Personal Development Plans

Personal Development Plans are a relatively new and trendy innovation in the continuing education of all doctors in the UK.  They are said to be an effective way to address our need for continuing medical education (CME).  Production of a PDP is now obligatory for all doctors in PMS practices, although for the rest of us remains optional. 

The assumption however is that we will seize the idea with enthusiasm and excitement and it will revolutionise our professional lives, and just in case not, it has been made an integral part of the new national GP contract.

As appraisal based on a PDP is also mandatory for all non-principals, you will need one of these whatever your career plans are (assuming they are in the UK anyway!) at the end of your GPR year.

History

GPs have been encouraged to undertake CME since the mid ‘70s.  Initially costs of courses were made reimbursable as “Section 63” funding.  This lingers on as the repayment mechanism for your expenses associated with the DRC.

The odious, cigar-smoking Ken Clarke, however turned all of this upside down with the introduction of the “new contract” in 1990.  Essentially he stole a sum of money from us (about £3,000), returning it to us only if we attended 30 hours of education covering topics in disease management, service management and health promotion.  This was known as the Postgraduate Education Allowance (PGEA).  The key word in all of this was “attended”.  It didn’t matter if you slept through it, refused to engage, or always went to the same talk by your favourite cardiologist. 

PDPs

Somewhat spookily these were first developed by the Ford motor company, as a way of encouraging the personal and professional development of their employees.  The concept is actually simple, but most papers and guides to the subject get rapidly bogged down with detail.

Essentially PDPs are analogous to the audit cycle (goody! we hear you cry).

However, they are not quite so dour and worthy.  The idea is to find out what you know/don’t know, plan some education to plug the gaps you have identified, reflect on what you have learned, and put it into practice.  The next year you do the whole thing again:

A well produced PDP will simply document each of these stages.

How do I know what I don’t know?

There are loads of tools for these, many of which your trainers will have inflicted on you.  Examples include the PEP MCQ CD, competence questionnaires, video analysis, reflection on personal strengths and weaknesses.  This is called formative assessment.

Each tool has various strengths and weaknesses, and in general it is a good idea to use 2 or 3 in order to increase the validity (jargon word: "triangulate") of the assessment of your educational needs.

You will inevitably work out a huge list of needs. You need to prioritise these and stick them down into an “action summary page” (known as Form 4 in the annual NHS appraisal). It looks a bit like this:

Area identified	How was it identified?	What needs to be learned?	What methods will be used?	Target date	Evidence of learning	Date achieved
Ophthalmology	PEP Confidence questionnaire PUNS and DENS	Practical eyes	Courses. Computer based learning CD Outpatients	April 2005	Reflective diary Redo confidence questionnaire and PEP. Peer Appraisal

 

Top tip: if your action summary page has more than 4 or 5 things on it at a time, you have lost the plot. No-one can take on more than that and do a good job at addressing each of the areas identified.

What education should I do?

Unlike the “bums on seats” approach of PGEA, PDPs allow you to choose a method of education that suits your learning need and preferred learning style (remember the stuff you did at Urchfont on Honey and Mumford).  You may decide a traditional lecture is the answer. Alternatively, you may prefer to read a book, attend an outpatient clinic, or join a young principals’ group.  If you have an activist style, you may prefer a different approach to someone with a pragmatist style of learning.

To an extent this will be determined by your educational need, e.g. "I am crap at consulting, therefore some video work is likely to be more helpful than just reading a book on consulting".

Reflecting?

Reflection on what you have learned is helpful, and may just take the form of a list of key facts learned.  By so doing you will think about what you have learned, and whether it can be applied to real-life general practice.  Lots of the more enlightened postgraduate courses provide you with forms to help with this.

This is the idea behind our DRC feedback forms.  We also pass the summary e-mail to each of the local trainers in the hope that they will discuss the DRC day with you, aiding this reflecting process.

Application

This is, of course, the key step in the process.  There's not much use learning all about the management of hypertension, if you carry on sticking all your grannies on ganglion blockers…  It is of course easy to “talk-the-talk”, but much harder to “walk-the-walk”!

Ways of doing this include presenting what you have learned at practice team meetings, and clinical audit (e.g. "how many patients did I have on ganglion blockers before auditing, and how many 6 months after?").

Problems

Well, this all sounds hunky dory doesn’t it?  The problem is, like most educational ideas, it is kind of difficult to prove that the approach actually works.  This doesn’t necessarily mean it doesn’t (try devising a research project to demonstrate it does!), but just take all of this with a small pinch of salt for now. 

We can supply you with copies of a review paper which suggest that it is probably more effective than “bums on seats”, but nothing approaching A or even B category evidence.

If you're interested, take a look at Michael's review paper on the evidence for portfolios.

The other key issue is that this all takes a lot of time.  If all of this planning and evaluation takes longer than the actual time learning things, something is a bit amiss.  A personal view however…

Appraisal and Revalidation

As mentioned above, we will all be appraised every year.  The only way this can be done is for appraisers and evaluators to look through your PDP.  A nice logical, well organised personal learning plans will (absolutely 100% guaranteed) get you through this tedious annual hurdle. 

You guys have a distinct advantage in that the learning portfolio that you keep as a registrar will easily evolve into a PDP with minimal effort on your part.

The personal aspect to PDPs

There may seem very little that is truly personal about these so-called plans and of course you may wish to keep it that way! It is important not to forget that, to be effective doctors and to keep up to date with all these various educational aspects and aspirations, we need to look after ourselves too.

You may like to include in your plans some self reflection on other areas of your life. How do your other roles ie

• partner,
• yoga practitioner,
• family member

impact, become enhanced by, or indeed suffer because of the medical aspect of your life.

By self reflection and examining some of these areas, you may find ways to improve your time management and thereby find the motivation to do some of the educational stuff.

PPDP’s

Finally (I promise) a short word about “Practice Professional Development Plans”.  Your practice (particularly if PMS) should have one, although I have to say that these, perhaps because they are optional extras, have never really taken off in the same ways as PDPs.

The idea is that your practice (i.e. not just you) have an interest in what you learn.  It goes without saying that it would like you to be competent in the cores GP skills (e.g. managing hypertension).  However it might also have views on skill mix.  For example it might like you to develop a special interest in diabetes or minor surgery so that you can act as a practice resource.  Similarly if your partner does all of the IUCD fits, does it really make sense for you to go on endless coil refresher courses?  These practice learning needs will feed into your own PDP.

PPDP’s try to systematically identify learning needs for everyone (e.g. basic CPR), and individual staff members (doctors, administrative and nursing).

Reading

You may want to take this further.  (Equally you may not!)  It is certainly a hot oral topic for those of you tackling the MRCGP.  Try the following (which should be in your practice library):

      Amar Rughani’s: excellent (and short!) book on PLPs: The GP s Guide to Personal Development Plans ISBN : 1857754271 

      Robin While (yep, our very own!) and Margareth Atwood’s longer, but still excellent review of both PDPs and PPDPs; Professional Development. A Guide for General Practice ISBN: 0632056290

 

Written by:    Bill Irish, updated by Jane Savage

Last update: 29 August 2007