Continuing education for general practice. 1. Experience, competence and the media of self-directed learning for established general practitioners.

The arrangements under which continuing education for general practice is provided and attendance by general practitioners is rewarded have now been in operation for three years. More recently, reaccreditation has emerged as a significant issue for the profession. For these reasons it appears timely to review the whole basis of ongoing learning by established general practitioners. In this the first of two papers, learning by established professionals is considered in relation to the educational development of the learner, the role of experience and the goals of competence and performance. It is concluded that self-directed learning based on experience should form the centre-piece of continuing education for general practice and that educational provision should adopt a complementary role in sustaining motivation to learn and by enabling learning from experience to be shared and enriched. A model of self-directed learning, connecting experience and competence through systematic application of three learning media, reading, reflection and audit, is proposed and related to appropriate educational participation by established general practitioners.