2. Continuous Professional Development prepared by prepared by Dr.mohammed almansour Adopted from medical education departement KSU

3. Contents/Overview 1.Who is Professional? 2.What is Competence? Levels? 3.How to maintain competency? 4.What is Continuous Prof Devlop. (CPD) 5.Methods of keeping updated (CPD). 6.Reflective learning & Practice 7.Summary.

4. Assignment? 1.Who is a professional? 1.What is Continuous Professional Development (CPD) 1.Why Continuous Professional Development (CPD) in medical education? 2.How we can involve in CPD?

5. WHAT MEDICAL COLLEGES WANT? Proficiency Communication skills Interpersonal skills Confidence Critical thinking & problem solving skills Flexibility Self motivation Leadership Teamwork

6. Core competencies The national competence framework that has been developed by medical schools in the Kingdom of Saudi Arabia (SAUDI MEDS) Saudi Meds: A competence specification for Saudi medical graduates RANIA G. ZAINI, KHALID A. BIN ABDULRAHMAN, ABDULAZIZ A. AL-KHOTANI, ABDOL MONEM A. AL-HAYANI, IBRAHIM A. AL-ALWAN & SADDIG D. JASTANIAH Medical Teacher, 2011; 33: 582–584 6

7. Majmaa Core competencies The graduate should be: 1. scientific in their approach to practice 2. proficient in clinical care 3. professional 4. community conscious 5. a scholar. 7 Scientific approach Clinical care expertise Community orientation Scholarship Professionalism

8. Level of competence: Consultant Registrar Resident Intern Medical student

9. Novice Advanced beginner CompetentProficientExpert Medical studentResident Senior resident Consultant Levels of competence:

10. What is Competence?

11. Definition of competence: Competence can be defined as: “ the ability to perform a specific task in a manner that yields desirable outcomes”.

12. Different Aspect of Competence Competence is defined in the context of particulars: ▫Knowledge ▫Skills ▫Abilities Competence develops over time and is nurtured by reflection on experience

13. Professionalism Attitudes Skills Knowledge/ Cognition Does Shows how Knows how Knows Miller’s Triangle

14. Bloom’s Taxonomy Evaluation Synthesi s Analysis Application Comprehension Knowledge

15. Hierarchy of Knowledge Bloom’sTaxonomy, 1956 Knowledge - What is the most common cause of...? Understand - If you see this, what must you consider…? Application - In this patient, what is causing…? Analysis,synthesis,e valuation - critical thinking?

16.  Skills refers to “actions (and reactions) that an individual performs in a competent way in order to achieve a goal”  Skill is the capacity to perform specific actions: a person’s skill is a function of both knowledge and the particular strategies used to apply knowledge. Skills:

17. Abilities:  The power or capacity to do something or act physically, mentally, legally, morally, etc.  Abilities are the attributes that a person has inherited or acquired through previous experience and brings to a new task.  Abilities are gained or developed over time and, as a result, are more stable than knowledge and skills.

18. Technical Competencies: 1.Patient care 2.Medical knowledge 3.Practice base learning and improvement 4.Interpersonal and communication skills 5.Professionalism 6.Systems-based practice

19. Non-technical elements of competence: Six key areas: ▫Communicating Skills. ▫Principles and organization of the health care system. ▫Teamwork ▫Shared learning across professional boundaries ▫Clinical audit and reflective practice ▫Leadership

20. How is competence acquired: It is gained in the healthcare professions through: ▫ pre-service education ▫in-service training ▫work experience Continuous Professional Development (CPD).

21. Acquiring and maintaining professional competence involves collaboration: Regulators Institution Employer Individual

22. Personally motivated and strive to learn, develop, and continue to do so over a life long period ▫Active learning ▫Learning through mistakes ▫Reflective learning Individual:

23. Individuals: Learning through mistakes: It is crucial that errors in practice, or gaps in skill or knowledge, are acknowledged as early as possible Must be used as an opportunity for learning, rather than being suppressed or hidden out of fear of blame or sanction.

24. Contents/Overview 1.Who is Professional? 2.What is Competence? Levels? 3.How to maintain competency? 4.What is Continuous Prof Devp (CPD) 5.Methods of keeping updated (CPD). 6.Reflective learning & Practice 7.Summary.

25. Continuing Professional Development (CPD)

26. Competence is an ongoing process: ▫Initial development during undergraduate & postgraduate studies ▫Maintenance of knowledge and skills ▫Remediation and redevelopment ▫Acquiring new knowledge / skills

27. The conscious updating of professional knowledge and the improvement of professional competence throughout a person's working life. What is CPD?

