Personal Development Plans (PDPs)

What is a PDP?

In fact it is just a summary plan of your intended educational activity

However  in a broader sense it can be thought of as:

•  A plan for identifying your short and long term educational needs and goals

•  The methods by which you will meet those needs

•  The process by which available resources will be identified and utilised

•  A mechanism for reflective practice and learning through experience

•  Encourages you to apply what you have learnt to your every day practice

•  A way of identifying barriers to achievement  and reduced where possible

• A dynamic process thereby facilitating your active learning

What's the point of a PDP?

Good point!! Seems like yet more forms to fill in. Several reasons in fact:

1. The GMC has stated that in order to be fit to practice doctors have a professional duty to make sure that their knowledge and skills are kept up to date. GPs will be required to demonstrate this fitness to practice through the process of Revalidation. They will have to demonstrate over a 5 yearly cycle that they have engaged in systematic learning and that they have evidence to demonstrate this process.

2. The old system of Post-Graduate Education Allowance (PGEA) is being phased out. The criticisms of this process was that the education was not targeted to individuals in a way which reflected their educational needs. It wasn't referred to as "collecting Brownie points" without good reason. People often attended what they were interested in or because they needed the points rather than the things they needed to attend.

3. The PDP helps  you to identify, structure and prioritise your educational needs, aims and objectives. It encourages you to choose the most appropriate learning methods to achieve these and then reflect on your learning to establish further educational needs and to consider how you might apply what you have learnt to your everyday practice giving real practical benefit to you, your patients and your practice. This part of the PDP can be considered as the Educational Process

4. There is good evidence that a deep approach to learning (understanding concepts and principles )  is much more beneficial than a superficial approach (simply accumulating factual knowledge). A PDP encourages this process.

5. A PDP also encourages us through reflection to learn from our experiences. This is based on Kolb's experiential learning cycle.

6. For me the most useful part of a PDP is that it acts as a dynamic educational tool to facilitate my learning, through a process of regular review, reflection and updating.

The Educational process as part of a PDP:

Many of the processes used in learning are what are called formative assessment methods in that they combine assessment with learning e.g. random case analysis.

Educational Portfolio and other terminologies (there is a lot of overlap!!)

PDP: for many people this means the summary spread sheet with a plan of activity

Educational Log: This includes the PDP as defined above, formative assessment, appraisal , the educational process or plan and evidence of learning

The PDP is wider than pure educational activity and as it name suggests includes activities related to personal development in its broadest sense. Other specific things that might be included in the PDP are

• Past educational Profile

• SCOT analysis

• Areas of special interest

• Past learning highlights

• Medical ethics and professional values

• Resuscitation skills

• Significant event analysis

• Risk management

• Communication skills

• Looking after yourself

• Research

• Activity as a GP Trainer

We need to keep a record of educational and other activity. This is partly to facilitate the learning cycle but also to provide evidence for revalidation.

A Educational Portfolio therefore in much the way that an artist will carry a portfolio as a record of his/her activity and achievement, will include the educational plan as part of the broader personal development plan along with any other material that demonstrates relevant educational and other activity. It might include  complaints, audits and appraisals. It is the document that we would want to present to meet many of the needs of revalidation. It will also contain a lot of relevant administration

It is often helpful to produce an action summary page for your PDP highlighting the main educational needs , how they will be achieved and an approximate timescale.

Ways to identify Learning Needs

1. Personal educational needs:

• Puns and Dens

• Clinical experience in everyday practice

• Needs arising out of a learning event e.g. from a tutorial

• Phased evaluation Programmes

• Significant event audit

• Rating scales

• Awkward moments with patients

• Blind spots

• Complaints

• Past educational profile

• SCOT analysis

• Patient feedback

• Analysis of referrals and admissions

• Analysis of PACT data

• Appraisals

• MCQ's

• OSCEs

2. Practice priorities which generate individual learning needs:

• Organisational issues

• Premises

• Range of patient services

• Practice Audit

• Staff

3. Local priorities

• Health Improvement programmes

• PCT issues

4. National priorities

• Government agendas

• National service frameworks

• NICE

• White papers e.g. The National Plan

Practice Professional Development Plans (PPDPs)

The Chief Medical Officer in A review of Continuing Professional Development in General Practices 1998 recommended that the key to professional development is the PDPP from which individuals could go on and develop their own PDP.

It identified 3 areas through which quality in primary care could be optimised: clinical governance; enhanced professional self-regulation and lifelong learning. There are 3 parties to consider with regard to professional development. These are the patients, the professional and his/her profession and the organisation (the GP practice or wider NHS).

The PPDP is a bit like a PDP applied to the practice. In its simplest concept it encompasses the 3 traditional  questions:

·        Where are we now?

·        Where do we want to be in 5 years?

·        How are we going to get there?

