Auldeen Alsop

Continuing Professional Development in Health and Social Care

Strategies for Lifelong Learning

Continuing Professional Developm

ent in Health and Social Care

SECOND EDITION

Continuing ProfessionalDevelopment in Healthand Social Care

Continuing ProfessionalDevelopment in Healthand Social Care

Strategies for Lifelong LearningSECOND EDITION

Auldeen Alsop, EdDEmeritus ProfessorSheffield Hallam UniversitySheffield, UK

A John Wiley & Sons, Ltd., Publication

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Library of Congress Cataloging-in-Publication Data

Alsop, Auldeen.Continuing professional development in health and social care : strategies for lifelong learning /

Auldeen Alsop. – 2nd ed.p. ; cm.

Rev. ed. of: Continuing professional development / Auldeen Alsop. 2000.Includes bibliographical references and index.ISBN 978-1-4443-3790-7 (pbk. : alk. paper) – ISBN 978-1-118-53954-5 (emobi) –

ISBN 978-1-118-53955-2 (epdf) – ISBN 978-1-118-53956-9 (epub)I. Alsop, Auldeen. Continuing professional development. II. Title.[DNLM: 1. Allied Health Personnel–education. 2. Education, Continuing.

3. Professional Competence. W 18]615.8′5150715–dc23

2012043160

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1 2013

Contents

Preface viAcknowledgements ix

1 Lifelong learning and continuing professional development 1

2 Regulation of allied health and social care professionals 12

3 The professional portfolio 22

4 The process of continuing professional development 34

5 Learning to learn 47

6 Learning with others 58

7 Learning in the workplace 68

8 Scholarly activity and research for the practitioner 84

9 Learning to write and writing to learn 101

10 Career development 114

11 CPD and career development for academics 125

12 Leadership and professional development 136

13 Learning strategies and CPD for support workers 146

14 Learning for leisure and pleasure 153

Index 159

Preface

A considerable number of changes have occurred with regard to the regulation ofhealth care professionals and the environment in which they work since the pub-lication of the earlier book on continuing professional development (Alsop, 2000).The new regulatory body for allied health professionals in the United Kingdom, theHealth Professions Council (HPC), was established on 1 April 2002, superseding theCouncil for Professions Supplementary to Medicine (CPSM) that had been in placesince 1960. More stringent criteria for the regulation of the existing 12 professionscame into force with the advent of the HPC. Over time, the HPC set up standards ofeducation and training, standards of proficiency for each profession, standards of con-duct, performance and ethics and standards for continuing professional developmentfor the allied health professions. Over the last 10 years, a number of other professionshave been admitted to the HPC register after fulfilling the strict criteria for entry. Amore significant change came in August 2012 when social workers were admitted onto the register and the HPC (after legal ratification) changed its name to the Health andCare Professions Council (HCPC) to reflect the new mix of registered professions.The number of professions now regulated by the HCPC is 16, and no further entrantsare expected. All changes since 2002 have placed significantly more responsibilityon the regulated practitioners to take steps to maintain their competence to practise.

The regulation of health and social care practitioners in other countries has alsoseen some changes, particularly in Australia. South Africa has had its own HPC forsome time. The United States and Canada have licensing systems that differ from stateto state or province to province. Australia has recently moved to a national regulatorysystem for the professions involved in delivering health care. Across the world, therange of health care professions that fall within the remit of a body responsible forregulation varies from country to country. All now have similar requirements for themaintenance of competence. Some countries such as Australia and South Africa alsoinclude students in their scheme.

Just as changes have occurred in regulation, changes have also taken place inthe employment context in which health and social care professionals practise, par-ticularly in the United Kingdom. Developments in technology and other workingpractices and financial constraints on service provision have required the professionsto do things differently and more autonomously. Being able to deal with change iscertainly on the agenda. No longer is the National Health Service (NHS) the onlysignificant employer of health care professionals. New working environments andnew business arrangements are being established that enable professionals to develop

Preface vii

practices that meet the needs of service users in very different ways and in a vari-ety of markets. Some new businesses and social enterprises have been formed byentrepreneurial professionals. Some have contracts with the NHS and some offerservices directly to the public. In the coming years, more of these services may wellbe established, offering more choices to service users and more directly meetingtheir needs.

