Recommendations for practice

11.7 Recommendations for practice

Based on the work of previous authors (e.g. Brockett & Hiemstra, 1991; Brookfield, 1995; Cranton, 1996; Merriam & Caffarella, 1999; Houle, 2001; Merriam, 2005; Jones & Jennings, 2007) and on the findings from this study; sonographers should display the following qualities in relation to their CPD in order for the CPD to be most effective:

x Motivation and desire to learn and enhance professional practice. x Responsibility for own learning. x Reflection/critical reflection on needs for learning. x Planning of learning. x Participation in learning activity. x Evaluation and review of learning activity. x Passing on new found knowledge to others. x Enhancement of personal practice. x Reflection.

This study found that, whilst some desirable elements for CPD are present at the moment in sonographers’ CPD habits, such as a desire to learn and enhance the profession and the passing of new found knowledge on to others, other elements are missing or limited, such as reflection, critical reflection and planning. Another factor, responsibility for learning, was understood by some participants to be a part of CPD. This study also found that common complaints about the Australian sonographer CPD system included having to collect points rather than choose appropriate activities, inflexibility of the scheme and a tendency towards inappropriate activities. Pertinent comments came from two of the interviewees, whereby they felt that CPD needed to be adjusted so that it catered for different needs and circumstances, so that the mechanism of the CPD actually fitted the sonographers’ circumstances. In addition, one felt that the structure didn’t fit in with differing circumstances in a sonographer’s profession, for example, if one was an educator This study found that, whilst some desirable elements for CPD are present at the moment in sonographers’ CPD habits, such as a desire to learn and enhance the profession and the passing of new found knowledge on to others, other elements are missing or limited, such as reflection, critical reflection and planning. Another factor, responsibility for learning, was understood by some participants to be a part of CPD. This study also found that common complaints about the Australian sonographer CPD system included having to collect points rather than choose appropriate activities, inflexibility of the scheme and a tendency towards inappropriate activities. Pertinent comments came from two of the interviewees, whereby they felt that CPD needed to be adjusted so that it catered for different needs and circumstances, so that the mechanism of the CPD actually fitted the sonographers’ circumstances. In addition, one felt that the structure didn’t fit in with differing circumstances in a sonographer’s profession, for example, if one was an educator

At no time have any professional bodies in Australia used an outputs based CPD scheme (Friedman & Mason, 2007). Whilst some have elements of one, for instance, the use of portfolios, these are used as part of the points quota. Mandatory schemes, using an inputs base, were primarily designed and introduced to keep professionals up to date with practice (Cervero, 2000). However, it is suggested and recommended by some that, in fact, CPD should have a broader base than to just keep current with practice alone (Fleet et al., 2008; Friedman & Phillips, 2004, 2008; Jones & Jenkins, 2007). According to these authors, CPD can include the personal, social and political aspects of the profession; also, CPD should encourage reflection and identification of needs.

In the UK there has been a marked trend towards outputs based CPD schemes, which is evident in the health professions. Chapter 1 described the CPD model currently used for radiographers and other allied health professionals. This UK model utilises virtually all the same activities or types of activities for CPD that are included in the Australian sonographers’ scheme. The main difference is that the responsibility of the choice of activity lies with the professional and it is up to that professional to plan and evaluate each learning activity; showing what value has been gained from each activity and how it has contributed to practice. The professional is not required to demonstrate collection of a set quota of points from CPD activities; rather, they do need to demonstrate and document a well-rounded approach to CPD which has demonstrable outcomes. At this time, according to Friedman and Woodford (2008), this CPD model is still in relative infancy and, generally speaking, greater resources are needed than for an inputs based scheme. In addition, they feel it may be difficult to judge if the outcomes of the CPD really do impact on patient care. However, the same could be said regarding outcomes with inputs based schemes.

This UK model would, I feel, help to address some of the main drawbacks of the current CPD scheme for Australian sonographers. In the first place, sonographers would need to reflect and plan for their learning. Secondly, they would need to reflect on their learning and demonstrate outcomes of their learning. These are lacking at the present time and are unlikely to be addressed in the current system. As has been shown, the present CPD system for sonographers in Australia can be quite rigid and lacking in flexibility. It does not allow for different circumstances and career paths to be taken into account fully and perhaps has allowed the burgeoning of too many activities that have little benefit to a proportion of sonographers.

Findings from this study, both from commentary on the survey and from interviewees identified several other strategies for the support of self-direction in CPD. These strategies have been identified in each appropriate chapter according to element and are tabulated below in Table

Table 11.1: Strategies for Australian sonographer CPD Element - Belief in the value of

Strategies to support CPD CPD

• Education regarding the reason for • Mandatory CPD

mandatory CPD i.e. regulatory and • Professionalism

motivational reasons • Poor recognition of profession

• Education on the meaning and value of • Necessity of keeping up to date

professionalism and CPD’s role in this. • Necessity of broadening horizons

• Code of ethics

• Bureaucratic agencies • Self-promotion and promotion by • Outcomes of CPD

professional associations • Education on the value of new

knowledge • Education about the benefits of broadening the CPD base • Simplify and improve the official

procedures • Promote critical reflection on CPD and

practice • Promote peer review

Element - Barriers to Strategies to support CPD Participation

• Use of outcomes based CPD • More funding from government

• Rural and remote – distance – cost agencies for CPD, possible • Rural and remote – female

scholarships, provision of more mobile • Work load

CPD activities (travelling workshops) • Lack of personal time

• Recognition of (usually) female family • Lack of flexibility/points capping

responsibilities by management – • Lack of quality courses, repetitive

allows scheduled work time for CPD • Reduce work load by employment of more staff, may need government sponsorship to entice personnel to rural areas

• Allow suitable appointment scheduling • Sonographers encouraged/taught to

plan ahead using calendars • Introduction of internet based interactive activities • Monitoring and regulation of work place training –accreditation of work places as training centres

• Introduction of peer reviewed conferences and seminars • Encouragement of disengaged sonographers to engage in planning for activities and presenting at activities

• Introduce courses that teach, encourage broader base

Element – Reflection – self-direction

• Promote critical reflection by use of outcomes based professional • Reflective

development

• Non-planning of activities • Management recognition of • Work load, too busy for reflective

responsibilities - allowing time for CPD practice

• Training by trained personnel • Planning and evaluation

• Promotion and coaching in critical • Critical reflection

reflection

• Mandatory CPD • Teach sonographers planning • Rural, remote single-handed

strategies

sonographers • More online activities in the form of virtual chat rooms • Interactive activities such as webinars • Mentoring

• Exchange programs

Element – Motivators Strategies to support CPD

• Sustain by encouragement and support • Job satisfaction.

from management, peers and tutors • Patient well being.

• Management recognition of the benefits • Lack of work place recognition and

of a supportive work environment support.

structure

• Unmotivated sonographers. • Management understand the • Lack of professional recognition

underlying principles of CPD • Lack of confidence.

• Fair rewards

• Constrained • Fairer attainable workloads • Encouragement from tutors and seniors

and management • Demonstrate the benefits of CPD, such as confidence and empowerment • Marketing of profession • Learning and sharing with other

professionals • Encourage to present and write about cases or research • Education to broaden horizons and

knowledge base