The link between continuing professional development (CPD) and evidence-based practice
(EBP) is very clear. CPD is a necessary component for the successful application
of evidence-based practice (1). CPD is used to describe the process of systematic
maintenance, improvement and broadening of knowledge and skills (2). The following
passage is from Core Standards of CSP (3). “CPD is the educational process by which
physiotherapists and associate members maintain and develop their skills, knowledge
and competency in order to provide safe and effective practice. It is a systematic
and cyclical process that is undertaken throughout an individual’s career to develop
and enhance performance at work and patient care”. CPD also involves identifying
areas of practise that need updating or extending, planning, implementing and identifying
learning outcomes (2). Journals are acknowledged as crucial sources of evidence-based
information and vital to CPD as research literature is continually changing. Journals
enable the therapist to keep up-to-date, whereas, the drawback with textbooks is
staying current (4). Failure to keep up-to-date may lead to decay in professional
knowledge and expertise, resulting in outmoded or ineffective practice (5). However,
not all journal articles should be implemented, the decision depends on the research
quality, particularly with respect to validity, reliability, relevance and applicability
(6). CPD can be achieved by engaging in a variety of activities e.g. attending courses
and conferences, delivering presentations, the critical reading of journals, sourcing
from electronic data-bases, reflective-practice etc.
Reflective Practice
Reflective-practice is recognised as an integral part of EBP and CPD and represents
a vital component in professional development. Facilitation of reflection and the
development of reflective abilities are acknowledged to be an important component
of education. By reflecting on events in day-to-day practice and identifying areas
of difficulty or gaps in knowledge, the clinician identifies specific learning needs.
The reflective process allows clinicians to question and analyse their experiences
and actions as a means of developing their knowledge, skills, and behaviour, to enhance
clinical practice (7). Reflection takes place after the event, it is a process of
thought, and leads to a new interpretation of the experience providing food for further
thought (8). Reflective-practice is used extensively as an educational tool for both
students and adults across many professions i.e. physiotherapy (9), sports therapy
(10), occupational therapy (11) nursing (7) and medicine (12). The concept of ‘reflection’
is also central to portfolio development which is a collection of information used
to summarise what has been learned from prior experiences and opportunities (13).
To develop reflective skills, Holey and Cook (14) suggest we ask our ourselves questions
e.g. Do I communicate well with my patients? Do my patients understand what I am
explaining to them? Am I a good listener? Am I applying EBP? Is my treatment effective,
and how do I know objectively? Do I monitor effectiveness? Do I respect my patients?
Finally, how am I going to correct deficiencies?
References:
1. Bury T, Mead J. Evidence-based healthcare: a practical guide for therapists.
Butterworth Heinemann 1998.
2. Roberts S. Continuing professional development: what the future might hold.
Jour. of Sportex Medicine 2004; 19:14-163
3. The Chartered Society of Physiotherapists (CSP). Core Standards of Practice
2005.
4. Steves R, Hootman JM. Evidence-based medicine: what is it and how does it apply
to athletic training? Journal of Athletic Training 2004; 39(1):83-87
5. Alsop A. Evidence-based practice and continuing professional development. British
Journal of Occupational Therapy 1997; 60(11): 503-550
6. Bleakley C, MacAuley D, McDonough S. Are sports medicine journals relevant and
applicable to practitioners and athletes? British Journal of Sports Medicine 2004;
38:541-548
7. Barnett M. Caring for a patient with COPD; a reflective account. Journal of
Nursing Standard 2005; 19(36):41-46
8. Grant A, Dornant TL. What is a learning portfolio? Journal of Diabetic Medicine
2001; 18:1-4
9. Donaghy ME, Morss K. Guided reflection: A framework to facilitate and assess
reflective practice within the discipline of physiotherapy. Physiotherapy Theory
and Practice 1999; 16:3-14
10. The Society of Sports Therapists’ Codes of Professional Conduct. Competences
and scope of practice for sports therapy 2005.
11. Bannigan K. To serve better: Addressing poor performance in occupational therapy.
British Journal of Occupational Therapy 2000; 63(11): 523-528
12. Wyatt JC, Sullivan F. Keeping up: learning in the workplace. British Medical
Journal 2005; 331:1129-1132
13. Cayne JV. Portfolios: a developmental influence? Journal of Advanced Nursing
1995; 21:395-405
14. Holey E, Cook E. Evidence-based therapeutic massage. A practical guide for therapists.
2nd edition. Churchill Livingstone 2003.
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