Who Owns Veterinary Continuing Education? Part 2: Counting hours vs measuring impact (#482)

In Part 1, I argued that we need to bring the same level of scrutiny to veterinary continuing education (CE) that human medicine has applied to its own system, especially around corporate influence.

But even if we solved the funding problem tomorrow, we’d still be left with a deeper issue:

Our regulatory systems treat time spent in a chair as a proxy for competence.

Even if a participant sleeps through all the lectures!

You know the drill:

• I need 20 hours this year.

• I’m short on points in anesthesia.

• This online module gives 3 CE credits; that’ll do.

Regulators, specialty colleges, and employers generally ask:

How many hours?

when they should be asking:

What changed in your thinking, your behavior, your outcomes?

The Tyranny of the Hour

The current CE-hour model was built for administrative convenience, not educational excellence.

It has some obvious attractions:

• It’s easy to count.

• It’s easy to audit.

• It gives the appearance of rigor: 40 hours per year sounds reassuring.

But it quietly distorts the whole ecosystem:

• For regulators, it reduces professional development to a compliance exercise. Did you tick the box? Great, you’re safe to practice.

• For providers, it incentivizes content volume over impact. The goal is filling seats and awarding certificates, not necessarily changing practice.

• For corporate sponsors, it creates a perfect marketplace: buy access to hours, and you buy attention.

The assumption underneath all this is fragile:

If you attend enough lectures, you must be keeping up.

We all know that isn’t true.

You can sit (or sleep) through hours of high-quality content and go back to practice unchanged.

You can also transform your clinical approach based on a single patient, a single conversation, or a single well-run small-group workshop that doesn’t carry a single CE point.

Why Hours Don’t Equal Competence

There are at least three big problems with using time as our main currency.

1.        Learning ≠ Attendance

• Being physically (or virtually) present in a session tells us nothing about:

• Whether you understood the material,

• Whether you can apply it, or

• Whether it fits the reality of your practice (spectrum of care, local constraints, client demographics).

• We’ve all watched colleagues scrolling phones or checking emails during lectures or sleeping … while collecting CE credit.

2.        No Link to Real-World Practice

• An hour on the latest in neurology counts the same whether:

• You’re a neurologist who will apply the knowledge daily, or

• A mixed-animal practitioner who will never see a similar case again.

• And even when the topic is relevant, nothing in the hour-based model asks:

• Did your prescribing change?

• Did your surgical complication rates fall?

• Did your end-of-life conversations become more nuanced and compassionate?

3.        Perverse Incentives

• When hours are the currency:

• Cheap, easy, sponsor-supported CE wins.

• Harder, slower, more reflective learning gets sidelined (journal clubs, audit and feedback, mortality rounds, quality-improvement projects, mentoring).

• It is much easier for a large company to bankroll a glossy 2-hour symposium than for a small, independent practice to fund a year-long project to reduce unnecessary euthanasia, improve dental care, or rationalize antibiotic use.

So, if we’re serious about protecting the soul of veterinary medicine, we must ask:

How do we move from counting hours to measuring impact?

What Outcome-Focused CPD Looks Like

Let’s use CPD (Continuing Professional Development) rather than CE, because CPD suggests a broader, deeper, more practice-rooted process.

An outcome-focused CPD system asks three questions:

• What specifically are you trying to get better at?

• What learning activities did you choose to address that gap?

• What changed as a result for you, your team, your patients, your clients?

Instead of a yearly total of hours, it might track:

• Changes in prescribing patterns (e.g., reduced use of critically important antibiotics).

• Surgical outcomes (infection rates, re-operation rates, anesthetic incident logs).

• Client experience (complaints, compliments, retention).

• Team well being indicators (staff turnover, burnout signals, psychological safety scores).

• Evidence of new skills (case logs, peer review of records, observed procedures).

That doesn’t mean every CPD activity needs a randomized trial attached. But it does mean building a culture of:

• Intentionality (Why am I doing this activity?), and

• Reflection (What difference did it make?).

And that culture must be supported - not sabotaged - by regulators, specialty colleges, and employers.

What Regulators Could Do (Without Breaking the System)

Regulators (state boards, national councils) often worry that anything beyond hours becomes too complicated. But there are practical, incremental steps they could take.

1.        Keep Hours, But Redefine Them

• Instead of 40 hours of anything, require a balanced CPD portfolio across categories, for example:

• Knowledge & Skills: lectures, courses, conferences, online modules.

• Practice-Based Learning & Improvement: audit-and-feedback projects, morbidity/mortality rounds, quality-improvement work.

• Professionalism & Communication: ethics sessions, client communication workshops, leadership training, mental-health resilience.

• Teaching & Mentoring: supervising interns, giving in-house talks, peer teaching.

• An hour of a well-designed audit project should count at least as much as an hour listening to slides.

2.        Require a Simple Annual (or biennial) Reflective Statement

• Instead of just logging hours, practitioners could be required to submit a short narrative:

• What did you identify as your main learning needs?

• What activities did you undertake to address them?

• What is one specific way your practice changed as a result?

• This doesn’t need to be graded like an exam, but it orients the system toward change, not box-ticking.

