CPD, Or Not CPD - That Is The Question

CPD - Will it ever catch on?

I’m not, by nature, a hoarder.

I chuck stuff out on a pretty regular basis and the only inanimate possessions I would risk my life to save in the event of fire or flood would be my treasured MacBook, iPad and iPhone – in short, anything with an Apple logo on it.

So, I suffered gargantuan cognitive dissonance the other day when I came across my massive folder of CPD certificates collected over thirty years in practice, in the loft. Why do I still keep it?

I’d been up in the loft because the gas engineer who installed our gas supply and heating system earlier in the year had been sent back by the safety people to fix all the bits he’d not done properly in the first place and after he’d gone I was just checking he’d not carried out some sort of ‘dirty protest’ as revenge for being called back to our house.

To say the gas engineer was a little ‘frosty’ on the morning he arrived, was an understatement.   When I saw him finally pull up on the road after a five-day wait, I went out with a cheery wave as he sat in his van, and started to back my car out of the drive to allow him to park closer to the house. He’d parked halfway across the drive and it was a bit tight getting out and I noted that I was quite close to him as I swung backwards. My car radio was quite loud as I reversed, but I was focussed on getting out of the engineer’s way and parked on the road. As I got out of my car, he was inspecting the front of his van. My “Morning Bill” was greeted by “Did you know you’d just hit the van?” I didn’t, but when I had a look, there was no denying it. There was no dent in his bumper, but there was a clear and undeniable smear of Peugeot 107 red on his immaculately matte black rubberised fender. If he HAD carried out a dirty protest, I would have understood.

Anyway, back to my CPD folder. I must have buried it up there a year ago, on retirement, though I don’t remember doing it. The folder lay under the bed for thirty years and it had about seventy elastic bands around it for fear that a valuable certificate proving I’d been on a day course on the use of Wizard Wedges in 1991 might inadvertently slip out from the pile of loose certificates on top.

For about a billionth of a nanosecond I actually thought about throwing the folder out, until I came to what passes for my senses and asked myself “But what if the GDC asks to see it retrospectively?” Yes I know, bizarre thought – why would they? But I was always a dentist scared of not only his own shadow, but the shadow of a hostile dental litigation lawyer carrying a sharpened writ. In my head I could visualise a scenario where the GDC demanded to see my CPD folder, realised I’d not followed the rules and retrospectively declared my career null and void. In consequence, every procedure I had ever carried out I’d done illegally and I’d be jailed for being a fraudulent dentist.

Torn, I realised that I needed guidance and so I went to my ‘go-to’ default advisor – Twitter of course. I asked whether I should: a) destroy the CPD records, b) destroy them, laughing or c) keep them in the loft. The results of my survey were closer than I anticipated. Fifty-five percent of participants thought I should destroy them with a maniacal laugh, but a surprising forty percent thought I should keep them in the loft. One Twitter wag, Rebecca Cox questioned my commitment to CPD. She said “One folder…in 25 years?” Fair point. Anyway, the loft it is, forever, until we find another house with another inaccessible loft, but hopefully, safe gas pipes.

I was sort of reassured that forty percent of the people surveyed erred on the side of caution and I was comforted by a Tweet from a dentist I follow, Adrian Walley, who said:

“This is sad, but 35 years qualified and I still have all my undergraduate files and coursework in a box in the loft. Every time I go to throw them out, I can’t quite bring myself to do it; all that work and if nothing else, (it) proves how neat my handwriting used to be!”

This Tweet struck a chord for my other confession is that I too have all my undergraduate notes still in the loft, sitting on piles of books ranging from Gray’s Anatomy to a worthless book written by one of my dental professors on restorative dentistry that seemed to have been aimed at dental students with ADHD.

I WILL admit that keeping my undergraduate notes is pretty much pointless. I also admitted on Twitter a few days ago that I used to write extensive notes during lectures. I’d then go back to my room and during the evening, write my notes up neater and add bits from textbooks. I always felt more comfortable with a fine black felt-tip pen and with every test we had during the course, I’d go back to my notes and highlight them in fluorescent pink or green. When we came to finals, I opened my files one day to find that the writing was unreadable, the black felt-tip having dissolved in the washes of fluorescent felt-tip. I was inconsolable, and for a while, hysterical. My fellow finalists found it pant-wettingly funny.

Despite all that, I still can’t throw the notes folder out. I’m really not sure why. I don’t know whether the CPD folder and the notes represent all that time invested and all that agony endured in order to qualify as a dentist and then keep the ball in the air. I suppose they’ll stay there till the ceiling starts to sag with the weight of them plus the folders we’re keeping for the kids for some obscure reason, from their ‘A’ level days, nigh on 15 years or so ago.

