The introduction of Continuing Professional Development (CPD) audits by the Health Professions Council (HPC) (2008) provided another step towards a truly ‘professional profession’. The reliance on in-house recertifcation courses provided by ambulance services raises concerns of the effcacy of ‘sheep-dip’ style education where the best, average and poorest clinicians underwent the same courses, irrespective of their learning need. Clearly an evolution which enabled professionals to continually develop their knowledge and skills, thus becoming more effective practitioners, was a determining moment. But has the paradigmatic shift in how we educate and check our registrants created a bias towards developing skills at the expense of good-quality current ones?
By design, CPD is a valuable part of any profession’s substrate; the principle of training a person to the standards required for registration and then using this base line to develop their knowledge in the ensuing years proffers a professional utopia. The HPC defnes CPD as ‘the way professionals continue to learn and develop throughout their careers so they keep their skills and knowledge up to date and are able to work safely, legally and effectively’ (HPC, 2012)
In reality, I would suggest our substrate is not as robust as the regulatory body hopes for; is fragile and riddled with crevasses that are exposed every single clinical day. As a profession we appear to have been forced to accept what works well for others, with no real grasp of what a paramedic requires to ensure they are safe practitioners, but more importantly, feel educationally supported while in practice. The Training and Development Agency defnes CPD as ‘refective activity designed to improve an individual’s attributes, knowledge, understanding and skills. It supports individual needs and improves professional practice’ (TDA, 2007).
It would be imprudent and misplaced to suggest that CPD has no value in our clinical world. I am a firm believer in the benefts of refection both on and in action, with the ability to identify lacunae and seek solutions component parts of being a professional. My concern is that this current system relies too heavily on this higher level of ensuring patient protection and misses a very obvious step in our professional evolution.
Based on reviewing clinical records, clinical negligence cases, delivering courses and witnessing clinicians in practice, I am convinced that we need to promulgate a new model based on ensuring continuing professional standards (CPS) providing quality assurance suited to delivering good patient care across the spectrum of clinical abilities.
By introducing a license that required annual revalidation through attending a recognised advanced life support course, trauma course and paediatric course, and with a bi-annual requirement to attend a speciality course such as obstetrics, geriatrics or major incidents—surely the promise of CPS could be more sincerely upheld? With many courses now adopting a blended learning style delivery method, the clinician would not necessarily be unavailable any longer than through current training systems.
As a patient, I would be reassured to know that a paramedic treating me has at least once in their career attended an accredited advanced life support (ALS), trauma or paediatric course—I would be somewhat concerned if I knew that they had not attended any of these in over 20 years—worryingly, I know many who ft the latter...