When we look at continuing professional development (CPD) and its related fields — continuing medical education and continuing education across all the health professions — we see the relatively smooth integration of multiple procedural hierarchies. Various frameworks guide CPD activities, including AMA PRA Category 1 CreditTM, the ACCME’s Accreditation Rules, ANCC certification requirements and the APA’s “Standards and Criteria for Approval of Sponsors of Continuing Education (CE) for Psychologists.” Despite their differences, these profession-specific schema for the development of CPD activities all share common elements familiar to each of us who do this work.
The ACCME, as an accrediting agency, focuses on the mechanics captured under their “Educational Planning and Evaluation” rubric: Establish a need, design the activity for change, employ an appropriate format, address a recognized practitioner competency and analyze change.
However, I have always felt something seemed to be missing. This realization came from reading the Liaison Committee on Medical Education's (LCME) “Functions and Structure of a Medical School,” the accreditation guidelines for U.S. allopathic medical schools. Close attention to structure and function is essential to any complex, integrated and coordinated human enterprise, but an additional element is needed — the necessary-but-not-sufficient conundrum.
That missing element is beauty. Even our own CEhp National Learning Competencies, which provide a thorough unpacking of the terms and concepts that underpin our field, do not mention it. This is not a criticism, as no emphasis on beauty has been placed on CPD. Other professions though, like architecture, can’t survive without it. Let’s explore that further.
The Roman figure Vitruvius, widely regarded as history’s first architect, lived in the first century B.C. His work was compiled later in the “De Architectura,” which asserts that the core concepts governing our built environment are stability, utility and, yes, beauty. For our purposes, we can view stability and utility as structure and function, or precisely how the LCME describes the accreditation process for a medical school.
In Vitruvius’s architectural idiom, stability describes those elements of a building’s structure by which it can withstand external stress and endure. In the CPD enterprise, the concept of stability can refer to robust curriculum design, valid content, a sound accreditation system and the appropriate use of technology, among other facets of our work. These are the tools that frame and support CPD activities, no less than quality materials are essential to the buildings in which we live and work.
For Vitruvius, utility underscored the purpose of a building — its function and the deeply human matter of how we arrange our social interactions. Buildings shape our sense of community; architects know this intimately. In CPD, we can think of utility, or purpose, as the needs assessment, asking “Why are we doing this?”, and the community as those for which and by which an activity is created. “Who are all these people involved with the project?”
Like architects, CPD professionals must make difficult judgements about the relevance and need for an activity. The community aspect is equally important. Just as an architect should consider everyone who sees or enters a building they design, a CPD professional will consider, select and coordinate the participation of everyone involved — including project managers, the target audience, faculty, other staff (such as finance and legal) commercial supporters and joint providership partners.
Finally, we come to the last principle — beauty. In the Vitruvian sense, beauty represents a structure’s aesthetic appeal. But it’s not just about aesthetics. Beauty is understood as the design element that ties the others together. You create a building or an activity that is robust, purposeful and enduring, but beyond aesthetics, your project communicates respect and affection for all who will interact with them. Great buildings are loved for exactly this reason. The care CPD professionals put into creating activities for learners is no different; they also bring beauty to their work.
In “The Song of Significance,” author Seth Godin caught the essence of this — that work is never just work — when he wrote: “Great work creates more value than compliant work.” It probably always has.