Lifelong Learning: Planning and Evaluating An Introduction to CPD: and Mike Rouse, BPharm(Hons); MPS Assistant Executive Director, International & Professional Affairs Accreditation Council for Pharmacy Education (ACPE) American Association of Colleges of Pharmacy & Association of Faculties of Pharmacy of Canada Annual Meeting & Seminars Sheraton Chicago Hotel & Towers Chicago, Illinois Tuesday, July 22, 2008 8:00-9:30am A CPD Cycle Defining the Terms Continuing Professional Development: self-directed, ongoing, systematic and outcomes-focused approach to learning and professional development (adopted for state-based pilots 2006-2007) Continuing Education: a structured educational activity designed or intended to support the continuing development of pharmacists and/or pharmacy technicians to maintain and enhance their competence. Continuing education promotes problem-solving and critical thinking and is applicable to the practice of pharmacy (ACPE) 1
CPD Value Statement Pharmacists who adopt a CPD approach accept the responsibility to fully engage in and document their learning through reflecting on their practice, assessing and identifying professional learning needs and opportunities, developing and implementing a personal learning plan, and evaluating their learning outcomes with the goal of enhancing the knowledge, skills, attitudes and values required for their pharmacy practice. (adopted for state-based pilots 2006-2007) The Continuum of Education for Professionals The Continuum of Education for Professionals What competencies are required for pharmacy practice? Life Long Learning 4 6 Years ± 40 Years What teaching/learning methodologies are effective? What skills are needed for selfdirected, lifelong learning? 2
The Continuum of Education for Professionals Pervasive references in professional degree program standards Professional competencies and outcome expectations for students (development of skills for self-directed lifelong learning) From the earliest stages students to assume responsibility for their own learning CPD of faculty, staff, and preceptors Use of portfolios by students, faculty, and staff The Continuum of Education for Professionals Standards for continuing education focus on: identification by the learner of educational needs methodologies and strategies to enhance learning outcomes assessment of learning outcomes relevance to and application in practice (to improve patient and population outcomes) expanded roles for providers to support learners The Elements of CPD I consider my current and future practice, and self-assess my professional development needs and goals. I consider the outcomes and effectiveness of each learning activity and my overall plan, and what (if anything) I want or need to do next. I develop a Personal Learning Plan to achieve intended outcomes, based on what and how I want or need to learn. I implement my learning plan utilizing an appropriate range of learning activities and methods. In my CPD Portfolio I document important aspects of my continuing professional development; it is a valuable reference that supports my reflection and learning. 3
Develop an action plan to accomplish learning needs identified during reflection Develop individual learning objectives SMART objectives short-term and long-term objectives identify and set priorities Develop a proposed timeline Identify activities to help you meet your learning objectives Identify resources needed to accomplish your learning objectives Review at least annually Reflection on learning: outcomes and impact versus participation and satisfaction with educational activities Review of personal learning plan (at least annually): Evaluate progress toward achieving objectives Evaluate the educational activities to ensure adequate content and learning Evaluate outcomes and impact Evaluate appropriateness of overall plan and timeline Consider changes that have occurred professionally that may require adjustments in objectives and plan 4
Leads to, completing the continuum New plans are designed based on updated learning and development needs and goals Overview of Planning and Evaluating Terri Schindel, BSP, MCE, FCSHP Director of Outreach Education Faculty of Pharmacy and Pharmaceutical Sciences CPD Objectives Review and components of the CPD Cycle Identify learning resources available for self-directed learning (workshop activity) Identify ways to assist students, residents and faculty with CPD 5
Context In your role as an educator, you are approached by a pharmacist interested in changing practice to include anticoagulation management She tells you that she would like to: Learn more about venous thromboembolism (VTE) Adjust warfarin doses The pharmacist is employing a CPD approach for the first time Getting Started... SMART Objectives Specific Measurable Attainable Relevant Time-based 6
Plan Define Specifics Learn more about VTE Adjust warfarin doses Review the role of anticoagulation in the treatment of VTE by the end of August 2008 Gain experience adjusting warfarin doses based on INR monitoring in 20 patients by September 2008 Plan Define Specifics Learn more about VTE Adjust warfarin doses Review the role of anticoagulation in the treatment of VTE by the end of August 2008 Gain experience adjusting warfarin doses based on INR monitoring in 20 patients by September 2008 Is there enough detail? Plan Overall plan for learning Short term objectives Long term objectives Priorities Timeline 7
Plan - Learning Resources Materials/Programs Awareness Access Affordability Time Holland-Nimmo Practice Change System, ASHP 1998 Plan Learning Resources In this case, there are two scenarios: 1. A formal learning program is available to meet her needs. 2. There is no formal learning program available. Formal Program Introduction to Anticoagulation Experiential training with a mentor Workplace learning mentor support Workshop Training Practice 8
Plan - Learning Resources Materials/Programs Awareness Access Affordability Time Holland-Nimmo Practice Change System, ASHP 1998 Scenario #2 A learning program is NOT available. How will you advise the pharmacist to plan for learning? What learning resources are available? Workshop Activity Based on the pharmacists stated objectives, identify learning resources for this pharmacist. Work at your table, or in groups of 5 Appoint a recorder/presenter Allow 10 minutes for this exercise Each group will be invited to share 1-2 resources identified 9
