Introduction of Web based Continuous Professional Development to Sri Lanka

Continuous Professional Development (CPD) can be described as a continuous process which begins on the day a person start practicing as a doctor. Continuous Medical Education (CME) concentrates on improving individual professional knowledge by education and training in areas determined by experts. But in CPD, professionals play an active role in defining the knowledge which they see as relevant to their own professional needs and learning takes place not only at individual level but also at organisational level. CPD is becoming a popular mode of learning worldwide by which doctors keep their practice up to-date. CPD is seen as essential for effective practice and for professional development. Even though the standard format of CPD for many years has been formal, there is no specific method in operation. Over the last decade there has been increasing interest in the use of computers to facilitate collaborative learning between healthcare professionals for CPD. Web-based learning is an attractive methodology for medical education and offers some advantages over traditional methods. There is improved clinical practice and improved clinical decision making as a result of web based learning. Professionals are satisfied with the flexibility and the convenience offered in Web-based mode of CPD delivery as it saves time and money. Web based CPD programmes will fulfil the educational requirements of health professionals in the peripheral parts of Sri Lanka who have difficulty in attending formal education sessions due to their geographical isolation. Meeting the educational needs of professionals already in practice remains a challenge and web based online CPD can play a major role in proving the high demand.


What is CPD?
Continuous Professional Development (CPD) refers to the education of physicians following completion of formal training, which will help to maintain, develop or increase knowledge, technical skills and standards, resulting in better healthcare.
The spectrum of CPD is broad which include not only acquiring new knowledge or skills as a doctor but also encompass one's personal development (6) .Studies have demonstrated that there is no designated method of CPD (12) .

The difference between CME and CPD
CME concentrates on professionals keeping them upto date.CME focuses on improving specialist knowledge by education and training in areas determined by experts.In CPD, professionals play an active role in defining the knowledge which they see as relevant to their own professional needs.Learning takes place not only at individual level, but also at the organisational level (1) .Due to these facts CPD is an active mode of education which addresses a broader spectrum of the medical profession.

Importance of CPD for medical professionals
The amount of biomedical knowledge available doubles every 20 years (13) .A doctor's practice could become rapidly outdated without activities that allow doctors to refresh current knowledge and skills.As needs of the patients, doctors and of the health service within which they practice keep changing with time, being up to date with these changes is necessary if a doctor is to engage in good medical care (5) .
CPD is becoming a popular mode of learning worldwide.Professional activity helps to maintain, develop or increase knowledge, problem solving, technical skills and professional performance standards with the aim that physicians can provide better healthcare (4) .Learning via CPD is seen as essential for effective practice and for individual professional development, whether or not it results in career progression (12) .

Integration of ICT to deliver CPD programmes
The standard format of CPD for many years has been formal study courses, conferences, symposiums or workshops.Doctors in developed countries perceive that CPD opportunities are mostly available to those who live in main cities.Due to difficulties with finances, time, job demands and work-life balance CPD programmes are inaccessible to most others (12) .Introduction of e-learning (which is defined as "learning facilitated and supported through the use of ICT) in recent history has revolutionised CPD programmes making it easily accessible even to doctors from rural areas.
Internet based CPD programmes across the world provide opportunities to deliver collaboration and social learning.CPD on the Internet has grown steadily over the past several years (3) .It has the potential to generate new knowledge and promotes higher achievement.Studies document that web based learning is an attractive methodology for medical education and offers some advantages over traditional methods (8) .Research has highlighted that professionals are satisfied with the flexibility and convenience offered in web-based distant education and it is an effective and efficient mode of CPD delivery, specially for technologically competent professionals (9) .Although e-learning is not universally accepted as a preferred learning style for all, it provides a potential method by which barriers such as lack of time and geographical isolation can be minimised.Some advantages of e-learning include: support for delivery by employers and the government, the choice of course can be based on content rather than geographic proximity, easy electronic access, potential daily contact with tutors and opportunities for cross cultural learning.Online CPD courses are possible due to developments in multimedia technology and the internet.Widespread use of the internet and new multimedia data communication technologies created the first generation of online CPD courses taught in virtual classrooms.The first online CPD course emerged in 1996 (7,11) .Second generation courses include interfaces that allow user interactivity, allowing the experience to approximate the traditional 'live' lecture which is the current educational 'gold standard'.Current CPD will provide a mobile, interactive, tactile, online, virtual reality experience.Specifically, online CPD courses represent a cost effective, convenient option and one that affords physicians much flexibility when fulfilling credit requirements (7) .Furthermore studies assessing the effectiveness of CPD across domains are less effective.Interactive techniques are more effective than non-interactive ones and multiple exposures to the CME activity are more effective than single exposure (10) .

The importance of web based CPD to Sri Lanka
Medical Officers and Specialists in rural areas of Sri Lanka are at a disadvantage when accessing CPD programmes as their geographical isolation influences attendance at seminars, workshops and informal discussions with colleagues.Lack of access to Continuous professional education can have a significant influence on recruitment and retention of healthcare professionals in rural areas.
eLearning using web based distance education principles has expanded opportunities for the provision of a flexible, convenient and interactive form of CPD that has fulfilled the requirements of health professionals in peripheral parts of Sri Lanka who have difficulty attending formal education sessions.