Continuing professional development
How different GPs approach and use PLAN.
Reflective learning is based on the belief that GPs can learn from their unique experiences, and each individual GP is in the best position to tailor continuing professional development (CPD) towards their own particular needs, aspirations and contexts.
The introduction of the RACGP’s planning learning and need (PLAN) quality improvement activity coincides with an increasing literature base of international best practice illustrating that reflective learning better ensures CPD is a planned, rational choice.1
A PLAN reflection
As a GP completes their identified learning activities within PLAN, they can then review and reflect on how the learning has gone towards meeting the outcome.
The final reflection occurs after the GP completes the previous four sections of PLAN: analysing their practice profile and identifying associated learning needs; reviewing the summary of learning needs; focusing learning on specific areas of needs; and completing activities relevant to the self-identified learning areas.
Each GP’s reflection will be unique, based on their own individual skills, practice profile and learning aspirations.
The reflection does not necessarily need to be long, but should demonstrate critical self-analysis against their previously identified learning outcomes.
The below examples of reflections show how GPs used an identical PLAN process but reached two entirely different learning plans and reflections.
PLAN and a full-time GP
Dr Wilson has been practising in a rural town for 20 years. Many refugees have moved to Dr Wilson’s area over the past two years and have started attending his practice, with patient numbers steadily increasing.
After completing the PLAN activity, Dr Wilson felt his general practice skills were up to date; however, he felt he would benefit from attending a comprehensive three-day general practice update with a focus on recent developments across a range of common general practice conditions. He also decided to attend a course on refugee health, which was an area he had identified as an emerging need for his community.
Later in the triennium, Dr Wilson’s local area was affected by bushfires and he found there was an increase in post-traumatic stress disorder. This led him to attend a course in the primary care management of stress-related disorders.
Dr Wilson’s final PLAN reflection may identify that although his initially identified learning activities were complete, the bushfire incident resulted in a change of his learning plan.
He noted that as new learning requirements arise he may need to adapt his learning plan to meet his community’s needs, and this is an area on which he will need to regularly focus in order to be able to provide the best services for his community.
PLAN and maternity leave
Dr Baxter recently returned to clinical practice following maternity leave. Having not been in practice for two years, she felt she could benefit from a ‘refresher course’ prior to coming back to the profession.
After completing the PLAN activity, Dr Baxter felt confident with most of her diagnostic and management skills, but identified that she needed to revise some procedural skills and knowledge of prescribing newer medications, and get some extra training in practice management systems, which were upgraded while she was on leave.
Following discussion with a colleague, Dr Baxter observed and revised some procedural skills, identified a course in therapeutics, and undertook training with administration and medical staff members to ensure she was using the new record management system correctly.
Dr Baxter also identified several other learning activities in her PLAN, which she completed over the course of the triennium. Her final reflection included a self-assessment of her confidence and how effectively she met her learning needs.
Do GPs have to complete activities in all areas identified in the practice profile and self-reflection?
GPs may identify a number of areas in which they want to expand their knowledge, but not all of those areas have to be documented in their PLAN activity. GPs can continue to expand their knowledge and attend educational activities on learning areas that are not added in their PLAN activity.
A minimum of five learning areas must be identified, documented and completed to complete the PLAN activity. Reflection on the outcomes is the key aspect of learning in PLAN.
GP not meeting learning outcomes
Dr Singh was an urban GP when he initially completed his PLAN, the learning outcomes of which reflected the needs of an inner-city patient population.
However, he moved away from the city in the middle of the triennium and began to undertake locum work in a rural location. This new work setting led Dr Singh to decide to complete courses in procedural medicine and Aboriginal and Torres Strait Islander cultural sensitivity.
In his final PLAN reflection, Dr Singh documented that his patient profile changed and some of his original learning outcomes were not met as a result. But he did meet a number of his new learning outcomes, successfully demonstrating his application of reflective learning based on the needs of his community.
Responsible reflective learning
Doctors’ professional responsibility to keep up to date with their medical and workplace knowledge can be an onerous one, especially in times of increasing accountability.
The RACGP’s PLAN quality improvement activity enables GPs to document, and therefore demonstrate, that they have systematically and critically reviewed their CPD on a regular basis.
Incorporating reflection into this planning process demonstrates that a GP is using best practice approaches to maintain and improve their skills to meet the needs of their community.
- Grant J. The good CPD guide. New York: Radcliffe Publishing, 2012.