Training needs analysis. A literature review and reappraisal

Continuing professional development training needs of allied health professionals in regional and rural Victoria

OBJECTIVE

The aim of the study was to identify continuing professional development (CPD) needs of allied health professionals (AHP) in regional and rural Victoria.

DESIGN

This study was an online cross-sectional design conducted between December 2022 and February 2023.

SETTINGS AND PARTICIPANTS

AHPs employed at a large multi-site regional public health service providing acute, subacute, community and outpatient care in Victoria, Australia.

MAIN OUTCOME MEASURE(S)

The online questionnaire included four sections investigating satisfaction of CPD, prioritised topics for CPD, preference for CPD sourcing and perceived capabilities in delivering education. To investigate prioritised topics of CPD, a tool was adapted from the Hennessy Hicks Training Needs Analysis questionnaire to align with allied health (AH) career pathways. For organisational alignment, a second questionnaire was sent to AH managers.

RESULTS

The response rate was 17% (53/316 AHPs) from members of 10 AH professions. The median years of clinical experience for participants was between 2 and 5 years. Participants with 6-10 years of clinical experience reported the lowest level of satisfaction. Research and education were identified as areas of highest training need. Self-perceived competence in education delivery was proportionately lower in areas of assessment, developing digital learning and constructive alignment.

CONCLUSION

CPD needs for AHPs in a regional and rural health service were shown to vary by career stage and weighted towards developing research and education delivery capabilities. Findings from this study may support public health sector and policy investment in CPD opportunities to support horizontal career progression opportunities, a balance of internal and externally sourced professional development and strategic investment in education delivery capabilities.

A Delphi study to identify and assess professional competencies in the education of optometrists

PURPOSE

The aim of this study was to identify, assess, and reach a consensus on the professional competencies that optometrists must acquire during their undergraduate training at the University of Valladolid. The results obtained may be useful in the revision of the current curriculum.

METHODS

A three round Delphi study was carried out with the participation of 116 participants grouped in 7 panels. In the first round, competencies were identified through an open-ended question and their frequency calculated. In the successive 2nd and 3rd rounds, the consensus and stability of each competency was established.

RESULTS

A total of 56 professional competencies were identified, with 43 of them (77%) achieving a consensus among participants, of which the highest scores were obtained by the competencies that correspond to health functions of primary visual care. Out of the 13 competencies without consensus, for 11 of them this was due to the significant differences in assessment among the consulted participants; for 8 competencies (14%) response stability was found, while neither consensus nor stability were reached in 5 (9%) of the identified competencies.

CONCLUSIONS

The results obtained with this Delphi study provide a set of relevant competencies for updating the curriculum of the university Degree in Optics and Optometry at the University of Valladolid, improving its suitability to current and future professional reality.

Understanding Training Needs in Pediatric Feeding for Allied Health Professionals: An Australian Perspective

PURPOSE

Clinician experience and confidence can negatively impact pediatric feeding service availability, but limited research has investigated what training allied health professionals (AHPs) need to increase these factors. This study developed and distributed a survey investigating Australian AHPs' self-reported confidence and anxiousness, training needs, factors impacting training access, and training preferences.

METHOD

This study was conducted over two phases. Phase 1 involved development and refinement of the survey, and Phase 2 involved distribution to Australian AHPs. Questions pertained to general demographics, feeding experience, feeding confidence and skills perception, and training needs. The questions were composed of multiple-choice, Likert scale, and short-response options.

RESULTS

Overall, 198 complete responses were received. Participants reported significantly lower confidence and higher anxiousness working with infants compared to older children (p < .01). Increased frequency of service provision predicted higher self-reported confidence and lower anxiousness (p < .01). Practical training opportunities including case discussion, videos, and clinical feedback were preferred. Access facilitators were online, on-demand training; however, respondents reported preferring hands-on training opportunities. Common barriers included cost, time, competing professional development priorities, and distance/travel.

CONCLUSIONS

Findings have highlighted that recency and frequency of practice impact self-reported confidence and anxiousness, and that AHPs self-report lowest confidence and highest anxiety working with infants compared to older age groups. Overall, the findings highlight the need for flexible, practical, and remotely accessible training opportunities, as well as the need for access to regular clinical supervision and a pediatric feeding caseload.

Oral health ambassador scheme: training needs analysis in the community setting

Introduction Successful oral health promotion relies on resource availability, adequate training and stakeholder engagement. Community nursing teams are in a unique position to promote oral health due to their vulnerable service users who have increased oral health concerns. This article will share results from a training needs analysis.Aims To understand the previous oral health promotion experience of staff within community nursing teams, including identification of previous training and barriers to oral health promotion.Materials and methods An electronic training needs analysis was distributed to non-dental, patient-facing staff within Birmingham Community NHS Foundation Trust.Results In total, 91% (n = 120) of staff members had seen a patient who displayed oral health concerns, 68% (n = 90) of responders had never received training for assessing a patient's mouth and providing mouth care and 9% (n = 12) of staff had received internal trust training regarding oral health. Lack of training impeded 56% (n = 74) of participants from providing oral care and 92% (n = 121) of participants expressed they would benefit from further oral health training.Conclusion Community nursing teams should be supported to engage with oral health promotion to encourage reduced knowledge and confidence deficits, which will support holistic patient management to encourage improvement of oral and general health.

