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Revalidation, Relicensing, Recertification. The Knowledge. Objectives. Discuss continuing professional development (CPD) Know some useful educational theory Understand Revalidation, Relicensure, Recertification Know your learning style Discuss RCGP proposals

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objectives
Objectives
  • Discuss continuing professional development (CPD)
  • Know some useful educational theory
  • Understand Revalidation, Relicensure, Recertification
  • Know your learning style
  • Discuss RCGP proposals
  • What you need to do now you’re on your own!
the 3 r s
The 3 R’s
  • Relicensure via GMC for all practicing doctors
  • Recertification by relevant royal college
  • Both processes done simultaneously every 5 years.

If successful =

Revalidation!

simples

how do i get there
How do I get there?

Reflect and improve and record!

slide8
CPD

GMC:

“A continuous learning process that complements formal undergraduate and postgraduate education and training. CPD requires doctors to maintain and improve their standards across all areas of practice.”

why is it important
Why is it important?
  • Individual: job satisfaction, decreased burnout, develop PDP, revalidation
  • Patient: trust, increased Dr knowledge, ?better Rx
  • Profession: trust
  • Society: Changes to medical regulation, rapid increase in medical knowledge, Janet Smith inquiry
how do i do it
How do I do it?

You probably are!

  • Choosing what to learn (Educational needs assessment)
  • Choosing how we learn (Learning Styles)
  • Time to think about what you learned (Reflection)
  • Making the learning work (Application)
  • Studying the effects of what we have learned (Evaluation)

(Write it down!)

educational needs assessment1
Educational Needs Assessment
  • We tend to focus on comfortable, familiar, fun topics
  • BUT, knowledge gaps lay hidden
  • Johari’s window
  • Identify using various techniques: PUNS, questionnaires, talking, feedback, MCQs, Audit, guidelines etc.
doing the learning
Doing the Learning
  • What skill / knowledge do I want to have after the activity?
  • SMARTER objectives
  • Learning Styles (Honey and Mumford)
    • Activist
    • Reflector
    • Theorist
    • Pragmatist
prioritising learning
Prioritising Learning
  • Most Impact – personal/patients
  • Urgency – clinical, time, resource
  • Team needs
  • National / local importance
  • Own desires (care!)
  • Easiest – time, travel
  • Least resources
  • Which fits best with PDP?
evaluation
Evaluation

Kirkpatrick’s Hierarchy of evaluation:

  • Own sense of achievement
  • You actually learned something!
  • Your behaviour changed and you use the learning
  • Your patients have benefitted from your learning
what is the normal
What is the “normal”

REFLECTOR

ACTIVIST

THEORIST

PRAGMATIST

reflector theorist
Reflector Theorist

REFLECTOR

ACTIVIST

THEORIST

PRAGMATIST

reflector theorist1
Reflector - Theorist

Commonest variant style

“Analysis to paralysis”

activist pragmatist
Activist - Pragmatist

REFLECTOR

ACTIVIST

THEORIST

PRAGMATIST

activist pragmatist1
Activist - Pragmatist

2nd commonest variant style

but they do things too quickly!!!

activist theorist
Activist - Theorist

REFLECTOR

ACTIVIST

THEORIST

PRAGMATIST

activist theorist1
Activist - Theorist

Not a common style

jump to conclusions

activist reflector
Activist - Reflector

REFLECTOR

ACTIVIST

THEORIST

PRAGMATIST

activist reflector1
Activist - Reflector

uncommon

But depending on the proportions, have the ability to reflect before they act = a good thing

