Editorial article
Recertification is comming. Afraid? Not at all
La recertificación que se avecina. ¿Miedo? Ninguno
a Hospital Universitario de Son Espases, Palma de Mallorca, Balearic Islands, Spain
b Hospital Universitario Arnau de Vilanova, Lleida, Spain
c Hospital Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
d Grupo de recertificación, Sección de Docencia y Formación, Sociedad Española de Anestesiología y Reanimación, Spain
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Ninguno" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Continuing Professional Development (CPD) and Professional Development (PD) have gradually, but heterogeneously, incorporated in the field of health care in recent years.</p><p id="par0010" class="elsevierStylePara elsevierViewall">CPD, from an international perspective, is primarily the concern of individual medical practitioners committed to the ideal of professionalism. This, in turn, is rooted in each individual's ethical–professional commitment to maintain a life-long level of competence in order to provide at all times the latest, scientifically-based medical treatment, and to fulfil a duty to work as a member of a team. It involves making every effort to improve patient safety, spare resources, and optimise the outcomes of one's professional endeavour.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">From a global perspective, CPD should be considered by practitioners as an opportunity for training/learning, assessing their care activity, teaching, research and clinical management, and for improving their ability to respond to changes in their surroundings, their ability to reflect on the practice of medicine and its individual, social and organisational impact. In short, the maintenance, development and evaluation of competence.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In Spain, Continuing Medical Training (CMT) and CPD are legally regulated, specifically by some of the most important laws governing the Spanish National Health System.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Although these laws have not been developed, in recent years the Human Resources Commission (HRC) of the Spanish National Health System has worked towards implementing a system of professional development. As part of their efforts, in their plenary session of 6 September 2012, the HRC approved the CPD and PD documents. Under the auspices of the HRC, the CPD and PD Working Group laid out its evaluation process in a technical document presented in November 2013.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Article 22 of the EU's Professional Qualifications directive (2013/55/EU) provides the basis for each Member State to implement continuing professional development schemes in their territory. The aim of these projects is to improve both professional quality and patient safety, and with it, the quality of care.</p><p id="par0035" class="elsevierStylePara elsevierViewall">However, as we know, evaluation of PD is structurally complex, expensive, and hard to implement, aside from the reticence of different associations or professional groups to embrace these changes.</p><p id="par0040" class="elsevierStylePara elsevierViewall">This is why we believe that the process of recognising PD should be simple, easy to explain and understand, and capable of improving clinical management without increasing the bureaucratic burden.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Recertification is a part of PD. It is the process whereby a competent authority ensures, by means of periodic evaluations, that a previously certified professional has maintained an acceptable level of knowledge and skills, and has applied ethical principles to the performance of their professional duties in accordance with state of the knowledge and skills required in their particular field.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Who is involved in this process?:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0055" class="elsevierStylePara elsevierViewall">Professionals in a position to request a CPD evaluation. This request is made on a voluntary basis.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0060" class="elsevierStylePara elsevierViewall">The administration, which has the responsibility of guaranteeing society the best possible medical care.</p></li><li class="elsevierStyleListItem" id="lsti1010"><span class="elsevierStyleLabel">3.</span><p id="par1060" class="elsevierStylePara elsevierViewall">Professional corporations, mainly:</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.1</span><p id="par0070" class="elsevierStylePara elsevierViewall">Medical associations, which are responsible for guaranteeing good practice and professional values (Periodic Validation by the Association: PVA).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">3.2</span><p id="par0075" class="elsevierStylePara elsevierViewall">Scientific societies, which have the authority and are the guarantors of the latest scientific doctrine. These societies are responsible for marking out the most adequate training and competence pathway (Recertification). And this is where our Society must be prepared to act.</p></li></ul></p><p id="par0080" class="elsevierStylePara elsevierViewall">PVA (Association-based) and Recertification (scientific society-based) may award, jointly or separately, the credentials corresponding to their respective authority, that is, to their field of competence. The public administration (s) may or may not include these credentials in PD evaluation processes.