The use of continuing professional development portfolios in healthcare professionals and their influence on the practice of pharmacists in secondary care

AIM: To investigate how the use of continuing professional development portfolios influences pharmacy practice and reflective writing, METHOD: The study consisted of 2 phases. Phase 1 explored the use of CPD portfolios in a purposive, stratified sample of 7 health professions, in a teaching hospital using semi-structured interviews. The psychological characteristics of portfolio use were examined in a cohort of 172 pharmacists. A questionnaire was designed using the theoretical framework of the Theory of Planned Behaviour and the Big-Five, for personality traits. Phase 2 was an in-depth, longitudinal study to explore the influence of CPD portfolios on pharmacy practice. Phase 2 used semi-structured interviews in a purposive, stratified sample of 9 pharmacists. Data were collected at 3 time points (base line, 6 and 12 months) and validated using focus groups. CPD records (n = 24) were analysed for the level of reflection. Ethics approval and informed consent was obtained. DATA ANALYSIS: Questionnaires were analysed using SPSS to report descriptive statistics. Discourse analysis was used for interview and focus group data. A modified version of "Written Reflections In a Theoretical Teacher-training" course framework was used to analyse CPD accounts. FINDINGS: Phase 1: 23 interviews were undertaken with 7 health professionals, mean age 33 +/- 8.4 years. Hospital pharmacists (n = 132), with a mean age 28.8+/-5.4 years returned the questionnaires (response rate 78%). Interviews, revealed that: a) support mechanisms not integrated, b) the effects on practice difficult to describe, c) the effect of reflection on practice difficult to verbalise, and d) a number of barriers to recording reflection. Questionnaire data found pharmacists experience and gender were not associated with keeping a portfolio. Pharmacists' attitude and perceived behavioural control influenced the intention of keeping a portfolio. Phase 2: Three cohorts of pharmacists (n = 9), mean age 31+/- 8.1 years, were interviewed. The findings included that after 12 months: a) portfolios are perceived negatively, b) perceived skills improved, with minimal influence from recording, and c) the effects on practice difficult to verbalise and inconsistent. The CPD records were objective, descriptive, and with little evidence of critical writing. CONCLUSION: The study found different beliefs and behaviours to keeping a portfolio and utilising reflection. CPD records were mainly descriptive with little evidence of criticality or effect on practice. Portfolios can be perceived as a form of professional discipline and not a learning tool.