Synonyms: personal learning plans, continuing professional development

Personal development plans (PDPs) and personal learning plans (PLPs) are part of the concept of continuing professional development (CPD) and GP appraisals. PDPs are a means to identify educational need and to document and hence demonstrate that need has been addressed. They are likely to become a requirement of GP revalidation in the future and, together with the Practice Professional Development Plan (PPDP), give the individual and practice a structure to manage and demonstrate a continuous development programme.

Good medical practice and continuing professional development

The General Medical Council states that:¹

• You must keep your knowledge and skills up to date throughout your working life.
• You should be familiar with relevant guidelines and developments that affect your work.
• You should regularly take part in educational activities that maintain and further develop your competence and performance.
• You must keep up to date with, and adhere to, the laws and codes of practice relevant to your work.

The principle of continuing professional development (CPD) is that it should be relevant to the doctor's practice, so should:²

• Take into account the context and environment of their practice
• Explore the benefits of learning across professional disciplines and boundaries

Doctors need to keep themselves up to date in all areas of Good Medical Practice. These are:^2,3

• Good professional practice
• Maintaining good medical practice
• Relationships with patients
• Working with colleagues
• Teaching and training
• Probity
• Health

There are many ways in which doctors learn:²

• Formally, through:
  • Annual appraisal.
  • Shadowing others; visiting centres of excellence.
  • Being involved in supervision; being a mentor.
  • Multidisciplinary team meetings.
  • Learning from patients.
• Informally, through colleagues and patients - more difficult to measure.

Setting up the personal development plan³

For UK general practitioners, agreeing a personal development plan (PDP) is part of their annual appraisal.

• Last year's agreed PDP can be updated to mark development tasks as completed.
• Any needs requiring further thought or action can then be 'brought forward' into the proposed PDP to be considered for further discussion in the next appraisal meeting.
• The proposed PDP and agreed PDP should be completed by the appraisee. The agreed PDP should be signed off by the appraiser.

Personal development plan goals, follow-up and reflection⁴

These should fit with the SMART objectives, meaning that the tasks should be:

• Specific - specified learning activities, not general statements.
• Measurable - possible to assess whether they have been achieved.
• Attainable - possible to achieve.
• Realistic - within the doctor's capability.
• Timed - agreed time for achieving and reviewing.

For each goal, they must contain the following elements:

• Statement of the development need.
• How the development need will be addressed (action to be taken and resources required).
• Planned date of achievement.
• Intended outcome of the goal.

At the next appraisal, record the outcome of each goal:

• Either, the goal has been completed and the extent to which the intended outcome from that goal has been achieved.
• Or, the goal was not completed, and an explanation, e.g. the goal became irrelevant or unachievable, and why.

This should be agreed between the appraiser and the GP at the appraisal. Reflection on goals is an important attribute of a GP's fitness to practise.

Leadership and management:

• The Royal College of General Practitioners (RCGP) advises that, over a 5-year period, the GP should not only consider clinical development but also leadership and management skills. These skills are part of a doctor's roles in providing safe healthcare systems.

What might go into the personal development plan portfolio?^3,5

The personal development plan (PDP) portfolio contains information about the doctor's current practice, educational activities and any available feedback on their performance. This is then used to prioritize and direct the next PDP, and to provide evidence that the PDP is being addressed. The PDP portfolio may contain:

1. An up-to-date curriculum vitae.
2. Current posts, roles and responsibilities - both in the practice and outside.
3. Practice profile - demographic details that perhaps highlight areas for concern/development; health improvement goals.
4. Personal developmental goals (medical and nonmedical).
5. Evidence of personal self-analysis.
   • Learning styles assessment.⁶
   • Myers Briggs® and/or Belbin® personality assessment.
   • Copy of minutes of annual appraisal.
   • Reflective diary (can include planned educational activities in the future).
6. Documentary evidence of methods used to demonstrate a learning need: with summaries of meetings or notes from personal study to demonstrate how the need was met:
   • Significant event audit or analysis.
   • Random case analysis, or clinical diary of interesting cases.
   • 'Patient's Unmet Needs' (PUNs) identified in a consultation, translated into a 'Doctor's Educational Need' (DEN).⁷
   • Personal and practice audits.
   • Video consultation analysis.
   • Prescribing analysis and cost tabulation (PACT) - review of prescribing habits.
   • Details of any 'Risk Assessments' carried out.⁸
7. List of educational meetings attended in the last 3-5 years, with minutes/summaries/learning points. These could vary from 'in-house' meetings with partners or interaction with peers to distance learning courses. Try to demonstrate that a previously identified learning need has been met (perhaps by a subsequent audit, or just a paragraph indicating how your practice has changed following the educational activity).
8. A retrospective evaluation of last year's PDP: good and bad points; lessons learnt; which ways of addressing learning needs worked and which failed, and why.

Advice for appraisers⁴

• Recognise that not all goals can be met. As a rule of thumb, at least two-thirds of agreed personal development plan (PDP) goals should be successfully achieved.
• Low achievement of goals may relate to poor quality of PDP writing.
• There should be supporting information to show reflection on what has been achieved, or reasons for non-achievement. If there is doubt about this, the portfolio can be referred to the RCGP's National Advisory Panel, where consistent national standards can be applied.

Document references

1. Good Medical Practice (2009), General Medical Council
2. Guidance on Continuing Professional Development (2010) General Medical Council
3. NHS Appraisal Toolkit
4. Guide to the Revalidation of General Practitioners, version 4.0. Royal College of General Practitioners (RCGP), June 2010
5. PDP Toolkit; NHS Eastern Deanery, updated 2005: website with collected resorces and links about PDPs, appraisal and good medical practice. The 'guide to PDP' link has useful examples showing how to write a PDP in relation to your learning needs
6. Learning styles; Richard Felder and Barbara Soloman; Index of Learning Styles Questionnaire. Online version. North Carolina State University
7. PUNS and DENS; North Thames Deanery website: PUNs and DENs as developed by Dr Richard Eve, UK GP from Taunton
8. Vincent C, Taylor-Adams S, Stanhope N; Framework for analysing risk and safety in clinical medicine. BMJ. 1998 Apr 11;316(7138):1154-7.

Internet and further reading

• Bruce D, Phillips K, Reid R, et al; Revalidation for general practitioners: randomised comparison of two revalidation BMJ. 2004 Mar 20;328(7441):687-91. [abstract]
• Teunissen PW, Dornan T; Lifelong learning at work. BMJ. 2008 Mar 22;336(7645):667-9.
• Colthart I, Cameron N, McKinstry B, et al; What do doctors really think about the relevance and impact of GP appraisal 3 Br J Gen Pract. 2008 Feb;58(547):82-7. [abstract]
• RCGP; Royal College of General Practitioners: Continuing professional development webpage
• gp-training.net; Website by Dr Brad Cheek, UK general practicitioner and trainer. Continuing medical eductation page with many useful links for appraisal and PDPs
• Personal Development Plan (PDP) Guidance for Appraisers. Royal College of General Practitioners, February 2008
• Building leadership capability in the NHS. NHS Institution for Innovation and Improvement. Accessed June 2010

Acknowledgements