But flicking through the CPD folder made me think about the whole Continuing Professional Development thing and how it’s developed since the days that I qualified and how I may have had a lucky escape retiring when I did, before Enhanced CPD really kicked in.

Back in the late eighties, we didn’t have CPD, we had Section 63 courses. I don’t recall having to declare the fact that I’d done a course to the GDC but I do vaguely have this feeling that someone was watching my course activity. After every course, you had to collect a certificate and a form which you submitted to the local Family Practitioner’s Committee. In those days (I was reminded by someone I follow on Twitter) you could claim your car-parking fees back at least, but I don’t recall having to didn’t have to fill in a feedback form.

In those days you didn’t even have to stay the full day. They were simpler, more naïve times. You could go to the course in the morning, sign in, pick up your certificate and your Section 63 expenses claim form and slip out at the first coffee break, being home for lunch or grabbing a swift half at pub before you caught the bus to catch the second session of the cricket (Birmingham Dental School is VERY close to Warwickshire’s Edgbaston ground). Not that I ever did that of course.

When Section 63 courses were about, the UDA system wasn’t, and there seemed to be more time and less financial pressure to attend courses. If you went on a day-long course, although you knew you weren’t earning any money, you didn’t feel you were effectively going to LOSE money by risking not hitting targets. Consequently, courses seemed to be well attended and filled with the sort of people you would cross the M25 on foot in order to avoid.

Some of the most excruciatingly irritating dentists on the planet I encountered at Section 63 courses. There was one lecturer who I had to take my hat off to, just for keeping his cool. The course was in London and was on ‘Endodontics in Practice.’ There was a little chap sitting down the front and he must have had the lecturer bitterly regretting his rash words: “Feel free to ask questions as we go along.” When the lecturer said: “I can’t emphasise this enough, you MUST irrigate with hypochlorite,” the audience member asked “So do you ALWAYS irrigate with hypochorite?” When the speaker said “It’s critical to use rubber-dam to stand any chance of success,” the irritant asked “So do you think it’s important to use rubber-dam to be successful?” When the speaker emphasised the importance of recapitulation, the annoying dentist asked “So you’d recommend recapitulation then?” And on and on. By the end of the day, the rest of the audience had had enough and every time the hand went up, there were murderous murmurings all over the lecture hall. I can almost guarantee you have met this bloke at a CPD meeting at some point in your professional life.

When the GDC officially threw its their hat in the ring and CPD came in with its implied threat of erasure if you didn’t take an apple for your teacher, all the fun seemed to go out of practice awaydays. Courses were suddenly geared towards meeting legislative requirements and you’d be really struggling to find a course that DIDN’T involve cross-infection control or compliance. I missed courses with titles like ‘Fun With Mercury’ and ‘Who Needs A Perio Probe?’

The prospect of the new 100 hours verifiable CPD in five years target didn’t particularly bother me. Apart from my last year in practice, I usually far exceeded requirements. That may surprise some. I was fascinated by the science behind dentistry, it was just the idea of being in the same building as patients that I hated.

When it came to non-verifiable CPD declarations to the GDC at the end of the year, my attitude was a little more ‘relaxed.’ I mean, I did quite a lot of journal reading, but I can’t say that I scrupulously logged my hours, so when it came to putting in a non-verifiable figure to the GDC it had the accuracy you’d normally associate with Oliver Reed telling his GP how many units he drank per week.

My difficulties with enhanced CPD would have been associated with the production of a Personal Development Plan. Every PDP I’ve ever been asked to produce in the past has basically identified endodontics as my weakness and all my CPD would have been directed towards attending endless courses on RCT until I finally found the Holy Grail – a course that that said hypochlorite and rubber dam was totally unnecessary.

I would imagine the pursuit of UDA’s and economic viability has led to an increase in the number of practitioner’s carrying out a lot of CPD online. I have no quantitative evidence for that assumption other than I was often asked while I was practising which organisations provided the cheapest online CPD content.

And of course, online CPD has opened up the opportunity for taking shortcuts to attaining verifiable hours. I knew one practitioner who never read the content of the course, but ticked the multiple choices as he thought fit and repeat until he hit the 80% pass score required for his certificate - it took him way less time than spending the two hours the course providers reckon he needed to complete the course, and failing that, he’d photograph each page of text and then go to the test at the end. If he didn’t know the answers, he’d scroll through the pictures till he found the bit he wanted and ticked the box with confidence.

Another well-known CPD website apparently counted up the time you spent online answering questions and issued certificates logging the hours spent on each subject. One ingenious practitioner I know discovered an App for his computer called a ‘Mouse-Clicker.’ You could set the App so that it clicked automatically every few seconds. This registered with the website that you were still active on the page and he could go off down the pub while he was automatically logging verifiable hours without breaking sweat.

I say! That’s not quite cricket!