It is important that your PDP should in some way integrate with the PDPP of the wider organisation within which you are working (usually a General Practice). Needs that  are identified for the GP Practice in its PDPP, can become individual learning needs for members of the Primary Health Care Team (PHCT) as described above in the section on PDPs.

There needs to be a process of coordination so that the skills that are being learnt by individual members of the PHCT integrate towards the common need of the organisation. If a development need for the GP practice was to advance IT within the practice, a member of the PHCT would need to acknowledge this as a learning need within their PDP. However it would probably not make sense for 4 people to do so, otherwise too many people will have the same skills at the expense of other skills.

As with a PDP reflective practice is an important part of a PPDP.

Health Needs Assessment

Rather than an educational needs assessment required for a PDP, a health needs assessment should be performed for the practice population. This involves discovering the health profile of the local population. This includes demographic, social, employment and epidemiological data along with an age/sex spread of the practice population. The locality of the practice is also going to be important as a rural practice population may well have different needs from an urban one. It might also be helpful to find out mortality and morbidity data to see how this compares to the national average e.g. for CHD or smoking rates or teenage pregnancies. From this you can begin to draw up a list of   health needs for the practice population and then prioritise this list.

It is important that all members are involved in the production and continuing updating of the PPDP. This will create a sense of ownership and create a more holistic approach as a health need is rarely confined to one team within the practice. The other group of people it is important to consult is the patients themselves. There are a variety of ways of doing this e.g. suggestions box, patient surveys and patient questionnaires.

Once the list of health needs has been prioritised, the team needs to consider whether it is within the abilities of the PHCT and the Practice to meet those needs, bearing in mind the available resources. Some things may need to be tackled on a national  or PCT basis. What you want  to change may form part of a Health improvement Plan.

Available Resources

The PDPP action list then needs to be tackled by finding out more about the chosen health need. This may mean data collection or audit and an assessment of the current position. The practice can then look how they would like to meet the need, what needs to be done and what resources will be needed and are available. An example of this might be the treatment of Asthmatic patients. The practice might have an above average prevalence of Asthma, but doesn’t currently arrange a systematic review. There are also a number of patients taking salbutamol who do not have a code for asthma.

The action might be to validate the Asthma Register, arrange a teaching session to update everyone on the current guidelines for Asthma management, organise further training for key individuals and set up a systematic recall system. As always it is important to be able to evaluate whether the interventions have been beneficial and this can be done by Audit. The roles of key individuals in this process will need to be identified.

In the light of these activities the skill mix and integration of teams within the practice might need to be addressed e.g. would it make sense for the district nurses who have great expertise in leg ulcer dressings to do all of these, both within the practice and the community, while the practice nurses with their chronic disease management experience might carry out all the annual diabetic checks, again for both housebound and practice patients. Similarly it may make more sense for a health care assistant to be taking bloods and doing ECGs rather than a practice nurse. Staff appraisals would be an important component  as well.

The PPDP will encompass other activities in a similar way to the PDP that will contribute to the learning cycle and identification of not only health needs, but also organisational and training needs for the practice. It is important to identify the skills within the whole PHCT.

Other activities which involve some reflective practice to include in a PPDP might be:

·        Producing a mission statement

·        Practice Aims and Objectives

·        Practice SCOT analysis

·        Outcome from an away day

·        Significant event analysis

·        Audit

·        Analysis of complaints

·        Risk management

·        PACT data

·        Performance Indicators

·        PCT annual review

·        Practice Research

The PPDP summary action plan therefore might well include areas on clinical practice, organisational issues and personnel, again as with the PDP identifying a timescale, methods to be used and an indicator of successful achievement. Assessment and evaluation of the  PPDP is an integral part of the process.

Resources:

In addition to the references below, all trainers have been sent Word based electronic copies of useful documents to get you started . The Swindon trainers group have put this together as a useful package incorporating a number of documents that I produced recently. This should be available through your trainer or contact Michael or Bill.

There is an electronic resource which enables to use a variety of on -line documents and tools to get you going: http://www.wisdomnet.co.uk/index.asp

The Wessex CD-Rom GP Registrar's education Portfolio. You should have received a copy of this. It has useful explanations and examples

On line portfolio resource: http://www.gplearning.co.uk/

Update produce a useful PDP folder

References:

1. While R, Attwwod M. Professional Development. Aguide for General Practice. Blackwell. 0-632-05629 Blank PDF forms can be down-loaded at www.medirect.com/professional-development

2. Rughani A. The GP's guide to Personal Development Plans.  Radcliffe. ISBN 1--85775-427-1

3. Practice Professional Development Plans- a review of a deanery pilot. Taylor G, van Zwanenberg T. Education for Primary Care vol 13, Number 2, p228

4. A pilot study of the introduction of personal development plans in Northern Ireland-practical experiences and implications for revalidation. Education for Primary Care. vol 13, number 2 P267.

Study guide written by: Dr Mark Dinwoodie

Last update: 02 October 2006

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