J Phys Ther. 2011;3:4-8.

Continuing Professional
Development within Physiotherapy-
a Special Perspective

Devdeep Ahuja.*
Introduction ABSTRACT
The demand for quality, accountability and efficacy of practice
Continuing Professional has highlighted the need for professionals to demonstrate that
development (CPD) has been they are keeping abreast of new knowledge, techniques and
defined as any process or developments related to their professions. The article defines
activity that provides added the basics of what constitutes Continuing Professional
value to the capability of the Development (CPD), explores the relationship between CPD
professional through increase and competence, draws on various studies on the effectiveness
in knowledge, skills and of CPD on physiotherapist learning and patient outcomes. The
personal qualities necessary paper also identifies the factors that encourage participation in
for the appropriate execution or act as barriers to CPD. Implications for future research are
1
of professional duties. The also discussed.
profile of CPD has risen
substantially across the Key words: professionalism, continuing professional
professions and in all sectors development, professional need.
of employment in recent years. Authors’ information:
The demand for quality,
accountability and efficacy of
*- Corresponding author. Rehabilitation Response Lead at
practice has highlighted the
Broadspire Rehabilitation Ltd. Milton Keynes, United Kingdom.
need for professionals to E-mail for correspondence: devdeepahuja@gmail.com
demonstrate that they are
keeping abreast of new the relationship between CPD, competence in order to
knowledge, techniques and competence and evidence improve performance at work.
developments related to their based practice. In addition, The basic principle
professions. There is a this paper reviews the current underpinning CPD is that it is
demand on healthcare CPD trends for individual to a professional as
professionals to critically physiotherapists report the per his/ her perceived goals of
review their skills and barriers that limit the development. It is a
knowledge, and continuously participation in and continuous process of
keep up to date with changes implementation of CPD, and analysis, action and review.
in practice. It includes clinical issues that should be This process needs to base on
proficiency as well as non- addressed for the future. identifiable outcomes of
clinical activities such as learning.
3
information technology,
What constitutes CPD?
management, and leadership
2 As defined in the introduction Though the regulatory bodies
and communication skills.
section, CPD is used to around the world have
describe the process to developed individual
This article aims to review the
maintain, develop and regulations and policies
underlying concepts of CPD
enhance skills, knowledge and governing CPD and its
within physiotherapy, explore

4

requirements from the
members, the recurring theme
is the acceptance of both
formal and informal learning
processes as a part of the
4-8
CPD. While the formal
learning includes working
towards a post graduate
certification and attending
courses, it also encompasses
informal learning opportunities
like peer review, journal clubs,
in service training, critical
reading, clinical supervision,
teaching and research as a
part of the CPD learning
process.
In a survey of musculoskeletal
physiotherapists in United
9
Kingdom, Stevenson et al,
found that ‘courses’ and ‘in-
service training’ were the most
common tools for informing
the clinical practice. A similar
survey of Irish
physiotherapists also included
‘clinical supervision’ as one of
the most important factors in
10
professional development.
Approaches to CPD
While various national
regulatory bodies having
adopted a mandatory CPD
4-8
requirement, which means
that the members have to fulfill
a minimum requirement of
CPD and maintain portfolios to
renew memberships, there
has been a continuous debate
as to whether CPD should be
11
voluntary or mandatory.
Mandatory minimum
requirement of CPD enables
professional bodies to
demonstrate competence of its
members and has been
preferred over re-examination,
but the proponents of
voluntary CPD postulate that it
is in conflict with self-learning
11
and self-motivation.
12
Clyne has postulated a third
J Phys Ther. 2011;3:4-8.
model which is the obligatory
CPD, wherein a professional is
strongly encouraged to
participate in CPD and it
affects the career progression,
but no explicit sanctions are
imposed for non-compliance.
Another model of CPD
performance is the reflective
practice which incorporates an
element of style within it,
outlining the necessity to
conduct and record the CPD
reflectively; it can be used in
combination with either of the
13
above three models.
CPD and competence
Professional competence has
been defined in a variety of
ways including the ability to
perform the task to a
14
prescribed standard,
acknowledging the need for
underpinning knowledge and
15
research, and appropriate
updating in line with
developments in professional
practice and thinking, research
findings, educational changes,
technological advances,
changing priorities in patient
care, contextual change and
16
legislative change.
While CPD can be seen as
relating to individuals’ interests
and plans for their personal
development and career
progression, however, it is not
be a guarantor of competence;
individuals might demonstrate
a strong commitment to their
professional development in
terms of the volume of activity
they undertake but fail to
address fundamental shortfalls
in their competence through
so doing.
This leads to a fundamental
question as to whether patient
safety and access to effective
care be assured and the
needs and interests of
individual professionals and a
profession be served?
17
Gosling has postulated that
this would be possible if the
approach taken to CPD
revolves around an outcomes-
based approach that focuses
on learning achievements and
benefits for patients, rather
than learning inputs or
process, and that encourages
individuals to relate their CPD
to identified learning needs
and to evaluate their learning
in terms of its impact on
patient care (whether directly
or indirectly).
Evidence for effect of CPD
within Physiotherapy
Recently, there have been a
number of studies which have
looked into the effect of CPD
on practice in physiotherapy.
18
Gunn and Goding in their
qualitative phenomenological
study to gain an insight into
individual physiotherapists’
experiences of CPD
concluded that undertaking
CPD improves confidence as
well as competence, enabling
individuals to form effective
therapeutic relationships with
patients and other members of
their teams. In a cross
sectional mail survey, Li et
19
al, found that participation in
arthritis related CPD courses
led to significantly increased
the expected number of roles
assumed by physical
therapists in management of
arthritis patients. In a
randomized controlled trial on
19 physiotherapists, Cleland et
20
al, demonstrated that
ongoing education for the
management of neck pain was
beneficial in reducing disability
for patients with neck pain
while reducing the number of
physical therapy visits. There
5