28. It is a commitment to being professional, keeping up to date and continuously seeking to improve. It is the key to optimizing a person's career opportunities, both today and for the future. What is CPD?

29. Why CPD? Requirement by the governing bodies of the profession This is only a superficial reason

30. Why CPD? Half-life of what we learn is very short If we do not update, we will practice obsolete medicine So, there is a high chance that patients will not get optimal care

31. How is CPD different? CPD is for professionals not in a formal educational setting Therefore, the learner needs to learn from whatever he/she does in the workplace There are no class rooms, prescribed curricula, prescribed learning events, etc. Also, there are no formal examinations So, motivation to learning comes from the necessity to improve practice.

32. How can we achieve CPD?.

33. Strategies for  Formal:  Lecture programs  Conferences  Workshops  CME courses  etc  Informal:

34. How can we achieve CPD? Many methods have been tried in the past Currently, reflective practice/learning is the most favoured

35. What is Reflective learning

36. Reflection Reflection relates to a complex and deliberate process of thinking about and interpreting experience, in order to learn from it. Reflection : stages  An awareness of uncomfortable feeling  Examination of situation  Exploration of alternative actions  Reflective thoughts results in action

37. Reflection Focusing on strengths & ‘weaknesses’ in one’s performance Focusing on identifying actions to undertake – learning requirements Goal to improve performance

38. What is reflection? Systematic revisiting of a learning experience with a view to learning from it Why reflection? Key to become a lifelong learner – if not most learning opportunities are lost Most of revalidation of medical practitioners is built around reflection

39. Kolb’s cycle Concrete experience Reflective observation Abstract conceptualisation Active experimentation Reflection - cyclical process - many ways

40. Reflective log: a simplified version 1. What is the learning event? 2. What did I learn? 3. What more do I have to learn? 4. How can I learn it? 5. Evidence for further learning / change of practice?

41. Concrete experience Reflective observation Abstract conceptualisation Active experimentation Reflection What is the event? What did I learn? How can I learn? Evidence for learning / change of practice What more do I have to learn?

42. A scenario: A 55 year old man came to clinic with complain of low back pain (LBP). You have examined his back which was ok. His height was 160 cm, and weight is 100 kg. You would like to manage this patient’s LBP contributed due to his excess body weight.

43. Example (LBP) 1. Learning experience – This obese person who needed to reduce weight. 2. What did I learn? Learned how the patient’s activities have been affected by obesity. 3. What do I have to learn more? Did not know the advice that should be given to the patient with a given BMI. Are there guidelines for interpreting BMI? 4. How do I learn it? Refer a book/article. Talk to the dietician. 5. Evidence / change of practice – BMI was accurately interpreted. Patient was advised about the dietary/lifestyle changes and referred to an obesity clinic. References of books referred.

44. Concrete experience Reflective observation Abstract conceptualisation Active experimentation Evidence for learning / change of practice What did I learn? What more do I have to learn? How can I learn? Cycle 1 Cycle 2 Reflective practice What is the event?

45. Cycle 1 Cycle 2 Cycle 3 Reflective practice: reflective spiral

46. Reflective practice 1. Reflection-on action 2. Reflection-in action

47. Assessing reflective ability 1. What is the learning event? 2. What did I learn? 3. What more do I have to learn? 4. How do I learn it? 5. Evidence for further learning / change of practice? 1.Descriptive 2.Analytical 3.Evaluative

48. Schon (1983) The Effective reflective practitioner is able to recognise and explore confusing or unique (positive or negative) events that occur during practice The Ineffective practitioner is confined to repetitive and routine practice, neglecting opportunities to think about what he/she is doing

49. Summary: Levels of competence It is acquired through ▫pre-service education ▫in-service training ▫work experience ▫Contentious Professional Development ** Reflection & Reflective Practice

50. عن عائشة رضي الله عنها أن رسول اله صلى الله عليه وسلم قال : ” إن الله يحب إذا عمل أحدكم عملا أن يتقنه “ رواه الطبراني

51. Referrences Dr.hamza abdulghani presentation

52. assignment At least 1000 word write up: “One of your friends who is smoker and studies in engineering college.he would like to quite smoking, and needs your help as he heard that there are some medications which may help him in quitting smoking” Apply kolb’s cycle(all steps),To learn about this scenario and how you can help your friend.(demonstrate your understanding of reflective learning in CPD)