Manage your personal development plan
Personal development plans (PDPs) are with us. PGEA has not been shown to adequately meet the needs of individual GPs or the NHS.
This guide is a practical overview of how best to apply PDPs to your professional practice and your own development.
This should be a frequent process, not an end-of-year panic. It should be a fluid, practical tool to help you plan your development, and not a sterile document.
So get your PDP started now by following these four simple steps.
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Step 1
Get started
If you have not already begun work on your PDP, grasp the nettle now and get started - especially if you wish to claim PGEA.
There are plenty of books and templates available to help you plan your PDP. Look at the templates on offer, or those of your colleagues. You may choose as a practice or primary care organisation to use one model. If not, you could cherry-pick the components that suit your own style. Such a hybrid would be a truly personal PDP.
Once you have a model you can work with, you need to develop systems to fit it into your regular practice. This could be a folder close at hand in your consulting room, a notebook or even a folder kept on your personal computer.
Whichever, it needs to be something you can dip into readily rather than a major chore that you put off until the deadline becomes desperate. Doing this will make the PDP process much less arduous than it could be.
Any regular reader of Doctor will know that GPs are under attack on all sides. Whether it be the primary care organisation, clinical governance visits, revalidation portfolios or Commission for Health Improvement inspections, it is highly likely that GPs will be asked to provide detailed evidence of their professional practice and development.
If GPs are cognisant of all of these issues as they develop their PDPs, they will save themselves much effort. I propose that GPs develop personal portfolios. Included in these should be the evidence needed for revalidation, and personal and practice plans.
The relevant elements could then be extracted as required. This flexibility will be essential, as there will be aspects of your personal reflections that you would not wish to share with the GMC.
Unless you have this security, your personal portfolio will be sanitised and therefore of far less practical use in your development. Confidentiality is essential. Indeed, you may wish to ask those reviewing your PDP (for example, your GP tutor) to sign a confidentiality agreement.
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Step 2
Identify learning needs
Historically, GPs have attended meetings about topics that they enjoy or feel confident about, considering other areas less often. While this is cosy, it can hardly be considered fulfilling. PDPs should address GPs' learning needs and the needs of those they serve. At times it will be challenging.
This is an area in which many of us have little experience. Yet we can all accept its value. How often have you left a lecture feeling that you learned nothing new? Was it a poor lecture, or should you have been elsewhere?
There is no perfect way of identifying need - different GPs could use different methods. A simple approach is to consider: who and where am I, where do I wish to be, how will I get there, and how will I know that I have got there?
Completing a personal profile will help you reflect on your current position and on how you reached that position. This could be brief, or as detailed as a curriculum vitae. You may also wish to consider including a review of your past education, including PGEA points gained and reflecting on what was learnt.
A practice profile will serve a similar purpose and also help you think about the aims and direction of the practice. As part of the practice profile, the practice team may wish to consider a health needs assessment. This could be based on the epidemiology of the population.
It is worth remembering that health visitors are trained in practice profiling. To enlist the help of other professionals will bring a new perspective, and may identify areas of knowledge which you had not considered.
It is worth considering national and local priorities. National priorities can be gleaned from sources such as national service frameworks. If you would rather not read the originals, see the NHS Alliance website at www.NHSAlliance.org.
For local priorities, your primary care organisation should have provided you with copies of and, ideally, consulted you on the health improvement plan and the primary care investment plan.
You may also wish to consider your patients' views. Many practices employ patient satisfaction surveys. In addition to asking about the services offered, these could be expanded to consider patients' desires and needs. While these are other people's agendas, they may suggest other areas to you.
Next it is worth considering your clinical practice. Some aspects of this are already becoming the norm, such as audit, PACT data and significant event monitoring, but you could consider other methods such as a diary of the last 100 to 200 patients that you have seen, referral rates and peer review.
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Step 3
Plan and address your learning needs
For most GPs, keeping up to date throughout their careers is not easy - indeed it is a major challenge. There are many different ways to learn, and GPs learn in many different ways.
You could evaluate your preferred learning styles using a questionnaire, or you could consider your preferred methods of learning by evaluating your own educational experience.
You will not be surprised that few people learn well from role-playing, but equally I challenge you to evaluate how much information from lectures you actually learn and apply - although they may be useful for finding out new information.
In addition to attending lectures, workshops and small group work, many GPs have learnt from taking up posts as clinical assistants.
You could take this a stage further by sitting in on outpatient clinics or operating lists for minor surgery. As primary care organisations break down barriers between practices, you may also consider observing and learning from primary care colleagues.
You may wish to consider job rotation within your practice, or even swapping 'jobs' with a GP from another practice for a week or two. I fancy a week in Jersey, but doubt that their GPs would relish a week at my practice in Northampton, so I may have to settle for Wellingborough instead.
In addition to journal reading and journal clubs you may wish to participate in journal education programmes, such as Update Plus.
New media bring wonderful new opportunities. Examples include the University of Leeds' CALIPSO psychiatry CD-ROMs or the PGEA-approved online courses at www.UKpractice.com. With PCs appearing on GPs' desks to be used for NHSnet and clinical systems, new media is available at an increasing number of practices.