Resources for SDL Literature Clinical visit or mini-sabbatical Peers Experts Mentor Coach Case studies/ storytelling Teams/ work groups Self-directed Learning Most adults conduct at least one selfdirected learning (SDL) project per year Typical learners engage in 5 projects annually An average of 100 hours is spent on each project SDL accounts for up to 90% of professional learning Evaluate 10
Evaluate Review the learning goal/objective you identified Did you meet the objective SMART components? Is it still relevant? Are their additional learning objectives arising from this experience? Review the learning activities you employed Was the learning activity/resource effective? What activity/resource offered the best learning for you? Review the impact of this learning on your practice (intended outcome of the learning) Reflect on what is yet needed to learn (and thus the cycle begins again.) Assist others with CPD To succeed. [a pharmacist] must develop strategies for lifelong learning: engaging in efficient methods of acquiring and assimilating new knowledge should become as intuitive as providing quality pharmaceutical care. Sheena R & Brown G, CJHP 2004: 57(5): 271-272 Summary Professional development integration of all components of the CPD Cycle Resources outside of accredited or formal programs are available and effective Assist students, residents and faculty with CPD 11
Summary of CPD Pilots Anna Legreid Dopp, Pharm.D. CPD Learning Objectives Describe the 5-State CPD Pilot Summarize key findings from 5-State CPD pilot Assist students, residents and faculty with CPD Continuing Professional Development Cycle I consider my current and future practice, and self-assess my professional development needs and goals. I consider the outcomes and effectiveness of each learning activity and my overall plan, and what (if anything) I want or need to do next. I develop a Personal Learning Plan to achieve intended outcomes, based on what and how I want or need to learn. I implement my learning plan utilizing an appropriate range of learning activities and methods. In my CPD Portfolio I document important aspects of my continuing professional development; it is a valuable reference that supports my reflection and learning. 12
Definition of CPD* Continuing Professional Development (CPD) is a self-directed, ongoing, systematic and outcomesfocused approach to learning and professional development. Null Hypothesis: Practitioners who adopt a CPD approach are not more likely to assess and identify their professional learning needs; develop and implement a personal learning plan; evaluate their learning outcomes; and document each of these elements when compared to those who utilize a traditional approach to continuing education. * As adopted for the State-based CPD Pilots, May 2006 Rationale for the CPD Pilot Primary Goal Develop and evaluate a CPD process that may be appropriate for pharmacists in the US Secondary Goal Obtain valid data about the effectiveness (or otherwise) of CPD as a learning model Measure differences in the learning habits and outcomes of pharmacists 13
CPD Survey Pre-survey completed by 251 pharmacists Post-survey completed by 91 pharmacists Five sections Identifying learning needs Planning learning Participation in learning activities and programs Evaluating the impact and determining the outcomes of learning Documentation of learning and professional practice Pre- and Post-Survey Results 14
CPD Challenges/Barriers for Pharmacists Documentation Cumbersome, Redundant, How To, Relevance Of Time constraints Work, Family, Making the Plan feasible and manageable Writing learning objectives Precise, Achievable Change Imbedded in mandatory CE vs voluntary Counting hours vs outcomes Who will pay added costs? Structured vs unstructured CPD a bit fuzzy and awkward to apply Benefits/Rewards for Pharmacists CPD process provides pharmacists with permission to seek out multiple educational opportunities Allows matching of learning opportunity & learning style Awareness of relationship between learning (ideal) and traditional CE Enables one to recognize learning moments Developing a professional learning plan Leads to self-discovery of personal/professional goals Networking to reflect and establish learning objectives Sense of accomplishment ACPE Standard 26 College or school must have or provide support for programs and activities for faculty and preceptor continuing professional development as educators, researchers, scholars, and practitioners commensurate with their responsibilities in the program 15
Tools for Assistance Effect of CPD on Professional Practice and Health Outcomes Zubin Austin BScPhm PhD University of Toronto CPD The Context Davis et al: Continuing education (in medicine) has no measurable effect on clinical practice or health care outcomes Parboosingh et al: Traditional continuing education does not result in sustained practice change Lonka: Inconclusive differences between CE and CPD systems with respect to uptake of educational programming 16
Experiences in Pharmacy Ontario, Canada: - Move away from traditional CE towards self-directed CPD model, including periodic competency testing since 1996 - Move to 2-part registration system - Learning portfolio with personal learning plan - Peer review system 10-year results from Ontario ~86% of pharmacists meet competency standards at first attempt, suggesting CPD is effective for maintenance of competency Identification of those at highest risk of not meeting competency standards, suggesting importance of systematic assessment of learning outcomes Development of remediation systems, including teaching pharmacists how to selfidentify learning needs 10-year results from Ontario Broader uptake of traditional CE Fundamental change in nature of CE delivery, to emphasize knowledge translation and skill development rather than passive knowledge transmission Expansion of workplace and in-service learning 17
Impact on Professional Practice For those who complete the peer review, opportunity to benchmark themselves against peers to determine their own level of competency The last time I saw someone do my job, I was in school and that was 25 years ago Identification of learning gaps When I graduated, pharmacists weren t even supposed to [counsel] patients things have changed! Confirmation of current practice It was a relief to know that I m doing things the way you re supposed to Impact on Health Care Outcomes Identification of individuals who have not maintained professional competency Implementation of remediation systems for those not meeting competency standards Conclusions CPD has been accepted by the pharmacy community Impact on professional practice appears positive Impact on health care outcomes is less clearly defined 18