Some advice for those at the start of their physiotherapy career on laying the foundations for continuous professional development
It’s not often that I write an article for one particular audience – mostly because the principles, issues and concerns around continuing professional development (CPD) are largely the same whether you are a technical instructor, healthcare support worker, student, consultant physiotherapist, or even the CEO of the CSP. But this month, I’m going to break with tradition and write this one with students in mind.
It seems apt to do this at this point in the year, particularly because I wanted to reach the first years at the beginning of your careers. For those on BSc programmes, including the new apprentice routes: I hope you have enjoyed the first few months. Fast-paced isn’t it? For those on the pre-reg or integrated masters or even the pre-reg doctorate routes who have just started in January: welcome to the profession and to a career where you’ll be developing until the day you retire. I hope that will be a long way in your future.
I have possibly the greatest job at the CSP. I work with your lecturers to make sure that your programmes are the best that they can be, and as part of that I get the opportunity to meet, listen to, and work with you the students.
I had such an opportunity just before Christmas. My colleague professional adviser Alex Nambyiah and I ran a virtual workshop for student reps who are either setting up or are running the student societies in your universities.
The goal of this workshop was to help them to think about how to offer meaningful CPD activities to you - their peers. We had asked Sue Hayward Giles one of the assistant directors here at the CSP to talk about the CPD opportunities that had shaped her career. Sue has grabbed opportunities in the most unlikely of places, so I hoped it would spark a conversation about CPD being about more than courses and more than opportunities to practice your clinical skills.
She absolutely fulfilled that brief. And with the students who had joined us, we ended up having a fantastic conversation about CPD. I promised that group that I’d think about how to share some of the discussion beyond those who were able to attend. As I promised this, it struck me that I could use this article to share snippets of what we’d discussed as well as share some of the things that I came away thinking about afterwards.
So, let’s get started.
What is CPD?
CPD is really just a formal term for learning, development, or growth – all terms you are familiar with. As a student or apprentice you’re definitely fully immersed in learning. Everything is new, especially if you’re reading this as a first year. These new experiences are going to continue for the duration of your studies – your lecturers have designed programmes – all different – to help you develop. While all the programmes are put together differently you’ll all get to the same end point – whether you’re at Nottingham or Teesside – and that end point is being ready for your first job.
As a regulated health professional you’ll be expected to keep that learning and development going throughout your whole career, and you’ll be expected to be ready to demonstrate your commitment to this once every two years through an audit process carried out by the HCPC.
Everything you need to know about audit process can be found by following the link in the useful resources box. I’ve included a couple of other helpful resources including the CPD principles co-written by CSP and the other AHP professional bodies.
From a learning perspective, the main difference between now and when you graduate is that for now someone else has structured your development whereas afterwards you’ll have to do this for yourself.
The big picture
So why mention this now? Especially as you’ve only just begun and there are probably more pressing deadlines than a potential audit in four year’s time.
Because I know how busy you’ll be, and I wanted to catch you early.
Over the next two, three or four years, your lecturers will be taking you on a journey to ensure that by the time you graduate you’re clinically competent, person-centred, and aware of your place within the systems and structures that you’ll be operating in, as well as knowing how to bring about change within those systems. One thing you’ll need to bring all of these together is the ability to step outside yourself, and question yourself and the systems. These are the same fundamental skills that will help you grow professionally. To flourish as a physiotherapist later you’ll need to learn the skills now at the beginning of your career to help you reach that potential.
Priorities
So what does that mean? It means that in between all that bustle and the temptation to be a surface or strategic learner (learning what you need to know to deal with what’s happening now – like all those exams, assignments and doing well on placement), you’ll also need to make time to learn how to develop skills that will allow you to continue to grow, learn and develop throughout your career.
Happily, your lecturers know you’ll need to do this. That’s why alongside teaching you anatomy and pathophysiology they’ll be giving you ample opportunity to reflect on what you’re doing and why you’re doing it, to question your own and others’ practice in a safe space.
The long game
Going back to the workshop – after Sue had shared her story, we were discussing with the students present why they were finding it difficult to know where to start in terms of CPD, and why it was potentially ‘easier’ to focus on clinical skills as CPD as a student. One of your colleagues eloquently summarised it when she said: ‘coming up with CPD ideas is hard because we don’t know what we don’t know’. I came away from that conversation thinking that if she applies that same level of reflection and self-awareness throughout her career my mum will be in good hands if she’s ever treated by her in a few years’ time.
Her statement wasn’t an excuse, just an acknowledgement that at this stage in her career – partway through her studies – she’s still developing an understanding of physiotherapeutic knowledge, skills, behaviours and values as well understanding herself as a physiotherapist. In fact for those who are interested it was a really neat summary of one of the theories of how we learn. She’d beautifully summed up stage 1 of conscious competence [see ‘in depth’ for further details].
And that’s where I’d expect you to be right now in your journey. Even once you’ve graduated you’ll only have scratched the surface, so from a professional development perspective it’s good to acknowledge that reality and be okay with it – it will save you later from either getting into a rut or becoming arrogant. So while it might feel uncomfortable to admit you don’t know everything, acknowledging your limitation is an essential part of growing as a professional. Looking back at the many times I’ve been a patient myself, I’ve certainly had more trust in clinicians who’ve said to me ‘actually right now I’m not sure what to make of your presentation, do you mind if I ask a colleague to join us?’
Be a sponge
So what do you need to do at this stage? As we’ve noted, while you’re studying you’ll have many pulls on your time. The best piece of advice I can give you is – pay attention to it all. There’ll be debrief sessions, assignments, reflections, questions from your lecturers and your practice educators all dedicated to helping you hone your ability to critique yourself and move from consciously incompetent through to unconsciously competent. Be a sponge, soak it all up and don’t dismiss these parts of your studies as ‘something for later’. These activities and assignments will lay the groundwork for who you’ll become in 10, 15, 20 years’ time.
The really long game
You are at a such an early stage in your development that it is hard to know who you’ll be in 10, 20, or 30 years’ time. But regardless of whether you become the England women’s football team physio or work in women’s health, one thing is a given – you’ll need to develop yourself and then move onto helping your colleagues and even the future students that will be coming through after you develop.
Those entering the profession after you are relying on you to help teach them, mentor and encourage them on their journey too. No pressure.
When you’re really far ahead in your career – as chief executive of an NHS trust, or director of AHP workforce or the chief health professions officer for Scotland - and are responsible for developing yourself, your staff and services you’ll still be drawing on the skills of reflection you’re learning now. I’m going to recommend a book to read when you’re that CEO. It’s called Good to Great by Jim Collins. It was written back in 2001 but the principles are still excellent.
I’ve included a link to an article based on the book in the useful resources box. But I’m also mentioning Jim Collins because he has some interesting theories around leadership. He talks about five levels of leadership with five being the highest.
He outlines some - perhaps surprising - qualities of a level five leader, needed in equal measure: humility and determination. Why am I telling you this now? Because you’re just at the start of that journey with your whole career ahead of you so you need to lay your foundations well.
You’ll never be a level five leader if you can’t stand in front of the mirror and ask yourself difficult questions: What did I do wrong?What will I do differently next time?
And these two questions are no different to those you need to learn now at the beginning of your career ready to work in your first clinical setting.
So wherever your career takes you – remember to keep growing every step of the way.
Useful resources
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