Two of my local colleagues needing to collect PGEA after maternity leave collected 38 hours of PGEA from UK Practice, learning about topics including malignant melanoma and diabetes.
The CALIPSO programme offers four interactive CD-ROMs to train GPs in general psychiatry.
It is important that in formally planning and then addressing your future development, you do not lose sight of the informal methods by which GPs learn.
There is much we can learn from our patients. I have learnt more about dementia from the carer of a sufferer than from any textbook or professor.
As for courses, I remain convinced that I learn more over coffee, or perhaps in the bar, than I ever do during the formal components.
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Step 4
Review and maintain your personal development plan
One of the failings of PGEA has been that for some GPs it resulted in an end-of-year panic, resulting in them attending anything they could find in order to obtain the last few points. You only have to look at the attendance figures for courses in March to see that this is so.
In view of this, there is now considerable fear among GP tutors across the country that they may receive everybody's PDPs to evaluate at the end of March.
In our area, we will each receive 100 to 200 PDPs to evaluate, approve and, more importantly, respond to constructively.
With just one session a week and other responsibilities, I expect this to take many months. Bearing this in mind, if you are going to need PGEA approval, then for your sake and your GP tutor's sanity do not wait until March to submit your PDP, as you will probably be disappointed.
In addition to staggering the submission dates, the PDP will be of much more practical value if it is a fluid document which is regularly updated throughout the year.
Whether it be adding a significant event, the results of an audit or evaluation of the outcomes of a learning experience, your PDP's value will be greater if you find the time to regularly review and update it.
Many people see the work involved in maintaining a PDP as a major chore. But it could be much easier if you spent ten minutes a week on it rather than many more hours once a year.
Perhaps, more realistically, you could spend half an hour on your PDP once a month, with a more detailed review perhaps quarterly.
The PDP will become a useful tool if it forms a regular part of your professional life, and if you view it as a tool rather than a chore.
At least once a year, the full PDP should be reviewed to ensure that future plans build upon each other.
At the same time, you will be accumulating evidence of your own development and hopefully recognising the true value of a simple and practical PDP.
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PDP resources
UPDATE Toolkits:
 | The Update Personal Development Plan. In my opinion this is the best PDP. It is simple, yet well-structured, easy to use and now available on the Internet, at www.DoctorUpdate.net. |
| The Update Personal Development Plan For Non-Clinical Primary Care Staff. If you use the clinical version, you may find it easier to collate information if your staff use this PDP from the same stable. |
| The Update Practice Professional Development Plan. Since this also also uses the same format, it may well make developing your PPDP easier. |
The above documents are all available from Update. For copies, call 020 8652 8878, fax 020 8652 8946 or e-mail GP-Update@rbi.co.uk.
| Professional Development - A Guide For General Practice, While R.
and Attwood M., Blackwell Science, 2000 This is a weighty book, but an excellent resource if you need ideas about how to develop your PDP. It may be worth buying a practice copy. |
| Continuing Professional Development In Primary Care - Making It Happen,
Wakely G., Chambers R. and Field S., Radcliffe Medical Press, 2000 This is a very practical book that manages the difficult task of drawing together the recent NHS changes as they apply to continuing professional development. In particular it bridges the gap between PDPs and clinical governance. |
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Summary
| Keep your PDP simple and short. You will be more likely to use it, and your mentor or tutor will appreciate it. |
| Remember SPAR: Simple; Practice-related - focus on your practice population to remain relevant; Achievable - if your goals are unrealistic you will be demoralised; Relevant - to you, your practice and the NHS. |
Step 1: get started
| Templates - use one or a hybrid of a few. |
| Create a portfolio that will serve many purposes. You already have enough to do - consider clinical governance and revalidation. |
| Use protected time to work on your PDP. |
Step 2: identify learning needs (methods and tools)
| Personal profile, practice profile, SCOT analysis (strengths, challenges, opportunities, threats), clinical areas. |
| The Work Of General Practice Questionnaire in Professional Development - A Guide For General Practice, While R. and Attwood M., Blackwell Science. |
| Audit, prescribing data (PACT), significant event monitoring, clinical (reflective) diary. |
| Referral rates, random case review, peer review, morbidity and mortality data. |
| Health needs analysis, patients' unmet needs (PUNs), doctor's educational needs (DENs). |
| Interesting patients, patient satisfaction surveys, patients' needs and desires. |
| Local NHS agenda, health improvement plan, primary care investment plan. |
| National NHS agenda, The NHS Plan, NSFs |
Step 3: plan and address your learning needs
| Review your own 'needs analysis'. Consider your own learning style and preferred learning methods. |
| Formal learning methods to consider - lectures, small groups, workshops, clinical assistant posts, OPD clinics, operating lists, sitting with other GPs, practice swaps, journals and books, journal clubs, research, audit, distance learning, Internet, CD-ROMs |
| Informal learning methods to consider - patients, colleagues, other social learning. |
Step 4: review and maintain your PDP
| Evaluate each learning experience. What did you learn? How did you learn it? Do you need to follow it up? Will you really apply it in practice? Would you recommend it to a colleague? |
| Your PDP needs to be a living, changing document. Regularly consider identifying learning needs, addressing learning needs and reviewing learning experiences. |
| Ensure your PDP evolves through a regular cyclical process. |