Today’s correspondent asks:

With paramedic registration now in place, paramedics are going to be looking for opportunities to both offer and undertake continuing medical education (CME) opportunities.  Since this will be new for most of us, are you able to offer some insight about what would be considered a legitimate source of CME?  I have heard, for example, that unless you are a registered training organisation (RTO) that you cannot offer a certificate of “competency” in anything.  Is this the case?  In this new marketplace for paramedics, with the principle of caveat emptor firmly in the forefront, are there any significant caveats that we need to be aware of in terms of either offering or undertaking CME activities?  Can just anyone offer a certificate?  What guidance can you offer about identifying errors in offering and undertaking CME activities?

The Health Practitioner Regulation National Law refers to Continuing Professional Development (CPD) rather than CME.   Section 128 says:

A registered health practitioner must undertake the continuing professional development required by an approved registration standard for the health profession in which the practitioner is registered.

The Paramedicine Board has issued a relevant registration standard – the Continuing professional development registration standard (17 May 2018).  That standard says that a paramedic must:

  1. complete at least 30 hours of CPD each year that:

a. seeks to improve patient outcomes and experiences

b. draws on the best available evidence, including well-established and accepted knowledge that is supported by research where possible, to inform good practice and decision-making

c. contributes directly to improving your competence (performance and behaviour) and keeping you up to date in your chosen scope and setting of practice

d. builds on your existing knowledge, and

e. includes a minimum of eight hours CPD in an interactive setting with other practitioners.

2. maintain a portfolio that documents your learning goals, records all your planned CPD activities, your reflection on how these CPD activities have or are expected to improve your practice and evidence of having completed these activities.

To assist practitioners the Board has issued Guidelines: Continuing Professional Development (17 May 2018).  It is hard to go past those Guidelines to answer my correspondent’s question.  The Guidelines say:

All CPD which helps you maintain and enhance your competence and is relevant to your scope of practice, will meet the standard.

The Board does not endorse/accredit CPD providers or activities but expects practitioners to select CPD activities that are consistent with the ethical and professional standards set out by the Board.

When selecting CPD activities you should consider:

  • the qualifications, credentials and experience of the provider
  • selecting a range of topics and activities over time
  • having a balance between practice-based reflective activities (for example clinical audit, peer review or performance appraisal), professional education and training activities (for example seminars) and professional experience and development activities (for example meetings/ discussions, self-study, forums etc.), and
  • choosing activities that are consistent with the Board’s other standards and guidelines.

Learning occurs through a wide variety of CPD activities. Examples include, but are not limited to:

  • higher education/accredited courses
  • conferences, forums and seminars
  • undertaking research and presentation of work
  • online learning and internet research
  • written reflections on experience in day-to-day clinical practice
  • reading books and journals relevant to your practice
  • quality assurance activities, such as accreditation, clinical audit or review of records
  • participation in committees relevant to your practice
  • work-based learning contracts and employment related professional development
  • participating in peer and performance review activities
  • interactive professional or inter-professional interactions such as meetings e.g. case reviews, clinical forums (may be online or face-to-face), and
  • activities that address current or emerging health priority areas, for example: cultural safety for Aboriginal and Torres Strait Islander peoples and identifying and responding to family violence.

Your day-to-day routine work duties cannot be counted as CPD.

Discussion

Registered training organisations (RTOs) are governed by the National Vocational Education and Training Regulator Act 2011 (Cth).   An RTO can deliver accredited courses within the scope of the RTOs registration.   A “VET qualification” is ‘a testamur … confirming that the person has achieved learning outcomes and competencies that satisfy the requirements of a qualification.’  A “VET statement of attainment” is ‘a statement given to a person confirming that the person has satisfied the requirements of units of competency or modules specified in the statement’ (s 3).

It is an offence for an RTO to issue a VET qualification or a VET statement of attainment where the training is outside the RTOs scope of registration (ss 93-98) or where there has not been appropriate assessment and confirmation that the student meets all the requirements for the Qualification or Statement of Attainment (ss 104-110).   It is an offence for anyone who is not an RTO to issue what purports to be a VET qualification or VET statement of attainment (ss 114-121; 126-129).

The rationale behind all this is that RTOs are expected to meet certain standards and deliver the approved courses within their scope of registration.  It means that as another RTO or employer if you have two people with the same VET qualifications you can or should be able to accept that they have equivalent training without having to ask questions about who did the trainng and what was covered.

My correspondent’s question was

I have heard, for example, that unless you are a registered training organisation (RTO) that you cannot offer a certificate of “competency” in anything.  Is this the case?

The answer is no that is not the case.  Anyone can deliver training and give you a certificate to say you were competent in that training.  If they are not an RTO or it is not a VET qualification or unit of competency they cannot issue a VET qualification or VET certificate of attainment but not every training is a VET qualification or unit.    I could design and deliver a course on ‘law and emergency services’ and issue a certificate upon completion.  Whether that would be worth anything to anyone is a different matter.  However, the short answer is ‘yes, anyone can issue a certificate’.   Whether it is of any value is a different matter.

We can then return to the Paramedicine Board’s Guidelines: Continuing Professional Development.  The Registration standard and the Guidelines do not require that CPD be delivered by an RTO.  There will be much CPD that will not be delivered by an RTO.   If you go to a lecture from your peers giving a case study report that won’t be delivered by an RTO and won’t have a ‘certificate of competency’ attached to it.  Nor will taking time to read or perhaps write a journal article on an issue that helps develop your knowledge.    Not every CTP event requires a ‘certificate’.

As for ‘significant caveats that we need to be aware of in terms of either offering or undertaking CME activities’ and ‘guidance … about identifying errors in offering and undertaking CME activities’ it’s impossible to go past the advice given in the Guidelines and set out, above.

Your portfolio

As noted above – the Continuing professional development registration standard requires you to:

… maintain a portfolio that documents your learning goals, records all your planned CPD activities, your reflection on how these CPD activities have or are expected to improve your practice and evidence of having completed these activities.

Paramedics Australasia (of which I am a board member) has developed an online portfolio that is available to PA members and that can assist you to meet that requirement and to prove your CPD compliance when it comes to renewing your registration.  For details on the PA portfolio, watch the video from PA president Peter Jurkovsky.

PA also offers a variety of CPD activities both face-to-face and via e-learning.