have been previous similar
studies as well, which have
shown beneficial effects of
CPD on clinical practice in
21-23
physiotherapy.
Even though these studies
demonstrate some positive
effects of CPD on clinical
practice, the results need to be
seen in the light on small
sample sizes and restrictive
methodology. In addition,
while formal learning has been
evaluated, there has been no
research on informal learning
activities. In addition,
attribution of improved
outcomes to CPD alone
presents considerable
methodological difficulties.
Participation and non-
participation in CPD
24
French and Dowds have
claimed that those
professionals most likely to
need participation in CPD
programs are the least likely to
attend. Some studies have
been done to look into the
factors that encourage
participation and those that act
as barriers to participation.
Motivation has been described
as a continual feature in
subjects willing to get involved
25
in CPD. Karp had concluded
that “Motivation is a casual
factor, the mediator and
consequence of learning” and
that “before learning can take
place, the learner must be
motivated”. This has been
recognised by CSP as well in
8
their briefing paper on CPD.
While acquisition of new
knowledge and competencies
remains the primary motivation
for CPD, softer gains like self-
esteem, morale, enjoyment,
job satisfaction, personal
confidence and reassurance
J Phys Ther. 2011;3:4-8.
have also been raised as
3
important motivators. Job
security has been highlighted
as another reason for people
participating in CPD. In most
of the developed countries,
there is some minimum
requirement for CPD to remain
5-8
on the professional register.
It has been shown that left to
their own conscience or if the
mandate was removed,
physiotherapists would
participate in lesser CPD
11
activities .
Another important factor is the
learning culture and aims of
the organization. It is
imperative that within the
context of aims and objectives
of the organization,
professionals’ needs and
learning goals are addressed.
It has been highlighted that
learning environment needs to
be established within an
organization for progression of
15
skills and competence.
Workplace support is an
important aspect and the lack
of it can be a major barrier to
CPD participation.
Along with the individual and
organizational culture, the
society plays an important role
in development of CPD
pathways. It is no longer
realistic to think in terms of
education, working life and
retirement as successive
phases of life, as the
knowledge acquired in the
early years becomes obsolete
at an accelerated rate. The
concept of lifelong learning in
society, by promoting
education and training
throughout the life cycle opens
up new prospects for shaping
and conduct of peoples’ lives
and for the way they manage
4
their work and culture .
There have been various
barriers highlighted in the
literature as contributors to
restriction on CPD. These
include time, finances, staff
shortage, family commitments,
lack of workplace
26-29
encouragement . As time
away from work can cause
loss of earning in private
practice or staff shortage in
teams, it can act as a
demotivator for the individual
or for the manager who has to
approve the course and
funding. The relevance of the
course to practice may also
influence a manager’s
decision to fund courses for
29
staff.
Though there is no published
resource as to the total cost of
CPD within physiotherapy, it
can a prohibitive factor which
can influence the decision of
the managers in course
30
approval.
Future Directions for CPD
The responsibility for CPD lies
at different levels including
individual, workplace and
professional bodies and
government. While the
governments need to give
utmost importance to CPD to
enhance patient care,
professional bodies have to
demonstrate that their
members are accountable,
efficient and effective through
CPD. Similarly, employers
would like to have staff with
appropriate skills and
knowledge to deliver
exemplary service. At an
individual level, a professional
need to understand the focus
and needs of the employer
and the requirements of the
professional registering bodies
to develop measurable
outcomes, ensuring that it is
relevant to their current
practice and future career
development.
6

In order to curtail the effects of
the identified barriers, flexible
learning systems and greater
accessibility to resources is
needed. In addition, it is
imperative that
physiotherapists are provided
greater education about the
CPD process and what all it
constitutes to allow them to
move away from the traditional
methods of formal CPD
towards innovative informal
learning methods.
This paper highlights the lack
of research on CPD in
physiotherapy, its effect on
clinical practice and career
development of
physiotherapists. Future
research needs to explore the
types of CPD activities being
undertaken by
physiotherapists and use of
sound research methods to
assess their impact on clinical
practice and patient outcomes.
Conclusion
CPD is an essential aspect of
the profession of
physiotherapy to maintain up
to date knowledge with
continuing development in
understanding of the theory
and practice of physiotherapy.
Various forms of CPD have
been identified and there is a
need for greater
understanding of the informal
methods of CPD to
complement the formal
learning. Future research
needs to incorporate sound
methodology to quantify the
effects of both formal and
informal learning and compare
their effects on patient related
outcome measures. In
addition, the perceptions and
attitudes of physiotherapists
towards CPD also need further
exploration.
J Phys Ther. 2011;3:4-8.
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ACKNOWLEDGMENTS

None

CONFLICTS OF INTEREST

None identified or declared.