All doctors are learners and throughout their lifetime of professional practice should be supported and encouraged to stay up to date. This is achieved through a process of continuing professional development (CPD). CPD is an acknowledgement of the need to maintain, develop and broaden expertise and personal qualities to be able to cope with work challenges of the future in a health service which is rapidly changing.
Revalidation may soon be a way of life for all doctors, including GPs. Regular revalidation may be necessary to continue to hold a GMC licence.
The RCGP has described a system of recording educational activity through learning credits which each GP (college member or otherwise) will have to self-rate. One aspect of this 'strengthened medical appraisal' from April 2012 is that your appraiser will need to sign off this self-assessment.
Most of us remember the postgraduate education allowance (PGEA) system of collecting points or certificates of attendance. This new system is different because the GP is encouraged to reflect on his or her educational activity and its impact on their work and patients.
A GP should collect at least 50 learning credits in a year, which is 250 learning credits in a five year appraisal cycle. This is one of 13 areas of supporting information where a GP needs to collect evidence to support their application to be revalidated.
Reflection and impact
It is not just the time spent learning that matters, but rather reflection and impact. So a learning credit does not necessarily equate to an hour of educational activity.
For example, you might attend a one hour workshop on chronic kidney disease (CKD). On reflection you should record how this learning impacts on:
- Patients, for example starting a patient disease register and conducting an audit
- You and your personal development
- Service, for example reaching the standard to claim QOF points in this area
- Colleagues, for example by teaching or taking part in a local enhanced service.
If there has been a measurable impact from the CKD workshop you might claim double credits.
An educational diary is essential. Some GPs prefer a paper folder but, from 2012, GPs will use an ePortfolio that is currently being developed by the RCGP.
Reflections and their impact need to be carefully recorded as part of a learning log, including:
- Topic covered
- Further actions in relation to patient care/service delivery
- Fulfilment of part of personal development planning.
Certificates of attendance should not be required. However, you need to reflect on your learning from any educational event that you have attended.
It is recommended that GPs self-assess their CPD. To justify one hour of learning at appraisal it is important to write the following:
- Your learning outcomes (three or more things that you have learnt)
- Reflections and possible changes in your practice (impact of educational event)
- Self-assessment of number of learning credits (number of hours of learning).
The RCGP website provides helpful guidance on learning credits to members and non-members.
Sources of learning credits
Several possible sources have been identified on the RCGP website. These include:
- Presenting at a significant event audit meeting
- Online learning
- RCGP essential knowledge updates
- e-GP: the RCGP's new e-learning resource
- Educational events
- Patients' unmet needs (PUNs) or doctors' educational needs (DENs).
The key to gaining credits is first the time spent and then, following reflection, the impact on you and your practice. A GP needs to be able to justify the number of credits claimed.
The time taken should be recorded in the learning log as a learning challenge. For those GPs who can demonstrate personal, practice or patient benefit it is possible to claim two credits for one hour of learning. Evidence for outcome of learning and 'impact' should be robust - through an account of the change, an audit or case studies (as in the CKD example).
Credits can be gained through PUNs and DENs. These can be applied to any consultation when you reflect on how the consultation went with questions such as: 'Could the consultation have been conducted better?'
To provide quality healthcare and keep up with the pace of change in the NHS, such acronyms or models should be considered when analysing consultations. This is also learning that can take place at your practice rather than having to go to a meeting.
Revalidation is here to help us develop as GPs and provide even better care to our patients. The RCGP website has very helpful information in the revalidation guide.
- Dr Charlton is a GP principal, GP appraiser and associate clinical professor at Warwick Medical School
|CPD IMPACT: earn more credits|
|These further action points may allow you to earn more credits by increasing the time spent and the impact achieved.
Record all your learning with your free online CPD Organiser
RCGP revalidation guide; www.rcgp.org.uk/_revalidation.aspx