3.        Random Audits of CPD Portfolios

• Boards already do random audits of hours. They could just as easily audit CPD portfolios that include:

• Activity lists,

• Reflections,

• Any supporting data (e.g., before/after infection rates, prescribing reports, protocols you’ve updated).

• The point is not to punish but to keep expectations real: CPD is about improvement, not just attendance.

4.        Reward High-Impact Activities

• Regulators can weight some activities more heavily:

• Participation in a documented quality-improvement project might be worth multiple hours.

• Leading a team-based simulation or morbidity/mortality conference might count extra.

• Evidence of peer-reviewed change (e.g., local guideline creation, protocol adoption) could carry bonus credit.

• You don’t abolish hours overnight; you change what they stand for.

How Specialty Colleges Can Lead (Instead of Just Policing)

Specialty colleges are uniquely placed to model outcome-focused CPD because their members:

• see complex cases,

  
  

• work in teams,

  
  

• often have access to better data.

Instead of requiring a fixed number of conference hours, a college could ask:

• Show us your cases

  
  

  • Logs that demonstrate a range of case types, with commentary on what you learned.

• Show us your improvements

  
  

  • A brief report on a change you’ve implemented (e.g., new seizure protocol, improved post-op pain management, better ICU handover process).

    
    

• Show us your contribution to others’ learning

  
  

  • Teaching, mentoring, writing guidelines, leading journal clubs.

Re-certification could focus less on points and more on:

• Demonstrated ongoing engagement with emerging evidence.

  
  

• Concrete, documented efforts to improve care in your practice or region.

  
  

• Evidence that you contribute to a culture of learning, not just personal expertise.

This also reduces the leverage of corporate sponsors: a pharma-funded dinner talk becomes just one small piece of a much broader CPD puzzle, not the main currency.

What Employers Can Do: From “Go to a Meeting” to “Let’s Fix This Together”

Employers - independent and corporate - have enormous influence over how CPD feels on the ground.

Right now, CPD is often framed as:

• We’ll pay for you to attend X conference / Y webinar so you can get your hours.

An outcome-focused approach would sound more like:

• Let’s look at our data and see where we can improve - and then design CPD around that.

Concretely, practices could:

1. Use Their Own Data as a Starting Point

Even basic metrics (tracked consistently) can be powerful:

• Percentage of dental patients receiving appropriate radiographs and pain relief.

• Anesthetic incidents per 100 GA procedures, check or re-operation rates.

• Phone call follow-up compliance.

• Client complaints.

Pick one or two problem areas. Turn them into a practice CPD project:

• Baseline audit → targeted learning → protocol change → re-audit.

Suddenly CPD is not abstract; it’s about your patients and your outcomes.

2. Build CPD into the Work Day

Instead of only funding off-site meetings:

• Protect time for in-house rounds and case discussions.

• Run monthly morbidity/mortality meetings that are blame-free and genuinely educational.

• Encourage cross-role learning (vets, nurses, receptionists, managers in the same room).

You can still go to conferences, but now the conferences serve the CPD you’ve already committed to, rather than being the whole show.

3. Make Corporate CE Answer to Local Priorities

If a corporate sponsor offers a CE session, ask:

• Does this address a problem we actually have?

• Can we pair it with an internal project to see if it changes anything?

• Can we demand balanced content (pros, cons, alternatives)?

If the answer is no, consider whether the time could be better used on something that responds to your data.

Measuring Impact Without Losing Our Minds

Outcome-focused CPD often makes people nervous:

• Are they going to rank me?

• What if my infection rate is higher because I take on harder cases?

• Will everything become about numbers?

A few guardrails can help:

• Use multiple sources of evidence. Don’t rely on a single metric; combine quantitative data with narratives and peer feedback.

• Focus on trends, not snapshots. Are you learning and improving over time, not perfect right now?

• Keep the purpose formative, not punitive. The goal is growth and accountability, not shame.

• Respect context. A rural mixed practice and an urban referral hospital will have very different baselines and constraints.

Think of impact measures as mirrors, not weapons. They help us see ourselves more clearly so we can grow.

A Practical Path Forward

We don’t have to wait for a grand international committee to fix this. Here’s a realistic sequence:

• Tomorrow (as an individual)

• Pick one aspect of your work that bothers you. Gather a little data (10–20 consecutive cases). Do some targeted reading or a short course. Change one thing. Re-measure in a month. Write a short reflection: what changed?

• This year (as a practice)

• Choose one practice-wide improvement project and treat it as CPD for everyone. Log the activities, outcomes, and lessons. Submit this as part of your CPD evidence to boards or colleges where possible.

• Over the next few years (as a profession)

• Encourage regulators to recognize practice-based projects and reflective portfolios. Push specialty colleges to emphasize outcome-focused re-certification. Advocate for CE providers and conferences to include outcome-oriented sessions and encourage follow-up audits.

Corporate-sponsored CE won’t disappear overnight.

But as we shift the center of gravity from hours to impact, the value of simple logo-plastered seat time will decline.

What will rise in its place is something closer to what most of us wanted when we entered this profession:

A chance to keep getting better, in ways that help animals and their people, grounded in our own cases, teams and communities.

In Part 3, we’ll look at how this outcome-focused CPD approach can support spectrum of care, and how corporate sponsorship can either narrow that spectrum or help us widen it again, depending on how we design the rules.

#bunyipsbooksbeyond