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Paper
Paper Motivating factors and perceived barriers to participating in continuing professional development: a national survey of veterinary surgeons V. H. M. Dale, S. E. Pierce, S. A. May Although continuing professional development (CPD) is regarded as mandatory by the Royal College of Veterinary Surgeons, it is not yet a statutory requirement. To understand what motivates veterinary surgeons to engage in CPD and perceived barriers to participation, a national survey was administered to a sample of the profession. The study sought to report overall opinion and to compare the views of different groups in terms of decade of graduation, gender, employment status, area of employment and position in the workplace. The results of the study are encouraging in that recent graduates would like to engage in more CPD, compared with their predecessors, and are the most intrinsically and extrinsically motivated. However, significant barriers to participation exist, including personal barriers, a lack of workplace support and a lack of CPD activities at a suitable time, location or level. Part-time workers reported higher barriers than full-time workers. Although the majority (90 per cent) of respondents receive all or part of their CPD funding from employers, a significant proportion (41 per cent) are required to fund at least part of their CPD. First-opinion practitioners reported significantly less access to a professional library, which has implications for lifelong learning and the practice of evidence-based veterinary medicine.
Introduction
Although considered mandatory by the Royal College of Veterinary Surgeons (RCVS) (2012), Continuing Professional Development (CPD) is not currently a statutory requirement. Given the increasingly complex demands on the profession, a new Veterinary Surgeons or Veterinary Services Act is likely to make CPD a legal requirement (RCVS 2010), following developments in other professions such as medicine (Mahmood 2010) and dentistry (Hancocks 2011). In the meantime, to encourage full participation, it is necessary to find out what motivates different groups of veterinary surgeons to engage in CPD, and what perceived barriers might limit their participation. There has already been some published work on motivators and barriers to participation in veterinary CPD in the USA and Canada. A series of focus groups with veterinary practitioners in California by Moore and others (2000) revealed that they were most motivated to participate in CPD to interact and socialise with colleagues, and secondly by the need to improve their skill-set and identify weaknesses, with other reasons including keeping practice life fresh and Veterinary Record (2013) V. H. M. Dale, BSc, MSc, FHEA, PhD S. E. Pierce, BSc, MSc, PhD, S. A. May, MA, VetMB, PhD, DVR, DEO, FRCVS, Dipl. ECVS, The LIVE Centre, Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK
doi: 10.1136/vr.101492 E-mail for correspondence:
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vercoming feelings of isolation. Barriers related to the timing of o events, distance, money, solo practice, stage of career and family demands; with time, distance and money being the biggest obstacles. A recent study of the continuing education needs of veterinarians in Alberta, Canada by Delver (2008) also concluded that workload and distance were barriers to CPD attendance, but paradoxically found that respondents in remote locations and solo practitioners expressed a preference for face-to-face programmes over distance learning, due to a desire to mix with colleagues and engage in practical training, and their relative inexperience with distance learning technologies. The study published here documents the findings of a survey distributed to a random sample of veterinary surgeons across the UK, to establish the profession’s current thinking on CPD. As far as we are aware, this is the most comprehensive research undertaken to date into veterinary surgeons’ attitudes towards, and experiences of, CPD, with the aim of understanding how engagement in CPD is influenced not only by demographics, but also underlying motivations, perceived barriers and learning preferences. An earlier paper (Dale and others 2010) detailed the relationship between learning preferences within the veterinary profession (reconceptualised as a preference for complexity versus a preference for simplicity) with motivating factors and perceived barriers to participation in lifelong learning. Here, this data is further explored with respect to views and experiences of CPD.
Provenance: Not commissioned; externally peer reviewed.
Methods
Accepted August 1, 2013
A paper-based questionnaire was designed to assess the UK veterinary profession’s attitude towards CPD. Although questionnaires are straightforward to administer and can be designed to gather large amounts of generalisable data at relatively low cost in a short amount
Questionnaire
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Paper of time, methodological challenges include respondent subjectivity, social desirability response bias, misinterpretation of questions and low response rates (Robson 2002). To alleviate possible biases, the questionnaire was piloted during development with eight clinicians (six at the Royal Veterinary College, one practitioner and another recently retired practitioner), and a focus group was conducted with nine RVC clinicians (with small, equine or farm animal expertise), to ensure that questions were comprehensive but also straightforward and easy to read, to reduce the possibility of misinterpretation. Suggestions arising from the piloting phase and focus group discussion were used to refine the questionnaire, in terms of reducing the length of the survey, modifying instructions and wording throughout, changing some response options, and allowing participants to clarify their role as employer versus employee. The final version of the survey comprised five main sections: 1. Demographics: Demographic information (largely replicating categories used by the RCVS (2006) survey of the profession) was sought to allow for the comparison of different groups, for example, by gender, decade of graduation, employment status, area of employment and position in the workplace. 