Capacity development challenges and solutions for Natura 2000: an approach through blended learning

Capacity development is essential for the effective management of protected areas and for achieving successful biodiversity conservation. European Natura 2000 sites form an extensive network of protected areas and developing the capacity of staff at all levels is a priority that will positively influence the appropriate implementation of conservation actions. In this study we identify the main challenges and potential solutions to developing the skills, knowledge and tools required for effective Natura 2000 site management. Our findings are based on a case study of the European project LIFE e-Natura2000.edu, which focuses on capacity development in practical biodiversity conservation and management through integrated and blended learning experiences (i.e. a combination of face-to-face and virtual teaching). We illustrate the main elements for successfully building capacity within a variety of knowledge and experience backgrounds and operating levels related to the management of Natura 2000 sites. Multifaceted, blended learning approaches are key to tackling the various needs of Natura 2000 managers in terms of skills, knowledge and tools.

Identifying the core competencies of backup nurses in the acute care hospital through a modified Delphi process†

Background

The backup nurses are created to meet emergencies in the case of inadequate nursing staff and emergency circumstances, and there are no clear definitions of the core competencies for training and evaluation of backup nurses in the acute care hospitals in China.

Methods

This study used a modified Delphi process where an initial list of potential competencies is established following a framework of training need analysis (TNA), literature review, and focus groups. This process generated as a list of 47 core competencies, which is presented to an expert panel (n = 20) for consideration in two rounds.

Results

As determined by the survey, a combination of 26 core competencies in three specified categories is identified: professional practice ability, critical thinking ability, and interpersonal skills. A total of 154.99 h is required to complete all 26 core competencies, and each item has a corresponding evaluation method.

Conclusions

The core competencies provide a scientific basis for the hospital nursing managers to train and evaluate backup nurses, and it may ensure consistency in standards across the country.

A cross-sectional study of implicit rationing of care in publicly funded nursing homes in Shanghai, China

AIMS

To investigate the level of implicit care rationing and its association with training needs in nursing homes in Shanghai, China.

BACKGROUND

Nursing homes in Shanghai are confronted with a lack of care resources. Implicit care rationing can emerge due to inadequate training of care workers.

METHODS

A cross-sectional survey was conducted between 10 September and 17 November 2020. A total of 374 care workers from 16 randomly were selected nursing homes from each of the administrative districts participated the surveys. The Basel Extent of Rationing of Nursing Care-Nursing Home instrument and the training needs analysis were adopted to measure implicit care rationing and training needs, respectively. Multiple regression techniques were used to explore the factors associated with implicit care rationing.

RESULTS

Activities related to social care, documentation and activation/rehabilitation (mean rating = 2.8, 1.89 and 1.93 respectively) were mostly likely to be rationed. Training needs of activities of daily living (ADL), activation/rehabilitation and documentation were significantly related to their implicit rationing (β = 0.864, 0.21 and 0.166, respectively, p < .01).

CONCLUSION

Training needs are crucial determinants of implicit care rationing.

IMPLICATIONS FOR NURSING MANAGEMENT

Quality control systems are needed to ensure care comprehensiveness. The current training system should be re-designed according to results of training needs analysis.

Towards an analysis of the transfer of training: empirical evidence from schools in Spain

Purpose

The transfer of training has been identified with the effectiveness of training. The purpose of this work is to analyse the impact of training stages (training needs analysis, application and evaluation) as they relate to training transfer.

Design/methodology/approach

The study participants correspond to a sample of 116 teachers with managerial responsibilities (management teams and department heads) from 17 secondary schools in Spain. This work hypothesises five significant relationships: needs analysis and application of training, application and transfer of training, evaluation and analysis of training needs, evaluation and application of training and evaluation and transfer of training. The hypotheses were tested using structural equations, namely, the partial least squares–structural equation modelling technique and SmartPLS version 3.2.9.

Findings

The relationships between application and transfer of training, between evaluation of training and needs analysis, application and transfer of training are positively contrasted. The relationship between the analysis and application of training is not contrasted.

Originality/value

This work analyses the relationship between the training process’s different phases (analysis, application and evaluation) in the training output (training transfer) and emphasises the role of evaluation in the training process.

Training needs assessment: tool utilization and global impact

BACKGROUND

Global demand for standardized assessment of training needs and evaluation of professional continuing education programs across the healthcare workforce has led to various instrumentation efforts. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire is one of the most widely used validated tools. Endorsed by the World Health Organization, the tool informs the creation of tailored training to meet professional development needs. The purpose of this project was to describe TNA tool utilization across the globe and critically appraise the evidence of its impact in continuous professional development across disciplines and settings.

METHODS

A systematic integrative literature review of the state of the evidence across PubMed, Scopus, CINAHL, and Google Scholar databases was carried out. Full-text, peer reviewed articles and published dissertations/theses in English language that utilized the original, adapted or translated version of the TNA tool were included. Selected articles were appraised for type and level of evidence.

