1. Carrie Jackson and claire thurgate
Embedding the CPD Impact Tool in Faculty Programmes: a snapshot pilot of its potential application
Carrie Jackson and claire thurgate

2. Jackson, Manley, Wright and Martin
STUDY Aim To devise and test a CPD outcomes tool that identified mechanisms for measuring impact of learning on individual, team and organisational effectiveness in relation to improvements in quality of care and patient experience outcomes in the workplace
Background:
2015 HEE study
Jackson, Manley, Wright and Martin
The study obtained ethical clearance from the University’s Research Ethics and Governance Committee ref. 13/H&SC/CL67

3. CPD is the systematic maintenance, improvement and continuous acquisition and/or reinforcement of the life-long knowledge, skills and competences of health professionals. It is pivotal to meeting patient, health service delivery and individual professional learning needs. The term acknowledges not only the wide ranging competences needed to practise high quality care delivery but also the multi- disciplinary context of patient care” (Executive Agency for Health Consumers EAHC report 2013: 6
Rationalising resources for CPD requires clear understanding of what strategies work for whom, why and under what circumstances (Pawson and Tilley 1997)
Defining CPD

4. DESIGN
Multiple case study design was chosen to enable development and refinement of a tool for evaluating impact of CPD in the workplace in the healthcare system
Data collection and synthesis underpinned by realist synthesis, a theory driven process that enables understanding of what works for whom, how and under what circumstances (Greenhalgh et al 2011).
Realist synthesis fits well with the case design –focus on‘how’ and ‘why’ questions and enable use of multiple sources of data to holistically understand phenomena in real life situations (Rycroft-Malone 2010).

5. Methodology and Methods
Realist synthesis and evaluation (Pawson and Tilley 2004)

6. Project Outputs
The overarching framework for understanding effective CPD
Four transformation theories
Impact indicators useful for determining the impact of CPD
A range of ways to evaluate achievement of CPD impact

7. The Conceptual framework
Conceptual framework incorporates four ancillary CPD purposes that focus on individual and team journeys of transformation in their work and workplace, specifically the transformation of:
The individual’s professional practice
Skills to meet a continually changing context
Knowledge, so that it is used and blended with other knowledge in practice through knowledge translation approaches
The workplace culture
The Conceptual framework

8. Four theories linked to transformation in CPD
Integrated with a specific set of outcomes
Transformation of individual practice
Transformation of workplace /context
Transformation of knowledge /knowledge mobilisation for practice
Transformation of skills to meet society’s changing

9. Theory 1: Transformation of individual’s professional practice through CPD
The theory of transforming individual professional practice infers that:
Work based CPD that is learner driven and founded on self-awareness and self-assessment within an enabling context that provides facilitated support and reflection, increases confidence, efficacy, role clarity and the individual’s positive attitude towards change creating opportunities for role and career development.

10. Theory 2: Transformation of skills through CPD to meet society’s changing healthcare needs
A concern for social justice underpins CPD with focus on providing equity of opportunity for all learners irrespective of their personal characteristics or social background  as well as collective responsibility to provide healthcare services that are inclusive and fit for purpose in meeting the needs of everyone in society 
System and teams’ skills gap assessment informs CPD for transforming skills to meet changing healthcare needs evidenced in, better service user experiences, effective teams, opportunities for career progression for individuals, effective use of human resources and better organisational outcomes in terms of integration and partnerships

11. Theory 3: Transformation of knowledge through CPD to enable knowledge translation
Focuses on knowledge, its uptake and use in practice
Knowledge translation =process of analysing sharing and ethically applying knowledge to achieve the overall purpose of immediate workplace culture in which people work
CPD in workplace contexts that support engagement with and active sharing of different types of knowledge in everyday practice focuses on blending multiple types of knowledge to inform professional decision- making, skills in facilitating dialogue, active enquiry and evaluation and fostering leadership evidenced by knowledge rich cultures such as knowledge development, active inquiry, innovation and creativity

