Currently the GDC requires that registrants attend and declare a minimum number of hours continuing professional development (CPD) activity within a five year cycle; essentially an 'input' based system.
Such an arrangement takes no account of the relevance of the course to the individual needs of the practitioner nor does it evidence what, if anything, has been learned and how the CPD will benefit the practice of the registrant.
The forthcoming enhanced CPD (ECPD) requirements are intended to address these shortcomings by introducing a format which encourages a cyclical approach comprising of four components.
Dental professionals will identify their own learning and development needs, aligned to the GDC's standards and their scope of practice, using a personal development plan (PDP). This activity can be carried out individually or with colleagues via activities such as appraisal.
Information from a variety of sources, for example complaints, feedback, practice inspections, audit and peer review can be valuable in informing this stage of the process.
Having identified the most appropriate CPD, registrants will then carry out those activities in accordance with the timeframes set out in the PDP.
All conscientious dental professionals will look back on their working day and consider what went well, what didn't, and whether they could have done something different to affect the outcome. To this extent, reflection has always been a feature of dental practice but in the past it has often been an informal affair.
With ECPD, after undertaking the above CPD activity the registrant is required to reflect upon it, considering how it may contribute to meeting GDC standards, maintaining and developing skills and improving patient care. This stage may also highlight further learning needs and opportunities, feeding back in to the process, beginning the cycle again.
Dental professionals must keep a CPD record containing a PDP, a CPD log including dates and duration, any independently verifiable documentary evidence such as certificates, and finally each item of CPD must be mapped against one or more of the GDCs four development outcomes relating to GDC standards. These outcomes may be summarised as communication, management and leadership, skills and knowledge, and professionalism.
There is a very helpful and detailed Q&A on the GDC's website but the key points are as follows.
- ECPD comes into force from January 2018 for all dentists and August 2018 for all dental care professionals. For those part way through their five-year cycle, a pro-rata approach is taken.
- All CPD must be verifiable, with a minimum of 100 hours for dentists, 75 for hygienists, therapists, orthodontic therapists and CDTs, and 50 for dental nurses and dental technicians.
- A minimum of 10 hours CPD per two year period (even across cycles).
- Keeping (and maintaining) a PDP for each cycle is mandatory. A GDC template will be available but other formats will be acceptable.
- Submitting an annual CPD statement is mandatory (even if declaring zero hours). It is mandatory to keep a CPD record - only submitted upon request but compliance declared annually in the CPD statement.
- Must maintain records for a minimum of five years after the end of the cycle, as the GDC may audit.
- Risk of removal from the register for non-compliance.
The DDU has helped many members develop a PDP and from our experience the reflective element of the new process may well be that which colleagues find most challenging.
The following pointers may help you develop as a reflective practitioner:
Recognise the benefits
Some people are introspective by nature but others feel actions should speak louder than words. If you find the idea of setting aside time for reflection self-indulgent, bear in mind that the process has a practical purpose.
The FD Handbook says that foundation trainees' reflection for their e-Portfolio helps them improve critical thinking, become self-aware, know about their future learning needs and develop safe practice with better patient outcomes. If you can set clear objectives for your reflection - such as how you can improve your communication skills - it's likely to be time well spent.
Don't confuse quantity with quality
For reflection to be meaningful, it needs to be relevant. It is not enough to describe the learning outcomes for every course you attend if you don't consider how this learning fits with your own personal development plan, or how it can be applied to your own practice. A succinct piece of reflective writing is more valuable than a lengthy narrative.
Develop a process
Reflection will become easier with practice but it also helps to develop a consistent methodology. While there are no hard and fast rules for reflection, you may find it useful to review the guidance within the FD Handbook. In addition, some CPD course providers now provide templates to support reflection and encourage participants to explore the subject further.
If you're still struggling, it's worth considering the systematic approach you would usually employ during a significant event audit or use a series of questions to prompt you. For example:
- what happened?
- what went well?
- what could have been done better?
- what you learned from the activity/experience?
- what actions you will take as a result and by when?
- how will this improve your practice?
- what difference will it make to patient care or to your colleagues?
Keep your reflections anonymous
In the normal course of events your reflections are confidential. But at the same time, concerns have been expressed about the disclosure of reflective notes about adverse events for use in civil litigation.
However, the risk of being compelled to disclose a written reflection is vanishingly small if it is properly anonymised. There is no need for patient identifiable information to be included in a piece of reflective writing. Equally, fear of disclosure should not prevent you from reflecting on an adverse incident.
Take your time
Set aside time to write your reflections when you won't be interrupted.
Revisit your reflections
Once completed, don't file away your document and forget it. While it may be useful evidence if the GDC decide to audit your CPD activity in five years, it should also inform your personal development plan.
If you have identified a gap in your learning through reflection, you will need to update the plan accordingly. It can also be helpful to return to your reflections at a later date to see how your practice has developed.
As a profession, dentistry already demands an analytical approach, from weighing the advantages and disadvantages of a course of treatment to assessing a radiograph. Reflective practice is simply a matter of directing that critical eye towards the person wearing gloves and gown.
Head of the DDU
John Makin BDS PgDL PgCDE FHEA is head of the DDU. He qualified in Manchester in 1983 and has worked as a general dental practitioner in Lancashire and Devon before joining the DDU as a dento-legal adviser. He was involved with foundation training for many years as both a trainer and VT adviser/training programme director with the Manchester and Exeter DFT schemes.
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