Confidence and flexibility in learning

01 April 2014, at 1:00am

Chris Whipp continues his series on methods of learning and discusses the need to move away from traditional CPD to a system for general practitioners that is more agile and overload-proof

TRADITIONALLY, veterinary CPD has centred on the progressive development of ever greater amounts of clinical knowledge whilst ignoring much of the non-clinical and integrated skills that are so important to the GP vet.

Whilst this might have worked in the pre-internet era, the overload of information now engulfing us and the rapid changes occurring within that information over time mean that the landscape of learning has changed dramatically. We are still very early in the change process within the profession compared to elsewhere.

Teaching clinical knowledge is an important skill set and remains popular because it is relatively easy, enjoyed by recipients and relatively cheap and predictable to provide (though not necessarily cheap to receive!).

For those working within limited, specialised fields it may be more important than those working in more general fields where greater learning agility is required when what is “right” today may be completely “wrong” tomorrow.

Whilst the non-clinical and integrated skills are important with both specialists and GPs, the primacy within the GP field needs to be stressed because it has been overlooked in the past where education has lagged behind market need. This is reflected both in the nature of the complaints being received by the RCVS and in the disturbing wellness issues facing the profession.

Part of the shift needed is the move from remembering discrete boxes (or truckloads) of information to coping with complexity, uncertainty and developing the skills to implement and develop learning in real time in the real world.

A lot of work has been done in this field by the Human Systems Dynamics Institute in the USA and I would register my thanks to them for the image reproduced here and some of the content.

For this article we are going to focus on just two dimensions – confidence and flexibility – which, although relatively simple, are also very important in the modern dynamic learning landscape in that they can be applied to virtually any learning experience.


Traditional veterinary CPD is almost like going back to university: information is packaged and presented and the assumption is that it will be absorbed intellectually, taken from the room and applied effectively within the workplace.

This is often not the case and, not infrequently, this is because the confidence of the participant is not built to a suitable level.

Discussing with the participants implementation within their own workplace, sharing their thinking with tutors, peers, even clients and tailoring their thinking to their own context can build confidence and reduce the inevitable barriers that exist.

This moves them from the dependence of traditional classroom learning towards more mature approaches and ultimately to developing their own “expert” status.

It is a simple fact that we will not use what we are not confident with and the development of an appropriate environment to allow implementation is essential.


As confidence increases, so flexibility can grow and develop.

There is a basic difference in the learning requirements of specialists and GPs. Specialists need to know a lot about a small number of subjects and GPs need to know a little about a lot of subjects. This is frequently overlooked in CPD provision and can seriously undermine the effectiveness when CPD provided is by specialists for generalists.

Whereas learning within specialist domains changes incrementally and slowly, GP learning needs to be agile, just in time and overload-proof. This requires fundamentally different skills and approaches and the development of flexibility is central to survival, let alone thriving.

GPs work within a complex fast-moving environment, they need to be flexible; dealing with concepts, models and methods, generalising applications over a variety of situations, recognising and respecting underlying dynamics, teasing out the pieces of information and knowledge that inform decisions in particular places and times. 

Of course the same applies to specialists but the more rigid application of the scientific method here simplifies things somewhat. Ideally we should all work towards becoming a flexible synthesis of both approaches without allowing either to dominate.

Figure 1 describes three “zones” on the learning landscape but, of course, it is not that simple in that any individual can operate at multiple positions on the landscape, variable with domain, subject, skill and time. They do, however, give an impression of the progression from the dependence associated with traditional education and the independence of self-directed GP.


At this level, the learner has only just begun to grasp the meaning and usefulness of the concepts and methods presented. The theory base may be murky, meaning that only narrowly-defined tightly-described approaches are appropriate and learners need concrete instruction, short-term projects and potentially directive feedback and support.


As the theory base becomes stronger and experience is gained, confidence grows, flexibility increases and concepts, models and methods develop out of that theory base. Perspectives grow to see diverse situations and applications developing the best fit to current purpose.

Rather than the one “right” answer of the traditional system, opportunities to develop the “right” answer in a particular context develop. In this zone there is a need for larger, long-term projects, greater freedom of choice with more generalised feedback and questioning.


In this zone, theory becomes inseparable from application which supports creative and productive action. The learner is likely to be able to develop new applications of the concepts, creating new models and adjusting fitness to purpose with relative ease.

Traditional teaching approaches are not required and in reality can be detrimental. What is needed here are “thought partners” who can help them test and refine their ideas, continuing to seek both true and useful applications. n If you would like to know more about developing clinical (or other) expertise, e-mail