Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH		Volume 28 (1) Volume 28, Issue 1, Winter 2008 J Contin Educ Health Prof 2007; 28(1):32-37 FOUNDATIONS OF CONTINUING EDUCATION Self-Assessment in CPD: Lessons From the UK Undergraduate and Postgraduate Education Domains. Dornan T A b s t r a c t UK continuing education is moving from credit-earning, taught continuing medical education (CME) to a continuing professional development (CPD) system that explicitly links education to change in practice, managed and monitored through mandatory peer appraisal. Alongside multisource feedback and consideration of issues of poor performance, satisfactory personal development planning will be required for relicensure and recertification. That system gives self-assessment, in the guise of reflection, a central place in personal development. This article uses instances of directed self-assessment drawn from undergraduate and early postgraduate medical education to consider how a positive system of self-assessment and professional self-regulation could be operationalized. It explores why medical students made avid use of an e-technology that presents the intended outcomes of their problem-based curriculum in a way that helps them seek out appropriate clinical opportunities and identify what they learned from them. It contrasts the experience of early postgraduate learners who, presented with a similar e-technology, found it hard to see links between their official curriculum and their day-by-day learning experiences, at least partly because the intended outcomes it offered were remote from what they were actually learning. Any extrapolation to CPD must be very tentative, but I advocate continued exploration of how best to use e-technology to support and structure (ie, direct) self-assessment. Direction could originate from consensus statements and other well-defined external standards when learners lack mastery of a domain. When learners must respond to institutional demands, direction could be provided by corporate goals. In areas of mastery, I propose learners themselves should define personal standards. In areas of difficulty, external assessment would take the place of self-assessment. Lessons for Practice United Kingdom continuing education is moving from a system that primarily rewarded being taught to one that is more explicitly linked to change in practice. Inclusion of satisfactory personal development as evidence to support relicensure and recertification calls for clarity in the place of self-assessment. The term directed self-assessment refers to self-assessment activities informed by external resources such as preceptors and practice guidelines and influenced by practice context. Research from Manchester has shown how an e-technology can present undergraduate medical students with the intended learning outcomes of their problem-based curriculum in a way that supports self-assessment. Early evaluation of a similar e-technology in the United Kingdom’s new early postgraduate Foundation Programme suggests that the intended learning outcomes, as stated in the official curriculum, are rather remote from learners’ actual work-based learning and not fully supportive of self-assessment. External guidelines for directed self-assessment in CPD might be as follows: - When learners lack mastery of a domain: consensus statements and other welldefined external standards - When learners must respond to institutional demands: corporate goals - In domains of mastery: personal standards defined by learners themselves - When a learner’s practice is in question: external, rather than self-assessment
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