appraisal now
Appraisal Now
  • Started April 2003, all GPs appraised yearly
  • Formative process
  • Mixed responses from GPs, depends on area
  • Aim to discuss previous year and plan learning objectives for the next
  • Produce PDP at end of the process
  • Review each PDP at next appraisal
  • You can choose appraiser from a list
  • Documents in 2 weeks prior to appraisal
  • Meet and discuss for 2-3 hours
  • Post appraisal documents to be signed off
  • Paid full day if a locum by PCT
revalidation
Revalidation
  • = The process by which a regulated professional periodically has to demonstrate their fitness to practice
  • Professional regulation is all about patient safety
  • Three purposes of revalidation?
purposes of revalidation
Purposes of Revalidation
  • Minimally acceptable care
  • Reassure patients and the public
  • Improve quality of care
revalidation1
Revalidation
  • MORI survey 2005: half thought regular assessments already!
  • Much delayed; 2005 proposed – now due launch April 2011!
  • 20% Drs revalidated each year, five year cycle per Dr
  • Some revalidated on 1 years work initially
why now
Why now?
  • Good Doctors, Safer Patients, CMO 2006
  • Dame Janet Smith report - Shipman
  • Public pressure
  • International examples USA, NZ, Oz
  • Revalidation for every health professional proposed
relicensure
Relicensure
  • License issued every 5 years by GMC
  • You should be registered now! Starts officially 16/11/09
  • Standards for relicensing based strongly on Good Medical Practice
  • New GP version of GMP out (July 2008) – new focus on CPD
  • Relicensure will only be problematic if fitness to practice concerns
  • Local GMC affiliates and “responsible officers” can raise concerns
  • Mostly seems a paper exercise if no concerns
recertification
Recertification
  • Every 5 years
  • For all on any specialist register
  • Run by relevant College
  • Based on standards in GMP
  • Each college has different CPD plans and requirements
  • Annual appraisal forms bulk of evidence
revalidation2
Revalidation
  • Satisfactory recertification and relicensure = Revalidation - simples!
  • Unsatisfactory
    • Appraisal feedback
    • PCO Responsible officer
    • Local group (RO, College member, layperson)
    • National Adjudication Panel
    • GMC affiliates
    • National Clinical Assessment Service
    • GMC fitness to practice procedures
    • Council for Healthcare and Regulatory Excellence
rcgp proposals for gps
RCGP Proposals for GPs
  • From Revalidation for GPs v3
  • Pilots 2009/10 Merseyside
  • Enhanced Appraisal will form basis
  • Collect evidence across 12 GMC attributes
  • Greater role for appraisers in validating supporting documents
  • Additional compulsory elements e.g. SEA, MSF, Complaints, Audit
documentation
Documentation
  • ePortfolio for GPs!
  • Currently annual appraisals/PDPs form evidence
  • GMP for GP’s will form standards – exemplary Vs Unacceptable
revalidation portfolio
Revalidation Portfolio
  • Basic details
  • Exceptional Circumstances
  • Evidence of appraisals
  • PDP’s from each appraisal
  • Review of PDP and reflection
  • Learning credits
  • MSF
  • Feedback from patients
revalidation portfolio1
Revalidation Portfolio
  • Causes for concern / complaints
  • SEA
  • Audits
  • Statement on probity and health
  • Evidence from extended practice
rcgp learning credits
RCGP Learning credits
  • RCGP managed CPD scheme
  • Members free, non members charged
  • Credit system for CPD
  • Scored by time and impact
  • Double credits if followed learning cycle
  • Includes reflections/reading etc
  • 250 credits needed over 5 years

for recertification

essential knowledge updates
Essential Knowledge Updates
  • Knowledge updates for credits released every 6 months by RCGP
  • Linked essential knowledge challenge, voluntary, 70% pass rate
  • Online now
  • Based on curriculum for GP and latest developments
role of appraiser
Role of Appraiser
  • Effective delivery of appraisal
  • Maintenance of standards
  • Develop and analyse PDPs
  • Validation of credits
  • Feedback on MSF
  • Feedback concerns to GP and RO if needed
role of responsible officer
Role of Responsible Officer
  • Senior doctor in healthcare organisation e.g. Medical Director
  • Advised by GP assessor and lay person
  • Access performance data about each Dr and assess revalidation portfolio
  • Appears satisfactory Vs Needs discussion Vs Substantial issues raised
  • National Adjudication Panel
  • GMC
money
Money!
  • Remediation will be biggest cost
  • RCGP think DOH should pay
  • Government thinking about it
minimum requirements
Minimum Requirements
  • 3 appraisals, 150 credits, 200 sessions over 5 years – 100 of which in previous 2 years before revalidation
  • Essentially 1 day a week over 2 years
  • Absence from work more than 2 years – re-entry course and assessments
sessional gps
Sessional GPs
  • 1/3rd of the workforce and growing
  • Most will manage fine
  • Some leeway allowed in extreme circumstances
  • Usually means doing video / CSA / MCQ instead of some elements
luddites
Luddites

Paper submissions not allowed!

what do you need to do now
What do you need to do now?
  • Protected by VTS/MRCGP until now
  • Plenty of material to date, all in ePortfolio
  • Read GMP for GPs
  • Record your learning and prepare well for appraisals
  • Ideally, write reflective comments after each learning activity
  • Consider doing an audit, SEA etc.
  • Take care if locuming – CPD trickier but revalidation still applies!
the good news
The good news!

Passing MRCGP counts as your first Revalidation!

summary
Summary
  • CPD to be much more scrutinised
  • Get used to learning cycles, reflecting/evaluating your learning
  • Record everything!
  • Annual appraisal the cornerstone
  • Recertification/Relicensure and hence Revalidation should follow easily for most good GPs