As part of a changing health services system, health workers need to keep up with the evolving health needs, policies, technologies and knowledge (WHO, 2006a; Frenk, et al., 2010). The exponential progress in technology, diagnostic tools and treatment methods, as well as changing population demographics and disease burden, makes updating and maintaining the knowledge and skills of health workers throughout their professional life more important than ever. Continuing professional development (CPD) refers to educational activities conducted after graduation to maintain, improve and adapt the knowledge, skills, attitudes and practices of health professionals, so that they can continue to safely and effectively provide health services.
There is some evidence of positive effects, for example, improvements in knowledge, skills and attitudes, as well as in clinical practice and health outcomes (weight gain or child-carers’ retention of nutrition advice), but the effects of CPD have not been systematic. In some studies, knowledge had improved, but clinical habits had not always changed (Johnson, 2012). Stakeholders’ acceptability was good and access to CPD was much valued and could be an important factor in retaining health professionals (WHO, 2010b).
The relative effectiveness of CPD methods depends on numerous factors, such as the intended target, the purpose (transfer of knowledge, acquisition of new skills, familiarity with a new technique), the techniques used, who delivers the training, and the subject. Reviews of studies of CPD programmes for medical professionals indicate that interactive techniques, reminders, patient-mediated interventions, outreach visits, multifaceted activities, audit with feedback, conferences, printed information and didactic activities without practice were found to be ineffective, though they are widely used (Davies, 1995; Bloom, 2005). The use of case studies and a combination of techniques, including multiple exposure, was found to be more effective (Mariannopoulos, et al., 2007; Forsetlund, et al., 2009). Effectiveness is also increased when CPD is linked to career progress and other educational interventions (WHO, 2010b). The strength of these conclusions is limited due to the variable quality of the methodologies used in the reviewed studies, but available evidence has good face validity and indicates credible trends.