These changes clearly impact on the ways in which health and social care practi-tioners now need to function. As Barnett (1994) has always advocated, professionalsmust be prepared to examine society’s changing demands and take steps to shapechange, embracing new practices and discarding outdated ones. It is important forprofessionals to have vision and be proactive in offering new types of services thatmeet current and future needs as changes continue to occur for the context of practice.Professional education has to prepare practitioners to develop new skills and qualitiesto meet changing demands. This is relevant not only for students of the professionsbut also for the professionals in practice. New schemes for continuing professionaldevelopment need to be developed to reflect the changes in practice and to enablepractitioners to develop the skills to operate in the new environments. Business skillsin particular are required to support practitioners in developing very different careerprofiles and to use their talents and skills creatively in a different way. As careeropportunities in public services wane for some health professionals, other opportu-nities become available. Professionals must thus make very different decisions aboutthe ways in which their career might progress and prepare themselves by developingnew skill sets for new opportunities in practice.

Although new requirements regarding professional regulation and maintenance ofcompetence have provided the impetus for continuing professional development, amuch wider perspective on learning should also be taken. Lifelong learning embracesimprovement of knowledge, skill and personal competence in order to participateactively within society across the lifespan and not just in working life. Therefore, thistext addresses the broader remit of lifelong learning, of which continuing professionaldevelopment is an associated part. Given the fast-changing nature of employmentin health and social care, professionals are advised not to limit their developmentactivities to those meeting the requirements of the regulatory body. Instead, theyshould take a wider view of their personal development and maximise their skills andcapacity to take advantage of new employment and career opportunities as they arise.Therefore, learning should take on a different meaning and not focus exclusively onthe requirements of the regulatory body.

Learning is an adventure. Learning takes us from the known to the unknown inorder to enhance our knowledge further. Reflection helps us make sense of otherwisesenseless situations and helps us make links between otherwise disparate entities.Learning brings the previously impossible towards the potentially possible and gen-erates a better sense of self and self-belief in the process. Learning can be risky.Learning can be fun. Learning can transform us. It depends on the way in whichlearning experiences are allowed to challenge or guide us. As Souza de Freitas (2007,p. xxvi) suggested in her Foreword to Paulo Freire’s work Daring to Dream: Towarda Pedagogy of the Unfinished, ‘to dream is to imagine horizons of possibilities’. She

viii Preface

reinforced Freire’s argument of the need to find joy in learning through curiosity andcreative imagination. After all, imagination (according to Einstein) is more importantthan knowledge (Park, 2007).

Thus, the venture in this book is to focus once more on learning and learningopportunities in the widest possible sense. The current political climate now requiresus as individuals to take more responsibility for our own development, our lifelonglearning and our work and career efforts, in very uncertain times. The responsibilityhas been firmly passed to us to take steps to become fit for a place in the workforce, tomaintain and develop that fitness and to contribute to society. Those with professionalcareers have even more obligations with regard to public safety and for demonstratingongoing fitness to practise in the professional role. Steps have to be taken to sustaincompetence. This demands energy, initiative, inspiration, imagination and organisa-tion. It requires constant attention to the potential of ad hoc learning opportunitiesand a creative approach to developing and using opportunities that can meet needs,targets and aspirations. This book addresses the issues of informal and formal learn-ing and provides ideas for personal and professional development that not only keepprofessionals fit to practise but also stretch their imagination so as to fulfil personaldreams. The earlier edition of this book also referred to ways of making dreams areality. Success in any venture means building self-esteem, setting demanding goals,always being positive, establishing good habits, mastering the art of communica-tion, learning from role models, thriving under pressure, being persistent, learningfrom adversity and surviving success. Engaging in lifelong learning and not just inthe essential development activity to maintain competence in the job brings morechoices and more opportunities to diversify and maintain meaningful employmentthroughout the lifespan. Learning for leisure and pleasure ensures a meaningful lifebeyond the work role and into retirement.

References

Alsop A (2000) Continuing Professional Development: A Guide for Therapists. BlackwellScience, Oxford.

Barnett R (1994) The Limits of Competence: Knowledge, Higher Education and Society. TheSociety for Research into Higher Education & Open University Press, Buckingham.

Park P (2007) Foreword. In: Daring to Dream: Toward a Pedagogy of the Unfinished(ed. P Freire), pp xxxi–xxxvii. Paradigm Publishers, Boulder, CO.

Souza de Freitas AL (2007) Foreword. In: Daring to Dream: Toward a Pedagogy of theUnfinished (ed. P Freire), pp xxx–xxxiii. Paradigm Publishers, Boulder, CO.