12. Theory 4: Transformation of workplace culture through CPD to implement workplace and organisational values and purpose
Addresses the immediate workplace culture and the implementation of shared values within the workplace, across the organisation and the health economy
Workplace culture significantly  shapes  professional development and knowledge translation theories and therefore has implications for both the impact of CPD, its content and focus.
Hypothesizes that:
in a context of organisational readiness, CPD that promotes developing and implementing shared values, evaluating the experiences of service users and staff relating to these values and leadership skills in developing effective workplace cultures achieves improved service user and provider experiences as well as effective teams and effective organisational   leadership.

13. Individual and Team Impact Indicators
Self-efficacy (self-awareness and self-confidence)
Shared vision and values
Role clarity
Interdisciplinary team working
Collaborative decision–making
Peer learning and review
A sustained person centred safe and effective culture

14. Service and Organisational Impact Indicators
Shared vision and values for the service/organisation
Integrated team working
Patient at the heart of decision making
Patient experience
Systems of shared governance
Person centred, creative and innovative learning culture
Organisational awareness and intelligence
Systematic mechanisms for capturing best and poor practice
Patient safety metrics
Effective staffing levels

15. 4 Hypotheses to be tested
CPD that is work based and provides facilitated support and reflection and include 360 degree feedback will increase self confidence and self awareness and role clarity
CPD that focuses on providing up to date knowledge about effective, safe practice will achieve knowledge translation if participants are supported to address their leadership and workplace contexts and cultures

16. 4 Hypotheses to be tested
CPD that focuses on expanding skills to meet a changing service will be reflected in outcomes around better integration of service provision
CPD that focuses on living organisational values across different boundaries will increase team effectiveness and organisational effectiveness

17. Key Messages Positioning CPD within the transformation agenda
Focusing on workplace as main resource for learning context of CPD
Needs facilitators of whole systems integrated learning development, improvement inquiry and innovation (New 5 I’s model of PD)
Tool can provide evidence based self assessment framework for revalidation & educational passport
Integrated into indicators of effectiveness in Education Outcomes Framework for workforce development
Indicators integrated into HEI CPD programmes

18. Our 2 centre Collaborative project
A pedagogic study to measure the effectiveness of an impact indicators framework for CPD learning on practitioner development in the workplace
(Making the link between learning, development, improvement and inquiry in the workplace)
AIM to evaluate the effectiveness of the CPD Impact Tool developed by the ECPD for Health Education England in level 6 and 7 workplace learning modules
HEIF Award 2016
2 Centre collaboration
Our 2 centre Collaborative project

19. 1. Explore the application of the individual and team impact indicators within a negotiated workplace learning module in relation to learning processes, assessment strategies and learning outcomes
2. Understand how useful the impact indicators are as a measure of learning development and improvement for level 6 and 7 learners
3. Identify the benefits and challenges of implementing the tool for academic facilitators of learning
4. Identify the potential ways in which the tool might benefit the Faculty in marketing CPD programmes in relation to demonstrating impact on improving practice for the future
5. Make recommendations for how the tool might be further embedded within the wider CPD curriculum
Project Objectives

20. Piloted in 1 cohort of students undertaking the negotiated workplace learning modules (Level 6 and 7) commencing in August 2016
The project will link the impact indicators to the module’s learning outcomes and explore the measurement of impact through:
Pre- and post-test evaluation using a cognitive mapping tool
Claims, concerns and issues framework pre and post.
Focus group discussion with the students
Documentary analysis of assignments
Consensus workshop with providers and commissioners
METHODS

21. Findings CCI data Staff focused Sharing knowledge from practice
Patient centered
Encourages EBP and innovation
Links to Trust values
Enables high challenge high support
Makes appraisal descriptors real
Good practice framework
Findings
Self Assessment Data
Growth of confidence in effectiveness in role
Demonstrate impact as a practitioner
Evaluate impact as a practitioner