Continuing Professional Development for Public Health Doctors Guidance on Validation and Documentation of Credits Prepared by the Faculty of Public Health Medicine February 2014
Introduction Since May 2011, every doctor registered with the Medical Council has to engage with a professional competence scheme. Each year the Medical Council audits 5% of all registered doctors to ensure that they are engaging with professional competence. They request a Statement of Participation from their member (which is issued annually by the relevant Training Body). In addition, each Training Body is expected to audit 5% of doctors registered with their professional competence scheme. The Faculty of Public Health Medicine (FPHM) manages two schemes Specialist and General Division and has responsibility to provide support to each registered doctor in the maintenance of their professional competence. Purpose of Document The purpose of this document is to outline what external and internal credits are acceptable, how they can be achieved and in particular how to ensure that the relevant/appropriate evidence is submitted in your e-portfolio. Role of Faculty of Public Health Medicine in Maintaining Professional Competence The Faculty of Public Health Medicine Professional Competence Scheme promotes selfdirected and practice-based learning activities. As well as promoting personal professional development, the Scheme aims to promote educational and professional activities directed towards developing the knowledge, skills, attitudes and personal effectiveness necessary to meet the changing needs of patients and the healthcare delivery system. It also encourages participants to plan, record and reflect on professional development needs, as part of their pursuit for lifelong learning. The FPHM engages with external bodies of knowledge to guide and develop education courses and professional development events. There is extensive collaboration between other post-graduate training bodies, such as Irish College of General Practitioners (ICGP), College Of Anaesthesia (COA), Royal College of Surgeons of Ireland (RCSI) and academic institutions in the development of some education programmes. Professional Competence Scheme The Scheme consists of two elements: Continuing Professional Development (CPD) 2
Public Health Audit PCS participants are required to meet the following requirements which are a common framework for all approved Professional Competence Schemes: Framework for Professional Competence Category Skill Number of Credits Category 1 Category 2 External (Maintenance of Knowledge and Skills Internal (Practice Evaluation and Development 20 credits per year (minimum) 100 credits per 5 year cycle (minimum) 20 credits per year (minimum) 100 credits per 5 year cycle (minimum) Category 3 Personal Learning 5 credits per year (minimum) 25 credits per 5 year cycle (minimum) Category 4 Research and Teaching 2 credits per year (desirable) 10 credits per 5 year cycle (desirable) External Credits The RCPI Education Committee oversees the process and procedure for accreditation of educational events and the FPHM, as a constituent Training Body of RCPI, is fully participant in this process. Educational events organised specifically for the purposes of CPD are eligible for CPD approval under Category 1 External, for example an academic or scientific meeting organised by a medical society. The FPHM outlines the following as acceptable to gain external credits: Category Example Activities Credits External (Maintenance of Knowledge and Skills) Events/activities accredited by Training Bodies that meet educational standards (in person or virtually) National/International meetings Scientific, RAMI and CPD meetings College/Society meetings Courses accredited by Training Body Medically related advanced degrees* Online Courses** 20 credits minimum per year 100 credits minimum per cycle 3
*Medically related advanced degrees Masters, PhD programmes sponsored by University, College, Institute or accredited Training Body. The number of credits is to be agreed in advance. ** Online Courses Courses will only qualify for accreditation by the Training Body in the External category if the following criteria are fulfilled: - Course provides for some type of learner interaction or self-assessment - Course objectives describe what the participants may learn or achieve by participating in the course - Provide access to appropriate bibliographic sources that allow for further study; and that reinforce and clarify specific activity topics - Practitioner produces evidence of activity and/or completion e.g a certificate of completion of a module The following are also examples of activities that merit External credits: RCPI CPD Training Events A number of CPD training days are organised each year by the Faculty to ensure adequate and appropriate Continuing Professional Development training is available to doctors. Some of the areas covered in the provision of training include: Public health emergencies Emergency planning Water Environmental issues Training in Public Health Audit RCPI Masterclasses Masterclasses are targeted at general physicians at the Consultant and Registrar level and are aimed at educating those at the front line of our health service to continuously improve their skill base, effectively facilitating excellence in patient care. Masterclasses are designed for keeping doctors up to date in evolving medical practice outside their specialty area and to facilitate their continuing medical education. Masterclasses highlight recent advances in management of common medical conditions that frequently require hospital admission as well as discussing early intervention that may prevent hospital admission or facilitate appropriate discharge. These are webcast to 29 centres across Ireland. Public Health physicians have access to these classes, both as participants and observers. 4