Acknowledgements

I would particularly like to thank Zoe Parker, Education Manager (Lifelong Learning)at the College of Occupational Therapists, London, for her ongoing support and adviceduring the preparation of this book. Zoe has spent significant amount of time readingand giving invaluable feedback on draft chapters. In the course of writing the book,Zoe and I have developed a friendship that is reflected in Chapter 6, in the pieceon critical kinship, to which she made a particular contribution. I would also like toacknowledge the guidance I have received from Professor Martin Rice, Universityof Toledo, USA; Professor Susan Ryan, University of Newcastle, Australia; andmy colleagues at the University of Alberta, Canada, and at the University of CapeTown, South Africa. All have provided insights into their regulatory and continuingprofessional development systems. Finally, I should like to thank Claire Craig for hercontributions through many critical discussions about practice and particularly withregard to the use of technology.

Auldeen Alsop

Chapter 1

Lifelong learning and continuingprofessional development

This chapter addresses:

1. lifelong learning as an underpinning philosophy for all personal learning anddevelopment;

2. the nature of employment and competent performance in practice;3. definitions and meaning of continuing professional development.

Introduction

The Preface of this book sets out the premise on which this book is written. ThePreface acknowledges the need for health and social care professionals to remaincompetent in the work that they do and thus to be able to undertake their workwith service users competently and confidently within the constraints of an ever-challenging and ever-changing health and social care environment. However, thisis only part of the story as the Preface advocates learning to fulfil wider ambitionsthroughout life. This chapter is first and foremost concerned with lifelong learning, anotion that is more wide-ranging than continuing professional development (CPD).This chapter sets the scene for CPD by first offering a more liberal view of lifelonglearning as an underpinning philosophy for all personal learning and development. Itestablishes lifelong learning as a highly desirable activity for everyone regardless ofany legal responsibilities that come with being a health or social care professional.This chapter explores the advantages of taking personal responsibility for engagingin development activities for life.

Later chapters in this book explore the rationale for CPD in both a legal andprofessional sense and address various ways in which competence to practise canbe both maintained and advanced. It is worth looking beyond the constraints of thelegal requirements in order to explore the nature of learning and the advantages it

Continuing Professional Development in Health and Social Care: Strategies for Lifelong Learning,Second Edition. Auldeen Alsop.C© 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.

2 Continuing Professional Development in Health and Social Care

brings within a lifetime. Lifelong learning activities thus become personally desirableand meaningful activities rather than selected activities to confirm ongoing fitnessto practise. This book offers a source of information for all those wishing to learnto improve their career prospects and develop their competence for new roles andresponsibilities in their field of work or wider career. First, there is a need to explorelifelong learning as a background to all aspects of life in support of employment andcareer enhancement.

Lifelong learning

The concept of lifelong learning is considered to have come to prominence early inthe last century, although it is thought that the notion of learning through life goesback to the time of Plato (http://www.infed.org/lifelonglearning/b-life.htm; accessed10 September 2012). Lifelong learning is to be distinguished from lifelong educa-tion. Education essentially comprises activities normally planned by an educationprovider, whereas learning is viewed as a cognitive process internal to the learner.Learning occurs through both incidental learning experienced by the learner andby the learner engaging with planned educational experiences, thus through bothinformal and formal learning opportunities. Lifelong learning is said to foster thecontinuous improvement of knowledge and skills for personal fulfilment as well asfor employment. Often, lifelong learning entails the learner drawing on a mixtureof educational programmes and informal learning to develop both capability andpotential for managing all aspects of life, including formal employment as desired.

Lifelong learning has been variously defined. One of the more neutral definitionscomes from the European Commission. It states that lifelong learning is:

all learning activity undertaken throughout life, with the aim of improving knowledge,skills and competence, within a personal, civic, social and/or employment-related per-spective (European Commission, 2001, p. 9).

This definition embraces all learning, both formal and informal, that occurs frombirth to old age and is not specific to learning for or in employment. There are manystages of learning throughout life. Initially, we use innate senses to set us on the roadto survival and development, but very early on in our existence, our efforts becomeincreasingly more focused in order to meet personal needs and goals. These needs andgoals change over time and our learning capacity extends to cope with the changingdemands of work and family life. Informal learning at home and compulsory formaleducation in school provide us with the grounding for future life and, for manypeople, the academic qualifications that will form the entry requirements for morespecialised education and training. According to Brownhill (2001, p. 73), educationand learning are transformational, ‘developing an individual’s capacity to be a rationalautonomous person who respects others . . . this is achieved mainly by the processof learning and self-reflection on that learning’. Lifelong learning thus supports usthrough all stages of life. It underpins the self-fulfilment of each person and not justthe requirements of competent performance in a professional role.

