Should Community First Responders do CPD and keep a portfolio record of their training and development?
From speaking to community first responders up and down the country, the continuing professional development that is required to be undertaken varies massively from one trust to the next, and in some cases, from one area of an ambulance trust to another.
When the first community first responder schemes appeared, well in excess of ten years ago, the initial concept surrounded training and equipping local people in (usually) rural communities to attend cardiac arrest and chest pain calls on behalf of the ambulance service to provide basic life support and reassurance until an ambulance arrived. Whilst I would agree that the primary function, and the driving force behind these groups has not changed, the role of a community first responder has evolved drastically alongside the ambulance service. With pressure being added to the ambulance service by the media, it is imperative A8 response times are met. Because of that, and because of the skill and willingness of the volunteers, community first responders are being dispatched to a far wider range of calls than initially intended.
For a number of years now, there has been more and more emphasis within the ambulance services, statutory, private and voluntary, to focus on continuing professional development – in short, continuing to learn and develop your knowledge for the benefit of the patient, even after qualifying. Again going back to the variety amongst norms within CFR groups, varying levels of emphasis is placed on CPD, from having to undertake an annual re-qualification, to group meetings every two weeks, and the need to keep a record of any training or development undertaken, either guided or unguided. No matter the level of development undertaken, its primary purpose is to benefit any patient the CFR comes into contact with.
CPD can be undertaken in a huge variety of manners, ranging from a basic life support refresher, practising skills that may not be used very often, in order to prevent skill fade, to reading up on newly-encountered conditions, through to reviewing your Trust’s oxygen administration guidelines to ensure you are confident in dealing with any situation. The level and depth of professional development undertaken should vary dependent upon the level at which the NHS Trust allow you to practise, and should be within the scope of your training, thus ensuring Trust guidelines are adhered to.
Whenever CPD is undertaken, it should always be documented. I am aware some Trusts have training log-books to keep a record of any training and development completed; however, it can also be helpful to keep a separate record. Not only does it allow you to visualise areas of your development you have not yet focused on, but it also aids in the understanding of the subject. By writing up the CPD undertaken, it allows you to review your learning, recapping on the essential points, and thus aiding information processing.
As well as undertaking practical or theoretical learning, another aspect of CPD is reflection upon incidents, regardless of whether they went well, or not so well. Patient confidentiality is important within these reflections, and if in doubt, double check with your CFR team leader.
I personally utilise Driscoll’s model of reflection, which at its’ most basic level asks – What? So What? Now What? This requires you to look in more depth about what happened, what yourself and others did, and what your reaction was. It then asks you to evaluate the consequences of what happened – so how you felt at the time, how you feel now, whether anything could have gone better. Finally, it encourages you to think if you could approach the situation differently in the future, and about how you could do that. The reflection doesn’t have to focus on the clinical side of the job, but can explore the way in which you handled communication, either with the patient, their relatives, any bystanders, or the ambulance crew.
I personally feel that by completing this model of reflection, both for jobs that went well, and those which didn’t, you will become a more competent, more confident first responder, constantly developing your practice. Once again, by documenting this, it allows you firstly to review the incident, thinking about how it went, and how you could have acted differently to affect the outcome, and also to allow you to reference your development as a first responder, and apply what you have learnt to a wider range of situations.
CPDme Development for Life - Community First Responders & Volunteers