What helps and hinders doctors in engaging in continuous professional development? An explanatory sequential design.

BACKGROUND Licensure and registration are the traditional approaches to ensure minimally acceptable standards of care for practice. However, due to advances in medical technology and changes in clinical practice, the knowledge and skills obtained from basic education and training may rapidly become out of date. There is no mandated, structured and ongoing mechanism to assess all doctors' competence in Hong Kong. This paper assessed doctors' perceived needs for continuous professional development, and to identify facilitators and barriers that are likely to influence the implementation of compulsory continuous professional development for maintaining professional competence and ensuring patient safety. METHODS An explanatory sequential mixed method design with two distinct interactive phases was adopted comprising a postal self-administered questionnaire survey among a random sample of 2,459 of doctors (Phase 1), followed by individual interviews of a stratified sample of 30 questionnaire respondents for the subsequent qualitative analysis (Phase 2). RESULTS The majority of doctors (over 90%) agreed the importance of continuous professional development to update knowledge and skills. However, just 30.7% of non-specialists compared with 65.4% of specialists agreed it would be desirable for continuous professional development to be a requirement for renewal of licenses. A relatively higher percentage of non-specialists compared with specialists reported barriers to participation such as accessibility, availability and relevance of the content of the programmes. Facilitators for uptake included more convenient schedule and location, relevant content, and incentives for participation such as making this a pre-condition for enrolling in government-funded services. CONCLUSIONS To address the needs of individual doctors, the spheres of practice, personal preferences and learning styles should be considered in deciding the content and processes of continuous professional development. Flexibility is also an important principle. A learning model, incentives for participation and a compliance strategy (instead of deterrence) could be effective strategy for continuous professional development.