The responses we received indicated broad support for the proposal that a future lifelong learning scheme should be based on a portfolio model. This would be a move towards a professionally owned, self-directed model, albeit within a framework set by the regulator. We understand and agree with those stakeholders who highlighted that a cultural change would be required if we are to move from a scheme that focuses on hours completed to one that has a ‘portfolio’ of achievements and skills at its core.
Some concerns were raised about the practicalities of the proposed model and how compliance would be monitored. We recognise that a future scheme would have to combine assurance that CPD had been undertaken within the framework we set with greater flexibility for the professional in the manner and type of activity they choose to do. We will explore suggestions made by some about the role that professional and peer networks and employers can play in supporting the move to a portfolio model. These suggestions included addressing CPD in appraisals and using peer reviews to plan their CPD.
Respondents broadly agreed with the list of proposed components of a future scheme: for each proposed component, over half of those responding agreed that they should feature in a future model. The list included ‘active learning’, which was the most popular component, and peer and mentor/coach interaction, which was picked by slightly fewer respondents. While most of these activities may not count as verifiable activities under the current CPD scheme, they can be extremely valuable and there is a strong argument that activity where value is gained should be counted in a future system. We also take on board the calls to develop and then promote a shared understanding of what these components mean.
Although there was support for the portfolio model, respondents raised some concerns about how this kind of model would be monitored. In a future system, the GDC would still require assurance that professionals carry out CPD. As noted above, we will explore the role peer networks and employers could play in supporting professionals to provide this assurance. At present we encourage professionals to develop and review their personal development plans with peers or within their workplace, and this may be strengthened in the future. The planned evaluation of the current scheme will explore what, if any, peer, or employer interactions already take place around CPD, and if these can support the future scheme.
There was much support for making active learning, such as peer learning, part of a future scheme. However, some noted that some existing peer review activities declined, that professionals lacked clarity and structure to make the best use of them, and that there was a lack of trained peer facilitators. We acknowledge that some decline in existing peer review schemes could be down to removing non-verifiable elements from the GDC’s CPD scheme. This is an unintended consequence of the changes to the scheme that we will look to remedy.
Many cited the lack of online and remote facilities for learning with or from peers as a key barrier. When we evaluate the current scheme, we will explore what, if any, peer review and peer learning activities professionals currently undertake and what impact the shift to online and remote learning during the pandemic has had on accessing different types of CPD, including peer learning and peer review.
We also invited views about the use of reflection in CPD. What we heard suggested that reflection was not as significant a component as might have been hoped in informing many professionals’ CPD activities. Respondents told us that they or other professionals don’t necessarily know how to reflect well, and that support from education providers and easily accessible guides or templates could help. We take away that more can be done to embed reflection.
Informing CPD choices
Opinion was divided about the idea that minimum hourly requirements could be removed. Some respondents argued that removing these requirements should make the system more flexible and meaningful and better tailored to individual needs and field of practice, and that the focus would shift to the quality of CPD and benefit gained, away from quantity and counting hours. However, others argued that retaining the minimum hours requirement was important to ensure that dental professionals carried out a minimum amount of learning. The minimum hours requirement sets clear expectations and provides a simple system for monitoring compliance. Also, some respondents raised concerns that a system with greater flexibility could lead to some professionals “cheating the system”. We acknowledge that a system where professionals have greater control over what activities count towards their development would be more challenging to monitor. We will explore how a future system could provide flexibility for professionals while assuring the regulator and the public that the statutory requirement to carry out CPD is met.
We heard a range of views about the possible impact of the removal of recommended topics. While a large majority of individual respondents agreed that recommended topics had a positive impact on their CPD choices, almost half of respondents also agreed with suggestion that they could be removed from a future system. Three quarters agreed with a statement that ‘recommended topics were a ‘tick-box’ exercise’. We noted that many referred to them as ‘compulsory’ subjects, which they are not. We will seek to identify the benefits of recommended topics in the next stage of this work. We will also consider how to address any element of the CPD scheme being a ‘tick box exercise’. We will also seek to promote and embed any changes in a way that ensures clarity that these are recommended but not compulsory topics.
We asked where the responsibility should lie for driving CPD activities and recommended topics for dental professionals. Most respondents told us that this did not sit solely with the GDC and that many organisations had a role to play in supporting better CPD choices. Some of these organisations also replied to our survey. They told us that they recognised their role too, and that they fulfilled it by informing their members of good and innovative practice and developing and promoting CPD around it. We want to work more closely with professional and specialist bodies, employers and indemnifiers, and education providers to develop a shared approach to supporting better CPD choices. We will continue to be responsible for setting standards for CPD, but we also recognise that others may be better placed to support professionals in keeping up to date on good clinical, legal, and professional practice, or to support professionals to build portfolios for career progression.
Incentives such as paid time off, free CPD, or a discounted ARF were common suggestions about how to motivate professionals to adopt positive changes into their practice. Some stakeholders argued that it would take the cultural shift mentioned above for professionals to better tailor their CPD choices to their field of practice. Some respondents suggested that an easy-to-use online system with less paperwork would help professionals to adopt a portfolio model. Others still said that carrying out CPD was part of being a professional and that little encouragement should be needed. While we cannot mandate employers to give dental professionals time off for CPD, we can help them understand the value of CPD to their employees, their patients. and their businesses. To do this we can seek ways to promote what we see as good practice, such as providing CPD at practice setting, or building it into appraisals. We recognise that the ‘cultural shift’ referenced by respondents is needed to make the proposals work. This will require more than simply changing the CPD rules.
Respondents stressed the importance of a wide-ranging outreach programme to inform and engage professionals, providers, and others before any changes are implemented. We agree with this point. These responses have also helped us to spot gaps in communication and engagement around the existing scheme, which we will seek to address.