Lifelong learning and continuing professional development 3

The attributes and qualities of the lifelong learner have been researched (Candy,2000) and are perceived to be as follows:

� An enquiring mind� ‘Helicopter vision’� Information literacy� A sense of personal agency� A repertoire of learning skills� Interpersonal skills and group membership

However, these attributes are more likely to be recognised within a formal academicenvironment rather than through working relationships within informal settings. Indi-viduals may still possess these skills even if they go unrecognised. An enquiring mindmay lead naturally to personal development through learning from experiences. Thosewith a sense of personal agency will take steps to engage with new projects and newventures. They will gather information and use problem-solving skills to developtheir capacity to progress in their endeavours. People who value learning will do sofor self-fulfilment often without recognising that they are also developing themselvesas autonomous lifelong learners. For example, many people in retirement continuelearning for self-fulfilment. As far as learning capacity is concerned, those who candraw on a variety of personal learning strategies will benefit most from differentlearning experiences. Working with others offers opportunity to engage in mean-ingful conversations and gain different perspectives on new experiences. Every newexperience helps build capability for use in later situations.

Lifelong learning is thus wider than making an effort to maintain competence topractise in the professional role. It supports career development and other significantlife changes. Lifelong learning thus spans a wide range of education and traininginitiatives and informal learning opportunities to promote the development of newknowledge and skills, flexibility, creativity, adaptability, preparedness for career andlifestyle change and self-fulfilment at any time of life. Changes may also embracetime out of paid employment, for example maternity leave or the resumption ofa career after a career break. They may include changes following redundancy orprogression into retirement. Lifelong learning experiences can help make a successof these transitions. A commitment to lifelong learning and CPD can help individualsto counteract the impact of change as well as prepare them for new roles within orbeyond a professional career.

Employability

A professional career commences with an education that prepares the individualfor a chosen profession or role in employment. Employability denotes a person’scapability of being employed in a job (van der Heijden, 2002) and is increasinglyused as a measure of success by universities, colleges and other education and traininginstitutions. These institutions are expected to ensure not only that graduates have thespecialist skills for their chosen trade or profession but also that they are accomplished

4 Continuing Professional Development in Health and Social Care

in key skills that will help them gain and maintain employment. Key skills arecommonly perceived as:

� communication skills;� teamwork;� skills of analysis;� problem-solving skills and creativity;� enterprise and self-management skills;� ability to work with technology.

Graduates should also have the incentive for lifelong learning. Education estab-lishments thus are expected to help further develop the skills that underpin lifelonglearning. Cheetham and Chivers (1999) initially referred to a selection of these skillsas the metacompetencies of competent performance recognised as common across allprofessions. They went on to define four areas of competence that would vary fromprofession to profession, namely (1) knowledge/cognitive competence, (2) functionalcompetence, (3) personal behavioural competence and (4) values and ethical compe-tence. A good grounding in the competence requirements of the chosen professionand well-developed employability skills should help secure the new graduate a job.Research has indicated that transition to another job depends more on the possessionof a wide range of professional skills and the capability to adjust flexibly to changingcircumstances (van der Heijden, 2002). A focus on developing professional expertiseis thus important for career mobility. Those with career aspirations need to ensurenot only that they remain fit to practise but also that they develop their professionalexpertise beyond the level of initial competence to practise. Employability is thus aphenomenon that draws on lifelong learning to show the ongoing development andapplication of key skills in more challenging areas of practice.

The professional career

Definitions of career have changed over time. Arthur et al. (1989) adopted thedefinition of career as ‘the evolving sequence of a person’s work experiencesover time’ (p. 8). This definition provided a ‘moving perspective’ that the authorsconsidered important, and that acknowledged personal growth and changes overtime, and the relationship between a person and a changing society. In 2002, Hallnoted changes that had taken place, particularly in relation to organisational changeas workplaces grew, merged, downsized and otherwise reinvented themselves,impacting significantly on the workforce. The new term protean career (Hall,2002) came to suggest a greater emphasis on the needs of the person rather thanthe organisation and an acknowledgement that change of employment over timewas becoming the norm. Changes in career direction became acceptable practice,offering opportunities for individuals to seek a greater sense of meaning and purposein their working life. Work–life balance also gained momentum and came to have abearing on employment decisions. Part-time employment became the choice of someemployees who just wanted greater freedom in their life to pursue other interests

Lifelong learning and continuing professional development 5

beyond work. Generally speaking, however, opportunity to create personal securityin work came from the development of skills and an ability to learn rather than fromreliance on organisational need. A belief in one’s own talents and capacity wouldallow for more risk-taking. Any uncertainty about jobs drives the need for lifelonglearning. Practitioners must take responsibility regularly to review their situationindividually, with a mentor or through work appraisal, and consider their longer termfuture. Relevant personal and professional development opportunities can then beplanned. These matters are further addressed in later chapters.

