theirpractising license. One hour of active learning will equal onepoint of CPD so each nurse will be required to accrue 10 CPDpoints each year. CPD points will only be allocated oncompletion of the CPD activity. A record must be kept by thenurse of the CPD undertaken which is verified by the providerof the CPD. CPD activities will include both formal and informallearning.

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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; conductingresearch; developing policies, protocols or guidelines; acting as amentor or preceptor; participating in committees eg quality improvement,

occupational health and safety)

self-directed (reading professional journals and books; keeping aself reflection journal; publishing articles)

CPD TABLE - Registered Nurses and Midwives1 hour = 1 point 1 hour = 2 points 1 hour = 3 points

Reading professional journals andbooks (SD)

Acting as a mentor or preceptor ifnot part of job description (EX)

Formal education programmesleading to a qualification (FL)

Keeping a self-reflection journal(SD)

Attending short courses distanceor online with a minimum of 3hours of active learning each week(SDO)

Attending short courses 3-6 monthsduration face to face with aminimum of 15 hours of activelearning each week (SF)

Attending conferences, seminars,workshops or in-service education(SWI)

Presenting at conferences,seminars, workshops or in-serviceeducation (SWI)

Writing articles for publication injournals or books (SD)

Active membership of professionalbody and its committees (SD)

Participating in committees egquality improvement,occupational health and safety(EX)

Developing policies, protocols orguidelines (EX)

Working with a mentor to improvepractice (EX)

Lecturing, teaching or doingassessments if not part of the jobdescription (EX)

Conducting research as principalinvestigator (EX)

Participating in case studies,clinical audits, clinical meetings,focus groups or peer review (EX)

Planning or running a seminar orworkshop or in-service (SWI)

Planning or running a short courseface to face, distance or online 3-6months duration (SF or SDO)

FL = Formal learning SF = Short course face to face SDO = Short course distance and onlineSWI = 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 professionalreading or discussion group orjournal club (SD)

Supervised practice for skillsdevelopment (EX)

Project management if not part ofjob description (EX)

Observation at disciplinaryhearings (EX)

Skills development in IT,numeracy, communications,problem solving and working withothers (SD)

Voluntary work relevant topractice (SD)

Investigating disciplinary cases ifnot part of job description (EX)

Project work if not part of jobdescription (EX)

Participating in research as a teammember (EX)

Supervising staff or students if notpart of job description (EX)

Reviewing educational materials,journal articles, books (SD)

FL = Formal learning SF = Short course face to face SDO = Short course distance and onlineSWI = Seminars, workshops, in-service EX = Experiential learning SD = Self-directed learning

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Documentation

What evidence should each nurse and midwifeprovide?

In what form? Log book, diary, professionalportfolio

_______________________________________Accredit or not?

It would be difficult to accredit all CPD activity asCPD activities should embrace both formal and informal(self-directed and experiential) learning.

Accepting only accredited CPD activities diminishes thevalue of self-directed (reading journals, presenting atconferences, publishing articles) and experientiallearning that takes place in the workplace (supervisedclinical learning).

Both accredited and non-accredited CPD activitiesshould be encouraged and valued.

_______________________________________Accredit or not?

Accreditation of CPD content requires the developmentof a formal process, establishing accreditation criteriaand ongoing evaluation of applications which involvespersonnel, time and cost.

Likewise, the accreditation of providers of CDP learningactivities requires the development of a similar formalprocess.

Is it the responsibility of a regulatory body to accreditCPD activities or encourage the development of anexternal body to undertake this function?

ACCREDITATION: FORMAL LEARNING

Nurses undertaking formal undergraduate orpostgraduate education (FL) at a school of nursing,college or university (either face to face, distance oronline) leading to the award of a certificate, diploma,advanced diploma, degree, post graduate certificate, postgraduate diploma, masters or PhD, may claim CPD pointsin each year they are undertaking the course.

Documentary evidence should be provided in the form ofa transcript of subjects undertaken and successfullycompleted or any other relevant documentation whichverifies the number of hours of active learning, includingclinical learning.

ACCREDITATION: SHORT COURSE CONTENT

A short course face to face (SF) is one with a duration of between 3-6 months with aminimum of fifteen hours of active learning in each week and may consist of theoryand clinical components.

A short course distance or online (SDO) is one with a minimum of three hours of activelearning 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 theirname, designation, contact details and signature.

ACCREDITATION: SEMINARS, WORKSHOPS AND IN-SERVICE

To claim CPD points for seminars, workshops and in-service education (SWI), theactivity 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 theirname, designation, contact details and signature.

ACCREDITATION: EXPERIENTIAL LEARNING

Experiential learning (EX) is learning that occurs by activeparticipation in a practical activity either in or outside theworkplace 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 providedin 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 bytheir supplying name, designation, contact details and signature.