RCPI Hot Topics Where Hot Topics are identified around the prevalence or management of diseases relevant to public health medicine, training and education around this is delivered over a half/full day. The programme covers the range of problems related to the selected topic and includes current and new developments addressing these issues. Hot Topics are designed to discuss areas of controversy and to facilitate lively and interactive debates. Med-Law The Med-Law Series facilitates the exchange of information and ideas between the medical and legal professions and informs them of the current medico-legal trends in Irish Health care. The series covers topics such as negligence, consent, risk management and malpractice litigation and the Coroner s court. The series also include advice on how to prepare for legal hearings and how to write expert medicolegal reports. Verification of External Credits As a general rule, all external events should be approved by the College. In order to get CPD approval for an event, the Provider must meet the quality criteria set out below: 1. The event should be predominantly aimed at post-training physicians 2. Providers should list all of the sponsors that are involved with the meeting 3. Providers should list any commercial interests that the presenters or speakers have 4. The learning objectives should reflect measurable outcomes, and use action verbs such as evaluate, identify, or review etc. 5. Providers should include details about what the event hopes to achieve, and how this will be put in practice. 6. Providers should include a detailed programme of the event. This should include an hourly breakdown and a brief description of the session. 7. Providers should include a full list of speakers/facilitators. This must include details about the posts they hold, where they are based and what speaking experience they have in relation to the topic discussed. The Honorary Secretary of the RCPI Education Committee assesses each application for accreditation and confirms whether it is suitable for Accreditation. Assigning External Credits not Organised through the College External credits can be accrued by attendance at an educational activity that meets the criteria for External CPD, regardless of the organiser. The College operates a central CPD 5
approval/ logging system on behalf of the six RCPI Training Bodies, and any body or institution who organises an event where the primary audience will be post-training physicians can apply to have their event or educational activity assessed for CPD approval. Some nonmedical activities can also be assessed and approved, for example risk management. A scientific meeting which is held in another country and has credits assigned in that country will automatically be accepted here. The doctor attending the meeting should make sure to obtain evidence of attendance at that meeting from the organiser. The evidence does not have to state the number of credits, but it should state the name of the attendee, and the date, title and venue. The credits assigned on the evidence document are often those assigned to the overall event, and not the individual. Professional Competence expects that a doctor would only claim for the actual time they have spent at the event. If it happens that the doctor can only attend for part of the meeting, they can work out the credit they should claim using the 1 hour = 1 credit formula. If an international meeting is organised by the UK FPHM, they do not routinely assign credits Five Nations Conference) but allow the individual to decide how many credits they have earned. The RCPI will always approve such events but must get notice of the details of the event in order to complete the CPD log. The RCPI is required to retain supporting documentation which supports the approval of credits. Therefore, the Irish organiser should submit the most complete version of the programme to allow credits to be allocated correctly. It is important that all CPD events delivered by the FPHM are logged as this must be reported on behalf of the Faculty in the annual Medical Council Qualitative and Quantitative Reports. If it happens that an application is submitted too late to get it logged and signed off by the College before the event takes place, then a register of attendance on the day should be kept so that there is a record of those who should receive certificates. It is somewhat similar to attending an international event and maintaining your own records and justification for attendance. If there is no process for assigning credits but the attendee feels the meeting/event merits external credits, they should claim using the 1 hour = 1 credit formula. They should make a note of how they have justified it to themselves in the Key Learning and Impact sections of the eportfolio form. There is no need to attach the programme, although it is useful information and should be maintained in their own files. If the notes are clear, the claim should make sense to a reviewer. If a meeting is organised by a body such as ICGP, credits assigned by that body are acceptable. This has been agreed between all participants in the Forum of Postgraduate Medical Training Bodies. A standard sentence should appear on all attendance certificates issued This CPD Recognition is accepted by all Irish Postgraduate Training Bodies. 6
Guidance on Maximum Number of Credits In 2013, the Forum developed new guidance on the maximum number of credits that can be allocated International educational research suggests that it is difficult to retain information from didactic presentations beyond 6 hours a day for this kind of educational programme. If the educational content is varied, for example, includes workshops or skills training, credits can be extended to 8 credits per day to incorporate these aspects of professional development. Internal Credits Educational activities organised within the workplace qualify for internal credits. Public Health Department/ hospital departments/ units etc are expected to hold regular in-house CPD activities. These activities are considered internal events for the purposes of recording Professional Competence. It is accepted that one hour s educational activity = 1 CPD credit. You can claim CPD credit for these and other educational activities that are departmentbased, hospital-based or practice-based. The FPHM outlines the following as acceptable activities to merit credits.. Category Example Activities Credits Internal (Practice Evaluation & Development) Activities that develop and improve the quality of public health practice In-house regular meetings must have an educational/professional development component Study Days Journal clubs Guideline development and evaluation Training Courses Quality of practice including clinical risk meetings Case presentations Outbreak/incident review meetings Grand rounds Multi-disciplinary meetings Peer Review groups Journal Appraisal Club meetings 20 credits minimum per year 100 credits minimum per cycle Other examples include: Small group meetings involving doctors from more than one hospital Peer review group especially for doctors working alone or retired doctors 7