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The recertification processes for which the scientific societies are responsible, and in this case the Spanish Society of Anaesthesiology, should be:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">Easily understood and implemented by all professionals; the competence-based evaluation model would be suitable for this purpose.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">Structured in such a way as to allow for individualisation, thus making it accessible to all professionals.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">Held every 6 years.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0105" class="elsevierStylePara elsevierViewall">The process should not be punitive, but should rather aim at achieving previously defined competences. Improvement programmes must be available for professionals who fail to achieve these levels.</p></li></ul></p><p id="par0110" class="elsevierStylePara elsevierViewall">Which areas are included in PD, and what percentage of the total activities will they occupy? Mainly 3:<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">1.</span><p id="par0115" class="elsevierStylePara elsevierViewall">Ethics and professionalism (deontological code, professional values, etc.) Yes/No.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">2.</span><p id="par0120" class="elsevierStylePara elsevierViewall">Health care (care, clinical management, clinical activities, clinical stays), 60% of the total.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">3.</span><p id="par0125" class="elsevierStylePara elsevierViewall">Training, teaching and research (CMT, teaching activities, research, other activities), 40% of the total.</p></li></ul></p><p id="par0130" class="elsevierStylePara elsevierViewall">The primary basic principle is that a professional cannot pass their recertification on the basis of a single activity, therefore, a minimum or cut-off level will be established for each area of activity.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Ethical and professional values should not be assessed on a numerical scale, but on the basis of accredited performance or documented breaches (reported by the Association, or on a legal, corporate or administrative level).</p><p id="par0140" class="elsevierStylePara elsevierViewall">The second group, health care, is divided into 3 subgroups: clinical activities, clinical management activities, and clinical rotations. This group will determine the level of professional development and quality of care, because only a professional engaged in clinical activity will request an evaluation of the PD. It is important to note, therefore, that a professional who is not engaged in clinical activity cannot request validation of their PD,</p><p id="par0145" class="elsevierStylePara elsevierViewall">and means that a procedure must be put in place to enable professionals who are temporarily not actively engaged in care activities to return to active service.</p><p id="par0150" class="elsevierStylePara elsevierViewall">The third group, training, teaching and research activities, will include accredited continuing professional development, teaching, research, and other activities, which will also and mark the distance between professionals.</p><p id="par0155" class="elsevierStylePara elsevierViewall">To launch this process, the chairman of the Association has asked the teaching and Continuing Professional Development division to create a working group made up of colleagues from different backgrounds and fields. All the members of this group have extensive experience in training and management, and their mission is to develop recertification programmes for PD groups 2 and 3 and, through our Society, help our professional achieve the minimum levels required.</p><p id="par0160" class="elsevierStylePara elsevierViewall">The technical document, which is still under development, will be reviewed by our Scientific Society and sent to all our member associates. This document will set out the care- and training-related criteria required, and provide different of training tools (online courses, simulations, face-to-face teaching, etc.) in order to facilitate achievement of the minimum levels required for recertification.</p><p id="par0165" class="elsevierStylePara elsevierViewall">All this will be done by and through the Association's different training divisions including, of course, the Teaching and Continuing Professional Development division. In parallel, all training activities accredited by the National Health System or regional authorities will also be validated.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Recertification is a necessary, recommendable and unavoidable process for highly qualified professionals such as: Scared? Not at all.... The future lies before us.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García Romero M, Sistac Ballarín JM, Escudero JA. La recertificación que se avecina. ¿Miedo? Ninguno. Rev Esp Anestesiol Reanim. 2018;65:303–305.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Desarrollo Profesional Continuo (DPC) y Desarrollo Profesional (DP) Comisión de recursos humanos del Sistema Nacional de Salud. Junio 2013. Available from: <a id="intr0010" class="elsevierStyleInterRef" href="https://www.redaccionmedica.com/contenido/im%26aacute;genes/documento%20ap.pdf">https://www.redaccionmedica.com/contenido/imágenes/documento%20ap.pdf</a> [accessed 20 Feb 2018]." ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ley 16/2003, de 28 de mayo, de cohesión y calidad del Sistema Nacional de Salud. 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