The personal educational or developmental plan is defined by the online medical dictionary as a personalized and formal self-administered program of education, knowledge maintenance, and professional self-improvement undertaken by a Doctor to ensure the quality of clinical care. This process involves tools that identify areas for further development and encourages the continuous improvement of one’s skills and competence.
Doctors in the United Kingdom (U.K) are expected to keep their knowledge and skills up to date throughout their working life and take part in educational activities that maintain or further develop their competence.
This is can do by having a personal development plan which will not only serve as a guide but enables the Doctor to be more self-aware of their learning needs which in turn enables them to understand how to improve performance and develop new skills. Having a personal development plan is a component of appraisals and revalidation.
My personal educational plan is to develop myself as a provider of women’s health service looking at the management of various menstrual disorders, providing contraceptive services including the insertion and removal of long methods of contraception as well as managing menopause.
This interest arose following my own learning needs as well as patient unmet needs. I felt this was an area that I could develop an interest in as well as provide a very important service in primary care. Most of the adult population of England are sexually active and having the correct sexual intervention and services can have a positive effect on population health and well being as well as individual risk.
Sexual health is an enhanced service and so will support my Practice to provide more holistic care for our patients rather than referring them to other centers or secondary care. It will not only reduce the waiting time for patients but also referral costs for the patients.
With the yearly appraisals required for revalidation, General Practitioners are required to keep a record of their reflection on all aspects of their work and make sure that their knowledge and skills are up to date. This record leads to the recognition of a personal development plan by identifying a learning need.
And there are various ways or methods that can be used to identify a learning need.
Dr. Eve’s description on PUNS and DENS as a mechanism by which a clinician identifies their educational needs by analyzing their own consultation following a patient’s unmet need
To do this we make a record of our experiences and prioritize not only what we need to learn, but how and when. My interest in women’s health arose following a patient’s unmet need and so I chose the PUNs and DENs method, which was self-directed and was based on my consultation. I decided to have a learning log, recording my learning needs, how I intended to improve my knowledge, and possibly create a timeline for this.
Identify PUNS – as a GP trainee in a general patient who presented with menopausal symptoms requesting for hormonal replacement therapy. At that time all I knew about HRT was that increased the risk of breast cancer, so I discouraged her and advised her to try other remedies. She left in tears. PUNS – The patient left very upset. I discussed with my trainer and tried inviting her back to discuss HRT but she refused to see me. I felt really bad.
DENS Identified – Management of menopause and hormonal replacement therapy. This led to managing women’s health problems because I also realized various forms of contraception had different effects on the menstrual cycle and women generally knew what they wanted but not the medication to achieve their needs. Record the DENS – My PDP at the end of the training was to increase my knowledge and skills in the management of women’s health problems. I enrolled in the DFSRH.
Fulfilling the DENS – I have now completed the DFSRH, competences in the insertion and removal of subdermal implants and intrauterine devices and also a menopause special skills module. I am keeping a record of my consulting and practical skills around female sexual and reproductive health.
The drawback of using PUNS and DENS is that it is very subject, it recognizes what we failed to do which can be de-motivating. It is best to use more than one method and a combination of subjective and objective methods especially feedback from colleagues and patients perhaps being the best.
To uncover previously unknown gaps in my knowledge of female reproductive health, by developing a new skill and providing an enhanced service for my Practice in a community.
In terms of achieving these objectives, I sort of used the SMART (specific, measurable, achievable, relevant, and time-bound) approach.
I began preparation for the diploma after passing my CSA exam last year. As a newly qualified GP I began the courses and clinical session needed to be awarded the degree and once this was completed early this year, I enrolled for the clinical sessions needed to be awarded the LoC of IUDs and implant, I felt the knowledge of the DFSRH will be necessary for the routine management of menstrual irregularities as well providing contraceptive options for patients. And I am working towards achieving the special skill module on menopause.
Various authorities and clinicians have described how having a personal developmental plan improves our clinical career.
Dr. M. Manoharan, a consultant in South London said, “A personal development plan is a dynamic and structured process of nurturing skills. It’s about reflecting on your current learning and performance and developing plans for the future. It helps give you direction and is essential at all stages of a career”.
A Program director described PDP as a means of achieving career aspirations and improving patient care. A Registrar in London said in a BMJ journal “Any route to success must start with a plan. Making a personal development plan (PDP) will help you to recognize educational needs as well as personal aspirations and it will allow you to map out how you can achieve these “.
A recent study by the sexual and reproductive service in England showed that over 700,000 women contacted the service for contraception and this figure has been rising in the last 10 years.
The need for sexual and reproductive health services in primary be care cannot be overemphasized, referral to secondary care not needed, patients are seen by their GP they know and comfortable with. It is also an enhanced service that provides additional income for the practice.
PUNS and DENS fulfills the GMC requirement for needs-based development
On completing the diploma and Letters of competences, I will keep a logbook on cases I have seen and carry out an audit over the first 3 months. Identify areas I need to improve, what went wrong, and how to avoid this. This will also need re-auditing.
As highlighted earlier, it is best to use one than one method in assessing learning needs, an audit will help identify if I have been able to improve my skills and knowledge. This is quite good as it promotes being patient-centered. However if unable to achieve these skills or not skillful enough to provide a good service, it will be devastating, especially with the time, money, and effort put into it. Time is a very important factor with respect to a personal development plan. A study in BMJ highlighted that while personal development plans are important, protected time needs to be provided in order to facilitate and complete them.
Some factors can affect completing this plan.
With respect to time, I have started the process so I will see how that goes. Family life is also a priority, so I know I can not rush to complete this plan, and perhaps having a timeline. If a more pressing learning need arises then perhaps I can take a break on this plan and pick up later.
A personal development plan is a career guide for all doctors, irrespective of their grade, specialty, or working setting. By carrying out this plan, I hope it improves my knowledge and skills to be able to provide the care and treatment my patients or clients need. I hope that it helps me to become, a better General Practitioner and that I can keep this cycle of learning going, even after achieving my objectives for this plan, I can apply the knowledge from this to clinical or academic areas that require improvement.