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281 Hans Karle, Greg Paulos, and Dennis K. Wentz chapter 24 Continuing Professional Development: Concept, Origins, and Rationale The move toward using the term continuing professional development (CPD) to replace the traditional term of continuing medical education (CME) is now a global movement and has huge implications for all stakeholders involved in the education of practicing physicians. It is regularly used today throughout the world as the preferred term for adult physician learning and continuing medical education, but its true significance is often obscure. This is the story of how CME is being transformed to being a subset of CPD. Origin of the CPD Concept The use of the abbreviation CPD for continuing professional development received increasing attention in the United Kingdom in 1993 when it was formally proposed for use by a governmentsponsored Standing Committee on Postgraduate Medical and Dental Education (SCOPME), chaired by Dame Barbara Clayton, MD. SCOPME was established in August 1988 to advise the UK government on the delivery of postgraduate medical and dental education in that country. The members were appointed by the Secretary of State for Health on advice from the Chief Medical O≈cer and the Chief Dental O≈cer. Although the committee was disbanded at the end of March 1999 due to a ministerial decision, during its term of operation it found that the educational needs of practicing doctors and dentists were more complicated than expected. Early on, SCOPME realized that the traditional CME approach no longer covered the whole of a doctor’s or dentist’s educational and career development needs in modern health care. It cited examples drawn from experiences within the National Health Service (NHS) where the following new learning needs were among several identified: ≤ Managers of NHS trusts want changes in skills or practice to underpin new service developments. ≤ Shared care across the primary/secondary care interface and between NHS trusts and general practice makes teamwork essential. ≤ Clinical audit—another new activity—is by nature multi-professional and presents new challenges. ≤ General practitioners are increasingly expected to understand areas such as information technology, population medicine, management, and communication skills. In its final report, SCOPME wrote: These requirements do not correspond, however, with the traditional specialist definition of continuing medical education. Change, whether rapid, discon- 282 emerging themes and forces in cme tinuous or incremental, more often than not means altered responsibilities for doctors and dentists. Wider roles, changing professional responsibilities and career development become important. Professional functions evolve or are adapted, but even more extensive role changes—sometimes even whole new career directions—may be needed. The prudent professional has to be responsible for mapping the clinical, organizational and social changes and negotiating a way through them.∞ The SCOPME report was a working paper titled ‘‘Continuing Professional Development for Doctors and Dentists.’’ Leading up to its publication , SCOPME carried out ‘‘a wide-ranging consultation about CPD, of which CME is an important part.’’ The committee concluded that traditional specialty-based CME does not meet all of the needs of doctors and dentists. It stressed that use of the term CPD would have major advantages, and that within CPD there should be ‘‘(a) strategies for personal coping and professional growth, career development, and role adaptations, (b) [education in] ability to manage , and (c) [education and training in] multidisciplinary and multi-professional working and learning.’’≤ Also important to this story was a special conference—‘‘Continuing Medical Education in Europe: The Way Forward through European Collaboration’’—held at the Royal College of Physicians in London, in March 1995. The conference was chaired by Sir Leslie Turnberg, president of the Royal College of Physicians, and brought together 31 faculty members and 149 delegates from most countries in Europe as well as the United States and Canada. Clayton, representing SCOPME, presented the recommendations brought forward by the committee, and these were debated by a subgroup of the attendees led by R. D. Atley of the Royal College of Obstetricians and Gynaecology in the United Kingdom. One of us (Dennis K. Wentz) served as the working group secretary and reported, ‘‘In conclusion, we feel that the term CPD best encompasses the total development of the individual doctor from medical student to retirement. It includes all that was in the term CME, in fact CME should and will remain a very important part of CPD, but CPD goes beyond to encompass self-appraisal, career development, personal coping and professional growth. And we believe the profession should take the lead in enunciating its...

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