Picturing the Future by Framing the Past: Approaches to Contemporary CPD

Introduction

The 21^st century has seen the emergent need for continuing professional development (CPD) within the health and medical professions to address not only the individual needs of clinicians to ensure their knowledge is current but that it serves a greater collective purpose in relation to the healthcare workforce (Lewis, 2023). From a theoretical perspective, seminal epistemological theories of learning remain unchanged but the challenge of how best to facilitate disciplinary experts in remaining motivated and passionate about learning opportunities amidst the pressures of their daily workloads remains an issue for address. Time and fiscal resources are the two attributable factors to engagement in practice, but this does not detract from the passion that most healthcare practitioners demonstrate in the context of patient centred care, where applied knowledge is fundamental to optimal healthcare outcomes.

The foundation of Social Learning Theory rests on the theoretical basis of experiential learning and where the work of constructivist theorists such as Vygotsky still has resonance today (Rapanta, 2023). Whilst individuals may have preferred learning styles, curriculum justification, design and development remain towards the domain specificities of the psychomotor, cognitive, and affective, with acknowledgement that it is experience which forms the basis of the tacit knowledge that becomes second nature to experienced clinicians and healthcare professionals in practice (Johannessen, 2022). Constructivism therefore lends itself to the differentiation of a job versus a vocation, where tacit, experiential knowledge becomes an embedded part of the clinician on a personal as well as a professional level.

Structured frameworks for curriculum development ought therefore to recognise the significance of the need for evidence-based approaches to teaching knowledge, skills and facilitating the consideration of the critical reflexivity that underpins attitudes and expressed behaviours at the front line of patient care (Ng et al, 2022). This also enables criteria for the assessment of quality to become an integral part of curriculum development against which the gauging of optimal practice can be made.

The foundational basis of extant knowledge is what Vygotsky used to frame constructivist approaches to learning, where the interdependency of experience and current learning are clear.

Critical Reflection, Reflexivity, And Trajectory Planning

Critical reflexivity in practice is now an integral part of all healthcare work. There are few models of reflection that fit all healthcare practitioners but the notion of reflexivity (defined for the purposes of this article as the ability to react to a similar incident in the future with informed discernment and reflection on previous incidents) is common to the majority (Cribb, Entwistle & Mitchell, 2023). Reflection necessitates the consideration of the multi-faceted nature of knowledge construction in a real world that is littered with nuance and complexity that must be negotiated and articulated carefully (Schaepkens, Veen, & de la Croix, 2022). This is what becomes of all healthcare provision – it is rooted in the unanswerable question and most celebrated of all human attributes i.e.) what it is to ‘be’. How we understand and apply meaning to how we interact with others in the context of healthcare provision for individual people, regardless of their physical or mental capacity in being part of the world, defines and frames our societies and our contributions to them.