Portfolio careers

Handy (1990) coined the phrase ‘portfolio people’, denoting those people who had aflexible approach to using their time productively. Just as Arthur et al. (1989) vieweda career as a sequence of jobs, Handy saw the merits of individuals having a varietyof employment options, that is, a portfolio of different types of work that could beundertaken simultaneously. Some employment might be paid work and some mightbe unpaid. For example, undertaking further study or engaging in creative activity orvoluntary work might not necessarily contribute to income generation. These mightbe elective activities that meet a different need and offer personal fulfilment. Someactivities, such as gaining an educational qualification, may provide the groundworkfor generating income in a different career at a later date. The political context ofwork can, from time to time, mean that employment is hard to find. Even thoseworking in health or social care environments may not be immune from redundancyif new policies demand reorganisation or where financial savings must be made bythe employing organisation. Professionals finding themselves without employmentwill need to review their options for future employment and the most productive wayin which their unique talents may be used. Working flexibly in different paid and/orunpaid occupations may be the best option at the time, rather than one of choice.Some people may not be able to afford to pursue a portfolio of activities as a full-timewage may be important. For others, particularly health care professionals, a portfolioof different types of part-time paid employment may offer much needed financialreward and also enhance job satisfaction. For example, part-time employment in ahealth or social care organisation and part-time private practice might bring a full-time income. As Handy (1990, p. 214) remarked, ‘The redefinition of work in modernsociety is changing the way we look at our lives and at our priorities.’ Any changes toemployment in services governed by politics are unpredictable. Strategies for lifelonglearning must have their place on the agenda of any health and social care professionalworking in such organisations. Not only can lifelong learning experiences helptransform jobs into exciting careers as they inform the development of new practicesand bring benefits for employers, but they can also help prepare professionals fornew challenges and opportunities that economic or political changes might bring.

In an uncertain financial climate, planning for a future in retirement is even moreimportant. An ageing population has meant that some governments have increasingexpectations that individuals work well into their 60s and possibly their 70s before

6 Continuing Professional Development in Health and Social Care

they are eligible for a pension and that they plan for their retirement. The nature ofemployment may well change as we get older and a portfolio approach to using timeproductively in different ways may well assist the transition that inevitably must bemade. The portfolio career enables individuals to maintain control of their workinglife, to plan for and adjust to different stages of their life, to engage in different typesof activities that bring different kinds of pleasures and rewards and to manage all thetransitions that might be expected for a productive life and retirement.

Given the many changes in the environment and the world of work, in individuals’expectations of a career and in relation to the ways in which individuals may chooseto spend their time, it is not surprising that other definitions of ‘career’ have beencoined. In a review of the term ‘career’, Hall (2002) suggested that it had variouslybeen seen as follows:

� Advancement, that is upward mobility of a person within an organisation.� A career, that is advancement within a profession as a career.� A lifelong series of jobs irrespective of the type of occupation or direction of

movement.� A lifelong sequence of role-related experiences that includes paid and unpaid roles.

Hall acknowledged a shift towards focusing on the process of a career and increas-ingly on a person’s right to make choices about employment opportunities. In thisrespect, values and attitudes come into play. The definition that emerged for Hallwas that a career is ‘the individually perceived sequence of attitudes and behavioursassociated with work-related experiences and activities over the span of the person’slife’ (Hall, 2002, p. 12).

Thus, work meets numerous personal needs, not just physiological and safety needsbut also affiliation, achievement and self-actualisation. However, in order to do this,it is up to individuals to take responsibility for decisions associated with work andother roles. Some decisions may require forward planning and some may demandrisk-taking. The choice rests with the individual who is ultimately viewed as an activeagent in making choices regarding their career and their career development. A careercan go through different stages throughout life as personal circumstances and valueschange and also as the external environment changes (Woodd, 2000). For this reason,Woodd advocated the need for individuals to continuously review and update plansfor career development. Meeting the CPD requirements of the regulatory body willenable professionals to keep practising, but will not necessarily ensure employment.Lifelong learning strategies that enable individuals to develop and grow place them ina stronger position for ongoing employment or for venturing into self-employment.

Ethics and quality of care delivery

CPD has so far been considered as a regulatory requirement that health and socialcare professionals keep up to date with their practice. Each professional may also besubject to a code of ethics set out by their professional body. Both professional andregulatory bodies tend to have standards or statements that reflect their requirements