Given the diversity of objectives CPD can pursue and the pedagogical approaches undertaken, CPD is difficult to standardize. CPD can be made mandatory, as is in place or being introduced in many countries, or can be include in accreditation criteria. In some countries, the educational institutions are accredited and left to decide how to organize CPD, and carry out periodic monitoring and reviewing by applying the same principles as for pre-service education. In other countries, professional councils are responsible for CPD.
Although warranting study, the cost-effectiveness of CPD interventions has had little attention. However, some impacts may be difficult to capture as CPD is not only an activity for knowledge acquisition or skills development, but it is also as an opportunity for health professionals to interact with other practitioners and to maintain professional and social networks, which is an important motivational factor. This is particularly important for professionals working in isolated regions (Van, et al., 2008).