Multi-disciplinary meetings/regional liaison meetings must have educational component. It is not necessary for an institution to seek CPD approval from the postgraduate training body for these types of educational events. However, under the requirements of the Professional Competence Schemes doctors must provide evidence of having attended these activities if audited. Therefore, it is suggested that the educational component of the meeting is explicit. The FPHM also advise that participation on Committees is eligible for Internal CPD credits to a maximum of 5 CPD credits per year and that attendees need proof of attendance. 1 hour of educational activity = 1 CPD credit. Note, that this can alternatively be logged under Personal Learning. Verification of Internal Credits The Annual Verification Audit process within the Professional Competence department of the RCPI undertakes an audit of 5% of participants each year and requests evidence of recorded credits. It is important that appropriate evidence is submitted to the e-portfolio. Further evidence may be sought at the time of the audit. In order to ensure that appropriate evidence is submitted, it is recommended that the organisers within the hospital/institution arrange the following: 1. Attendance at internal events recorded electronically OR 2. A register of attendance (Appendix 1). This can be a sign in sheet or sign in book clearly showing that it is being held to record CPD activities on behalf of the participating doctors. The register for each meeting should be held for a period of five years and should be easily available for checking. All attendance sheets should be centrally stored and readily available if requested as part of verification audit. An individual Statement of Attendance at internal events is issued quarterly or on request by the hospital/institution to each participating doctor. One certificate may be issued for recurring events with the number of credits clearly outlined. The Statement of Attendance should be signed by Manager or Senior Administrator as agreed internally (Appendix 2). It is not appropriate to photocopy/photograph Attendance Registers containing signatures of other attendees to use as evidence of participation for the purposes of Professional Competence It is recommended that the responsibility is assigned to somebody within the department /institution to retain the attendance registers in a central repository and to issue Statements of Attendance or certificates as per protocol agreed by participating doctors at the outset. 8
Online Courses You can claim credit for online learning in either the External or Internal category when the activity meets these criteria: It provides learner interaction or self-assessment e.g. Medscape The learning objectives describe what you may learn or achieve by taking part in the activity The course provides links to appropriate further study that reinforce and clarify the activity topics Practitioners produce evidence of activity and/or completion e.g. a certificate of completion of a module. Personal Learning You can claim credit for: Journal reading Studying for a Diploma course or towards a postgraduate examination E-learning where there is no learner interaction or evidence that you have completed the activity Membership of RCPI Committees You don t need to collect evidence that you have taken part in Personal Learning activities. Research and Teaching You can claim 5 credits for the first-time preparation and delivery of a presentation at an academic meeting. You can also claim credit for acting as an examiner for a postgraduate medical training body, setting postgraduate exam questions, postgraduate lectures, publications and national standards development (the latter can also be recorded under Audit). This is set at 1credit for 1 hour s activity (preparation or delivery). Publication of a paper in a scientific journal = 5 credits. In addition, a presentation of this work at a national/international meeting is also eligible for credits using the 1 hour = 1 credit formula. Evidence of the activity should be recorded in your e-portfolio. Exceeding Minimum Number of Credits for Cycle Professional Competence requires year on year compliance. There is no Professional Competence cycle. There is no mechanism to carry over credits or competence from year to year. 9
Appendix 1 CONTINUING PROFESSIONAL DEVELOPMENT ATTENDANCE REGISTER NAME OF MEETING: VENUE: DATE OF MEETING:_ Please retain this sign in sheet in your office for a five-year period following date of meeting FULL NAME WITH SPECIALTY IMC SIGNATURE INITIALS NUMBER Please retain this sign in sheet in your office for a five-year period following the date of meeting It is inappropriate to photocopy/photograph Attendance Registers containing signatures of other attendees to use as evidence of participation for the purposes of professional competence 10
Appendix 2 Continuing Professional Development (CPD) ATTENDANCE CERTIFICATE This Is To Certify That: <Delegate name> Attended A Meeting Entitled: <Title of meeting> At the Venue: <Venue> <Venue address> On The Following Date(s)*: CME Credit <Date of event(s)> Each meeting is approved for <no. credits> Total earned <period covered> <no. credits> Organised by: <Organiser name> Contact: <Organising Institution> <Address, Phone, Email> Signed by: Manager *Please note- one certificate may be issued for recurring meetings/events Doctors who are participating in a Professional Competence Scheme should retain this certificate in their PCS portfolio 11
Further Information is available on: www.rcpi.ie/professional Competence/ Resources - General PCS Information Professional Competence: Frequently Asked Questions: Clinical Practice Audit (A Guide to PCS): 12