Maintenance of professional competence in Ireland: a national survey of doctors’ attitudes and experiences

Abstract

ObjectivesProgrammes to ensure doctors’ maintenance of professional competence (MPC) have been established in many countries. Since 2011, doctors in Ireland have been legally required to participate in MPC. A significant minority has been slow to engage with MPC, mirroring the contested nature of such programmes internationally. This study aimed to describe doctors’ attitudes and experiences of MPC in Ireland with a view to enhancing engagement.ParticipantsAll registered medical practitioners in Ireland required to undertake MPC in 2018 were surveyed using a 33-item cross-sectional mixed-methods survey designed to elicit attitudes, experiences and suggestions for improvement.ResultsThere were 5368 responses (response rate 42%). Attitudes to MPC were generally positive, but the time, effort and expense involved outweighed the benefit for half of doctors. Thirty-eight per cent agreed that MPC is a tick-box exercise. Heavy workload, travel, requirement to record continuing professional development activities and demands placed on personal time were difficulties cited. Additional support, as well as higher quality, more varied educational activities, were among suggested improvements. Thirteen per cent lacked confidence that they could meet requirements, citing employment status as the primary issue. MPC was particularly challenging for those working less than full-time, in locum or non-clinical roles, and taking maternity or sick leave. Seventy-seven per cent stated a definite intention to comply with MPC requirements. Being male, or having a basic medical qualification from outside Ireland, was associated with less firm intention to comply.ConclusionsDoctors need to be convinced of the benefits of MPC to them and their patients. A combination of clear communication and improved relevance to practice would help. Addition of a facilitated element, for example, appraisal, and varied ways to meet requirements, would support participation. MPC should be adequately resourced, including provision of high-quality free educational activities. Systems should be established to continually evaluate doctors’ perspectives.

Doctors’ engagement with a formal system of continuing professional development in Ireland: a qualitative study in perceived benefits, barriers and potential improvements

“…The barriers highlighted by doctors in this study are broadly in line with those found by another recent study based in Ireland. 23…”

Influencing factors of self-directed learning abilities of medical students of mainland China: a cross-sectional study

“…The medical field is considered to have the most quickly evolving knowledge. 1 Medical professionals need to master the latest medical technologies and methods to maintain professional competence 2 and better serve patients. 3 A decline in physicians' knowledge with time may result in lower quality of care.…”

Doctors' attitudes to maintenance of professional competence: A scoping review

“…Most mixed‐methods studies involved surveys with quantitative and qualitative components. Seventeen studies integrated theory in the design and/or analysis of the research 26,39–54 . Theories applied included those focused on process change, societal control and regulation and individual behaviour change 23,55–57 (Table 1).…”

“…Requirements imposed by regulatory authorities, employers and health care associations were the dominant extrinsic motivator for engagement with MPC 25,47,61,65,68,72,80–82 . Conversely, patient and colleague expectations and perceptions were not strong extrinsic motivators for participation in the process 47–50,81,83 . A few studies' participants did think that MPC was important to their patients 61,62,84,85 .…”

“…Doctors had mixed attitudes towards the processes of MPC. Although some were positive, 26,48,49,60,62,65,68,70,76,78,90–100 several sources of evidence reported significant anger, frustration and negativity 21,47,66,67,82,83,88,101–105 . Attitudes of dissatisfaction were present across multiple specialties, scopes of practice and jurisdictions, with doctors describing MPC as a bureaucratic tick‐box exercise, serving little practical purpose 20,25,26,40,47–49,51,54,60,66,72,105–108 .…”