ACCREDITATION: SELF-DIRECTED LEARNINGSelf-directed learning (SD) is when the individual takes initiative to participate in anactive learning activity which is not part of the usual job description. Self-directedlearning 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 articleyou have just read and what you learned from it). Such verification must includetheir name, designation, contact details and signature.

Self directed learning which cannot be verified by an external person must notcomprise more than 25% of the minimum required CPD points each year.

QUALITY STANDARDS FOR CPD PROVIDERS ANDFACILITATORS

Providers and facilitators of CPD in Lesotho (short course face to face; short coursedistance or online; seminars, workshops or in-service) are required to meet thefollowing quality standards:

• Be familiar with and adhere to the Lesotho CPD framework.

• Ensure CPD is provided by teachers who use effective teaching and learningstrategies matched to content and the level and type of learners.

• Use valid and reliable assessment methods that provide feedback on whetherthe learning objectives have been met.

• Document and retain information about program design and content; numberof contact hours; names and contact details of participants; and evaluationoutcomes. Secure storage must be provided for this documentation.

• Understand the need to minimise any conflicts of interest related to commercialsupporters and willingly disclose any conflicts of interest to participants at thebeginning of the CPD activity.

ACCREDITATION - FORMAL LEARNING

Nurses undertaking formal undergraduate or postgraduate education at anaccredited institution of learning, school of nursing or university (either face toface, 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 thecourse providing:

• they have undertaken at least ten hours of active learning during the yearthat CPD points are being claimed,

• they have successfully completed course requirements for the year in whichCPD points are being claimed, and

• the course is directly relevant to the nurses’ current or future professionalpractice.

Nurses claiming CPD points for formal learning must be able to provide anacademic transcript of subjects undertaken during the year in which CPDpoints are being claimed as well as their assessment results or academiccertificate at the conclusion of their course.

ACCREDITATION - EXPERIENTIAL AND SELF DIRECTED LEARNING

For accreditation of experiential or self-directed learning and recognition by theSwaziland Nursing Council for allocation of CPD points, certain standards andcriteria must be met. Experiential and self-directed learning is that which occurseither in the workplace or similar environment or learning undertaken by thenurse 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 andother 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 orbooks

• 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 learningmust consist of at least one hour of active learning. Nursesclaiming CPD points for experiential or self-directed learningmust 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, in-

service coordinator or CPD provider including name,designation and signature.

ACCREDITATION - SHORT COURSE CONTENT

For approval and recognition from the Swaziland Nursing Council as quality CPDand allocation of CPD points, certain standards and criteria must be met. For creditpoints to be granted, all short courses must consist of at least one hour of activelearning. One hour of active learning equals one CPD point. An application from aCPD provider should meet the following requirements:

• A written statement which includes the course description, purpose or reasonfor offering the CPD, learning objectives, content area(s) and relevance topractice, target group of professionals, type of activities planned and expectedoutcomes.

• Content is related to and consistent with objectives and each objective has acorresponding content and expected outcome.

• Time allocated for content is consistent with objectives and appropriate forcontent to be presented.

• Teaching strategies are congruent with the objectives and content to bepresented.

• Principles of adult learning are evident in the selected strategies.

• Presenters of the CPD have knowledge and expertise in thecontent area and take an active part in planning theirpresentations and shall provide evidence of academicpreparation and/or experience in the content area.

• The evaluation tool used by the CPD provider is based onthe learning objectives and the overall purpose of theeducational activity.

• The CPD provider uses evaluation results to plan futureofferings and for quality improvement planning.

• The CPD provider clearly indicates in the application formthe number of hours in the course of active learning.

• Written confirmation of attendance must be provided toparticipants who successfully complete an educationalactivity with verification of attendance recorded in their logbook. Such verification must include the name of the CPDprovider; date of activity; and signature. A certificate ofattendance may also be issued.

• The provider has an established and maintainedrecord storage system that assures confidentiality,and easy retrieval by authorised personnel.

• The provider maintains a record of CPD pointsearned by the participants.

The Swaziland Nursing Council will determine thefees it will charge from time to time for processingapplications for approval and recognition of shortcourses for CPD points. Application fees are to bepaid by the CPD provider at the time of applicationfor accreditation of a CPD activity or program.

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Monitoring compliance?

Each nurse or midwife monitored or a meaningfulrandom sample?

What evidence should each nurse and midwifeprovide?

Establishing penalties for non compliance and anappeals process and criteria plus criteria forexemptions and deferment.

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Monitoring compliance?

CPD requirements must be:

reasonable, achievable, fair, accessible to all (includes cost considerations), transparent, flexible, and inclusive (avoid monopoly).

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Monitoring compliance?

CPD offerings must be:

relevant, current, available, accessible, and affordable.

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How are you going to evaluate yourprogram?

Collecting statistics (what CPD was accessed) Evaluating the process (did it work) Measuring outcomes (how many individuals were

compliant)

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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

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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, andinclusive.

8. CPD should be relevant, current, available, accessibleand affordable.

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