Continuing professional development: What it means for student pharmacists
The Joint Commission of Pharmacy Practitioners’ (JCPP) vision for the profession states, “Patients will achieve optimal health and medication outcomes when pharmacists are included as essential and accountable members of patient-centered health care teams.” In order to provide such care, pharmacists need to maintain their professional competency throughout their careers.
Professional degree programs cannot provide all the knowledge, skills, attitudes, and values needed by pharmacists to practice in a complex and evolving health care system. In addition to the foundational knowledge and skills built into the didactic curriculum and practice experiences of the PharmD program, it is essential for students to develop habits and skills that ensure their ability to effectively continue learning throughout their career.
A primary goal of the curriculum is to encourage students to become lifelong learners. Continuing Professional Development (CPD) is a model that fosters and supports this endeavor. CPD is a self-directed, ongoing, and outcomes-focused approach to lifelong learning. It involves the process of active participation in formal and informal learning activities that assist in developing and maintaining competence, enhancing professional practice, and supporting achievement of career goals.
Components of CPD
The CPD approach is cyclical in nature, where each stage of the process can be recorded in a personal learning portfolio (see Figure 1 below). According to the Institute of Medicine’s (IOM) report Redesigning Continuing Education in the Health Professions, a major attribute of the CPD approach is the emphasis on stretching learning beyond the classroom to the point of care.
The “reflect” stage requires contemplation on one’s personal and professional life and self-assessment of learning needs and goals. Using reflection, areas requiring professional development can be identified along with specific competencies (e.g., knowledge, skills, attitudes, or values) to be attained or enhanced. Faculty, preceptor, and/or peer input can offer valuable insights to assist in identifying true learning needs.
The “plan” stage involves formulating a personal development plan to accomplish identified learning needs. Planning involves defining SMART (Specific, Measurable, Achievable, Relevant, Timed) learning objectives, learning activities, required resources, and measures of success. Learning needs should be prioritized based on importance and urgency in order to guide development of a plan, specifying both short-term and long-term goals. Sharing the plan with others can help to support learning over an extended period of time.
In the “learn” stage, the personal development plan is put into action using an appropriate range of activities in order to allow learning to be tailored to one’s needs. Relevant learning activities can occur in a variety of formats and venues including academic courses, pharmacy practice experiences, participation in scholarship or research, or involvement in professional committees or community service.
In the “apply” stage, learned knowledge, skills, attitudes, and values are then applied into practice.
The “evaluate” stage involves assessing how successful the personal development plan has been in meeting stated learning needs by considering outcomes and impact. Outcomes could include directly measurable or observable results, such as knowledge acquisition, changes in practice behavior, or introduction of a new service. Impact, which is usually longer term and often more challenging to assess, could include improved patient or population health or reduced costs. If learning needs were not fully met, it may be possible to identify further development needs at this stage. Personal evaluation leads to reflection, which continues the ongoing cyclical process of CPD.
The value of CPD
With a focus on achieving pre-identified, practice-related learning objectives, the value of adopting the CPD approach is that learners tend to be more engaged and derive greater satisfaction from their learning. In A Five-State Continuing Professional Development Pilot Program for Practicing Pharmacists, Dopp and colleagues discussed that while continuing education can be effective in achieving sustained learning and practice change, it can be more successful in this regard if learning: is in an area of interest or preference; relates to daily practice; is selected in response to identified need; is interactive, hands-on; uses more than one intervention (i.e., continuing not opportunistic); uses reflection; is self-directed (in content and context); focuses on specific outcomes/objectives; and includes a commitment to change by the learner. These elements comprise the intrinsic nature of CPD.
Skills related to CPD
In its report, IOM articulated the need to instill the value and importance of CPD through prelicensure training to “secure this pursuit as a lifelong professional commitment and a vitally important educational practice of responsible health professionals.” Although students may not yet think of themselves as lifelong learners needing CPD, the competencies needed for self-directed lifelong learning are best developed before entry to practice.
The CPD model is not complex, but adoption of this approach can pose challenges for those who are not accustomed to directing their own learning. Using the CPD approach requires students to assume greater responsibility for their own learning and develop the necessary skills and attitudes. For example, identifying one’s learning needs and developing and evaluating a personal development plan are areas that may not come naturally to many.
Examples of skills and behaviors associated with the stages of CPD are:
Reflection: Identifying personal learning styles and preferences; identifying needs arising from an evolving health care system; and analyzing competency and/or performance gaps.
Planning: Establishing learning needs consistent with identified gaps; identifying goals and creating SMART objectives in order to achieve goals; and reviewing learning plans for specificity and achievability.
Learning: Actively synthesizing, analyzing, and assimilating information; personalizing learning for relevance to practice; and adapting to a wide variety of teaching methodologies.
Evaluation: Regularly analyzing and interpreting learning impact on performance and other outcomes; evaluating learning with the purpose of improving knowledge, skills and learning abilities; and gngaging others (e.g., faculty, preceptors, peers) in review of learning plans and evidence of success.
CPD in the professional degree program
The Accreditation Council for Pharmacy Education (ACPE) believes that the acquisition of the knowledge, skills, attitudes and values required for self-directed lifelong learning should be encouraged and supported from the earliest stages in the education and training of pharmacists. Upon graduation, student pharmacists must possess the competencies necessary to assume responsibility for their own lifelong learning. Such expectations are interwoven throughout the recently released revised accreditation standards for professional degree program in pharmacy (“Standards 2016,” effective July 1, 2016) and associated guidance (“Guidance for Standards 2016”).
Among the standards and key elements, colleges and schools are asked to have processes in place to guide students to develop a commitment to CPD and to self-directed lifelong learning as part of their personal and professional development (Standard 4). The didactic curriculum should inculcate habits of self-directed lifelong learning to prepare students for APPEs, including instructional methods that foster self-directed lifelong learning skills and attitudes.
Guidance for Standards 2016 encourages colleges and schools to include opportunities for independent study to foster the skills, attitudes, and values necessary for self-directed lifelong learning. With a focus on the CPD model, professional degree programs can develop mechanisms that permit students to self-assess learning needs and direct students toward curricular, co-curricular, and/or extra-curricular activities and experiences so they can seek out those experiences to grow professionally. Examples of co-curricular activities and experiences related to self-directed lifelong learning may include participating in reflective professional development retreats, initiating or joining a journal club, working with academic advisors on a CPD portfolio, and participating in career-discerning activities (e.g., research projects, specialized practice opportunities).
Additionally, professional development is expected to be integrated into the pharmacy practice experience whereby students should engage in such activities as demonstrating attitudes and behaviors consistent with a respected member of the pharmacy profession, providing evidence of self-directed learning, and demonstrating an aptitude to implement the elements of the CPD cycle. (i.e., reflect, plan, learn, evaluate, apply).