2. Views and experience of CPD: Respondents were asked to document the number of hours in the last 12 months spent giving and receiving CPD, as well as indicating their level of agreement with general statements regarding CPD on a 5-point Likert scale, where 1=Completely disagree and 5=Completely agree. Respondents were also asked to indicate their preference for different methods, based on a description of a CPD Preference Inventory by Sadler-Smith and others (2000), where 1=Never used, 2=Not at all useful, 3=Not very useful, 4=Useful and 5=Extremely useful. Respondents were also asked when they realised the importance of continuing education, and which types of learning resources they had access to. 3. Motivating factors for participating: Respondents were asked to rate 17 statements representing reasons for participation in CPD, adapted from those used in a study of nurses’ reasons for participating in continuing education in human medicine (DeSilets 1995), on a 1–4 Likert scale, where 1=Never, 2=Occasionally, 3=Often, and 4=Always (feel this way/do this), and to provide additional comments regarding reasons for participation. 4. Perceived barriers to participation: Respondents were asked to rate 13 barriers to participation in veterinary CPD extrapolated from the results of a focus group study by Moore and others (2000) on a 1–4 Likert scale, where 1=Never, 2=Occasionally, 3=Often, and 4=Always (feel this way/do this), and to provide additional comments regarding barriers, including how a disability might impact on an individual’s ability to engage in CPD. 5. Approaches to learning: To allow exploration of the relationship between learning preferences and engagement in CPD, respondents were also asked to rate a number of statements adapted from published inventories regarding their approach to learning. Items were extracted from the Approaches to Study inventory (Tait and others 1997), the need for cognition questionnaire (Cacioppo and others 1984) and the conceptions of knowledge scale (Vermunt and van Rijswijk 1988, cited in Richardson and Edmunds 2007). The impact of veterinary practitioners’ approaches to learning on their motivation to engage in CPD, and their perceptions of barriers, has been published separately (Dale and others 2010). The study revealed that individuals with a preference for complexity (deep approach to study, high need for cognition and construction and use of knowledge) were more motivated to engage in CPD and less deterred by barriers, while individuals with a preference for simplicity (surface approach to study, low need for cognition and intake of knowledge) were less motivated and more deterred by barriers. Sustained efforts were made to maximise the response rate. A letter was published in The Veterinary Record and The Veterinary Times in August 2008 to draw readers’ attention to the forthcoming survey. 2 of 7 | Veterinary Record | 10.1136/vr.101492
The questionnaire, assigned an anonymous identifier, was subsequently mailed to potential participants in August 2008 with a personally addressed cover letter outlining the importance and relevance of the study to the veterinary profession. The survey was also made available online to give potential participants flexibility in how they might respond. A personal reminder letter was mailed to individuals in October 2008, and a letter thanking respondents and requesting non-respondents to participate were subsequently published in The Veterinary Record and The Veterinary Times in November 2008.
Sampling
Two thousand veterinary surgeons (approximately 10 per cent of the workforce) were randomly selected from the RCVS database of homepractising UK graduates across four decades (1968–2008), from six UK veterinary schools. The selection was performed independently by the RCVS who supplied the dataset of potential respondents. The random sample comprised 39 graduates from the 1960s (2 per cent), 305 graduates from the 1970s (15 per cent), 419 graduates from the 1980s (21 per cent), 407 graduates from the 1990s (20 per cent) and 830 graduates from the 2000s (42 per cent).
Data analysis
Quantitative analyses were conducted in a number of stages using SPSS V.16-20. Frequency tables, simple descriptive statistics and bar charts were generated as a means of initially exploring the data. As detailed by Dale and others (2010), principal components analysis and Cronbach’s α were performed to assess the internal consistency of the different scales (preference for complexity vs simplicity; intrinsic, extrinsic and social motivation; and barriers). Between-group statistical comparisons were conducted using Fishers or χ2 tests for nominal data, the Mann-Whitney U test or Kruskal-Wallis analysis of variance (ANOVA) for ordinal data, and an independent samples t-test or ANOVA for continuous data, depending on whether there were two or more groups compared, respectively. Posthoc tests were conducted where significant differences were observed in one-way ANOVAs in which decades were compared. To reduce the possibility of a Type I error, the Bonferroni correction was applied such that the acceptable level of significance was 0.05 divided by the number of posthoc tests. The percentages reported in this paper are the valid percentages excluding missing values, and have been rounded to the nearest integer; where the value was 0.5, this has been rounded up, and thus, percentages may exceed 100 in the frequency tables.
Results
Of the 2000 questionnaires, 810 were returned. After excluding incomplete and duplicate submissions, the total number of valid responses was 803 (40.2 per cent). Responses from retired/semiretired participants were also excluded; therefore, the total number of returns analysed was 775 (38.8 per cent), comprising seven graduates from the 1960s (1 per cent), 116 graduates from the 1970s (15 per cent), 180 graduates from the 1980s (23 per cent), 149 graduates from the 1990s (19 per cent) and 323 graduates from the 2000s (42 per cent). Overall, 92 per cent of male respondents were in full-time employment versus part-time, while 78 per cent of female respondents were full-time versus part-time. In the 2000s, there was less of a gap, with 95 per cent men and 93 per cent women in full-time employment. The breakdown of respondents in relation to other demographic variables is shown in Table 1.
Views and experience of CPD
The overwhelming majority (97 per cent) of respondents agreed that ‘CPD is important for my professional development’, while there was a varied response as to whether ‘Mandatory CPD will make members of the profession more effective’ (50 per cent agreement). Nevertheless, a comparison of graduates from different decades revealed that attitudes towards CPD have become more positive, not only in relation to personal development (P
