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Revalidation, Relicensing, Recertification

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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Revalidation, Relicensing, Recertification

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  1. Revalidation, Relicensing, Recertification The Knowledge

  2. 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!

  3. Relicensing, Recertification, Revalidation

  4. 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

  5. How do I get there? Reflect and improve and record!

  6. Now for some background…

  7. What is CPD?

  8. 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.”

  9. 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

  10. 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!)

  11. Educational Needs Assessment

  12. 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.

  13. 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

  14. 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?

  15. 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

  16. The Cycle of Learning

  17. Honey and Mumford’s learning cycle and learning styles (Honey and Mumford, 1992)

  18. Learning Style Types

  19. What is the “normal” REFLECTOR ACTIVIST THEORIST PRAGMATIST

  20. Reflector Theorist REFLECTOR ACTIVIST THEORIST PRAGMATIST

  21. Reflector - Theorist Commonest variant style “Analysis to paralysis”

  22. Activist - Pragmatist REFLECTOR ACTIVIST THEORIST PRAGMATIST

  23. Activist - Pragmatist 2nd commonest variant style but they do things too quickly!!!

  24. Activist - Theorist REFLECTOR ACTIVIST THEORIST PRAGMATIST

  25. Activist - Theorist Not a common style jump to conclusions

  26. Activist - Reflector REFLECTOR ACTIVIST THEORIST PRAGMATIST

  27. Activist - Reflector uncommon But depending on the proportions, have the ability to reflect before they act = a good thing

  28. The Knowledge Part 2

  29. 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

  30. The Near Future…

  31. 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?

  32. Purposes of Revalidation • Minimally acceptable care • Reassure patients and the public • Improve quality of care

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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

  39. Documentation • ePortfolio for GPs! • Currently annual appraisals/PDPs form evidence • GMP for GP’s will form standards – exemplary Vs Unacceptable

  40. 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

  41. Revalidation Portfolio • Causes for concern / complaints • SEA • Audits • Statement on probity and health • Evidence from extended practice

  42. 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

  43. 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

  44. 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

  45. 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

  46. Money! • Remediation will be biggest cost • RCGP think DOH should pay • Government thinking about it

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