TRADITIONALLY, veterinary
CPD has centred on the
progressive development of ever
greater amounts of clinical
knowledge whilst ignoring much of
the non-clinical and integrated
skills that are so important to the
GP vet.
Whilst this might have worked in
the pre-internet era, the overload of
information now engulfing us and the
rapid changes occurring within that
information
over time
mean that the
landscape of
learning has
changed
dramatically.
We are still
very early in
the change process within the
profession compared to elsewhere.
Teaching clinical knowledge is an
important skill set and remains
popular because it is relatively easy,
enjoyed by recipients and relatively
cheap and predictable to provide
(though not necessarily cheap to
receive!).
For those working within limited,
specialised fields it may be more
important than those working in more
general fields where greater learning
agility is required when what is “right”
today may be completely “wrong”
tomorrow.
Whilst the non-clinical and
integrated skills are important with
both specialists and GPs, the primacy
within the GP field needs to be
stressed because it has been
overlooked in the past where
education has lagged behind market
need. This is reflected both in the
nature of the complaints being
received by the RCVS and in the
disturbing wellness issues facing the
profession.
Part of the shift needed is the
move from remembering discrete
boxes (or truckloads) of information
to coping with complexity, uncertainty and developing the skills to implement
and develop learning in real time in
the real world.
A lot of work has been done in
this field by the Human Systems
Dynamics Institute in the USA and I
would register my thanks to them for
the image reproduced here and some
of the content.
For this article we are going to
focus on just two dimensions –
confidence and flexibility – which, although relatively simple, are also
very important in the modern
dynamic learning landscape in that
they can be applied to virtually any
learning experience.
Confidence
Traditional veterinary CPD is almost
like going back to university:
information is packaged and presented
and the assumption is that it will be
absorbed intellectually, taken from the
room and applied effectively within
the workplace.
This is often not the case and, not
infrequently, this is because the
confidence of the participant is not
built to a suitable level.
Discussing with the participants
implementation within their own
workplace, sharing their thinking with
tutors, peers, even clients and tailoring
their thinking to their own context can
build confidence and reduce the
inevitable barriers that exist.
This moves them from the
dependence of
traditional classroom learning towards
more mature approaches and
ultimately to developing their own
“expert” status.
It is a simple fact that we will not
use what we are not confident with
and the development of an
appropriate environment to allow
implementation is essential.
Flexibility
As confidence increases, so flexibility
can grow and develop.
There is a basic difference in the
learning requirements of specialists
and GPs. Specialists need to know a
lot about a small number of subjects
and GPs need to know a little about a
lot of subjects. This is frequently
overlooked in CPD provision and can
seriously undermine the effectiveness when CPD provided is by specialists
for generalists.
Whereas learning within specialist
domains changes incrementally and
slowly, GP learning needs to be agile,
just in time and overload-proof. This
requires fundamentally different skills
and approaches and the development
of flexibility is central to survival, let
alone thriving.
GPs work within a complex fast-moving environment,
they need to be
flexible; dealing with
concepts, models and
methods, generalising
applications over a
variety of situations,
recognising and
respecting underlying
dynamics, teasing out
the pieces of
information and
knowledge that inform
decisions in particular
places and times.
Of course the same applies to
specialists but the more rigid
application of the scientific method
here simplifies things somewhat.
Ideally we should all work towards
becoming a flexible synthesis of both
approaches without allowing either to
dominate.
Figure 1 describes three “zones”
on the learning landscape but, of
course, it is not that simple in that any
individual can operate at multiple
positions on the landscape, variable
with domain, subject, skill and time.
They do, however, give an impression
of the progression from the
dependence associated with traditional
education and the independence of
self-directed GP.
Dependence
At this level, the learner has only just
begun to grasp the meaning and
usefulness of the concepts and
methods presented. The theory base may be murky, meaning that only
narrowly-defined tightly-described
approaches are appropriate and
learners need concrete instruction,
short-term projects and potentially
directive feedback and support.
Responsiveness
As the theory base becomes stronger
and experience is gained, confidence
grows, flexibility increases and concepts, models and
methods develop out
of that theory base.
Perspectives grow to
see diverse situations
and applications
developing the best fit
to current purpose.
Rather than the
one “right” answer of
the traditional system,
opportunities to
develop the “right”
answer in a particular
context develop. In this zone there is a need for larger,
long-term projects, greater freedom of
choice with more generalised feedback
and questioning.
Independence
In this zone, theory becomes
inseparable from application which
supports creative and productive
action. The learner is likely to be able
to develop new applications of the
concepts, creating new models and
adjusting fitness to purpose with
relative ease.
Traditional teaching approaches
are not required and in reality can be
detrimental. What is needed here are
“thought partners” who can help
them test and refine their ideas,
continuing to seek both true and
useful applications.
n If you would like to know more
about developing clinical (or other)
expertise, e-mail
chris.whipp@vetlearning.co.uk.
