Answer to a question of trust?

November 9, 2001

Can continuing professional development in fields such as medicine restore public faith? asks Claire Sanders.

At a time when scandals such as the Bristol baby deaths and the collapse of the Bank of Credit and Commerce International have undermined the public's faith in professional judgements, continuing professional development (CPD) is the panacea that promises to restore our confidence in doctors, accountants and other professionals.

But according to research from the University of Bristol, many professionals resent through-career training and some say that compulsory CPD invites fraud.

The General Medical Council is introducing a five-yearly process of revalidation for doctors that will require a record of CPD.

Mary Phillips, one of the authors of the study, says: "For doctors, fitness to practice is literally a matter of life and death. Accountancy bodies, an area where there has also been a number of scandals, are keen to prove their members are competent and CPD is a useful way of ensuring this."

The study was funded by the Department for Education and Skills and carried out by the Professional Associations Research Network (Parn), a research group at Bristol that studies professionals and professionalism.

Parn tried to collate all the surveys done by professional associations of their own members' attitudes to CPD. It contacted about 430 associations and had responses from 269. Of these only 47 had surveyed members and 19 supplied the results of the surveys to Parn. Parn also interviewed 18 individual professionals as well as their employers and organised focus groups and online discussions.

Dr Phillips says: "Previous research has shown that a third of professional associations make compulsory CPD a requirement of membership. It is our view that associations need to be much clearer about what they mean by CPD and what they require of members. We found two associations imposing sanctions if CPD was not completed - and yet the associations did not describe the CPD as compulsory."

The main barriers to CPD were identified as lack of time, lack of money, lack of access to relevant activities, a workplace culture hostile or indifferent to CPD, lack of incentives for doing CPD, an overly constraining CPD system and lack of professional support.

"Many professionals said that if CPD were compulsory, it would make it easier to get employers' support," Dr Phillips says. "Equally, professionals were against just having a checklist to tick, as this could lead to falsification. Far better was some sort of peer review where professionals were observed in practice."

CPD is seen as a growth area for UK universities and businesses. The market was worth an estimated £600 million in 1998, with universities taking only a small share. They may be missing out. "The problem of a trade-off between legitimacy and flexibility was particularly acute in professionals' assessments of commercially provided CPD activities," the study says. But "academic qualifications were certainly seen as legitimate".

Dr Phillips says: "Some companies get their courses approved by professional associations and professionals feel obliged to go on them. Universities were seen to offer unbiased informative courses - but had not always gone through professional associations for approval. This is an area universities could exploit more."

Continuing Professional Development in the UK: Attitudes and Experiences of Practitioners .
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