RESULTS

A total of 33 articles were synthesized using an inductive thematic approach, which revealed three overarching themes: individual, team/interprofessional, and organizational level training needs. Included articles represented 18 countries, with more than two thirds involving high-income countries, and one third middle-income countries. Four studies (12.1%) used the original English version instrument, 23 (69.7%) adapted the original version, and 6 (18.2%) translated and culturally adapted the tool. Twenty-three studies targeted needs at the individual level and utilized TNA to determine job roles and responsibilities. Thirteen articles represented the team/interprofessional theme, applying the TNA tool to compare training needs and perceptions among professional groups. Last, three articles used the tool to monitor the quality of care across an institution or healthcare system, demonstrating the organizational training needs theme.

CONCLUSIONS

Overall evidence shows that the TNA survey is widely used as a clinical practice and educational quality improvement tool across continents. Translation, cultural adaptation, and psychometric testing within a variety of settings, populations, and countries consistently reveals training gaps and outcomes of targeted continuous professional development. Furthermore, it facilitates prioritization and allocation of limited educational resources based on the identified training needs. The TNA tool effectively addresses the "know-do" gap in global human resources for health by translating knowledge into action.

A survey on the training needs of caregivers in five European countries

AIM

This survey explored caregivers' perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy).

BACKGROUND

Training can enhance the professional capacity of caregivers; however, caregivers' training needs within Europe have not been examined recently.

METHODS

A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open-ended items and by conducting statistical and content analysis.

RESULTS

The results indicated basic nursing skills and specialization, as well as training in psychology-related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas.

CONCLUSIONS

It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology-related skills could add to the professional capacity of European caregivers employed in health and social care.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings inform about employed caregivers' training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care.

Self-perceived educational needs of junior assistant professors in Conservative Dentistry and Endodontics in France

INTRODUCTION

Academic dental educators play a major role in training future dentists. They help students to develop medical knowledge and behavioural skills that improve the quality and rigor of their future practice. Therefore, their experience and knowledge are critical to ensure effective learning. However, a French national workshop revealed that most junior assistant professors lack educational skills at the beginning of their career. The aim of this study was to assess educational training needs of junior assistant professors in the Department of Conservative Dentistry and Endodontics.

MATERIALS AND METHODS

An electronic survey was sent to junior assistant professors belonging to Departments of Conservative Dentistry and Endodontics within the 16 French dental schools in 2016. This survey was designed to collect data regarding their motivations, teaching expertise and interest in pedagogy.

RESULTS

Sixty of the 69 junior educators turned in their answers, which represents a response rate of 87%. About 86.7% of respondents cited their attraction to teaching as one of the main reasons behind their application. The major difficulty encountered by junior faculty was related to course preparation. Only 15% had received educational training despite the fact that 98.3% were convinced of the usefulness of such a training for junior teachers.

CONCLUSION

This study identified the motivations and difficulties encountered by junior assistant professors. This collection of educational needs should be considered when planning a national programme for educational training of dental faculty that will promote the acquisition of teaching skills and improve the education of dental students.

Academic training of nursing professionals and its relevance to the workplace

OBJECTIVE:

to identify the training nursing professionals receive and its relevance to the workplace, as well as professional demand for continuous education.

METHODOLOGY:

this was a descriptive observational study using a questionnaire entitled "Training and Adaptation of the Nursing Professional to the Workplace" available at: http://enfermeriadocente.es for nursing professionals.

RESULTS:

53.8% of nurses do not consider the training received to be relevant to the needs of the workplace and 94.2% reported that linking academic education to the workplace impacts on the quality of care provided.

CONCLUSIONS:

Nursing professionals think that continuous education needs to be adjusted to their jobs and careers. Education should be viewed as a continuum, which begins with training.

A Systematic Review of Team Training in Health Care: Ten Questions

BACKGROUND

As a result of the recent proliferation of health care team training (HTT), there was a need to update previous systematic reviews examining the underlying structure driving team training initiatives.

METHODS

This investigation was guided by 10 research questions. A literature search identified 197 empirical samples detailing the evaluation of team training programs within the health care context; 1,764 measures of HTT effectiveness were identified within these samples. Trained coders extracted information related to study design and training development, implementation, and evaluation to calculate percentages detailing the prevalence of certain training features.

RESULTS

HTT was rarely informed by a training needs analysis (k = 47, 23.9%) and most commonly addressed communication strategies (k = 167, 84.8%). HTT programs that incorporated practice (k = 163, 82.7%) often employed high-fidelity patient simulators (k = 38, 25.2%) and provided participants with feedback opportunities (k = 107, 65.6%). Participants were typically practicing clinicians (k = 154, 78.2%) with a lower prevalence of health care students (k = 35, 17.8). Evaluations primarily relied on repeated measures designs (k = 123, 62.4%) and self-reported data (k = 1,257, 71.3%). Additional trends were identified and are discussed.

CONCLUSIONS

Many trends in HTT practice and evaluation were identified. The results of this review suggested that, in the literature, HTT programs are more frequently following recommendations for training design and implementation (for example, providing feedback) in comparison to findings from previous reviews. However, there were still many areas in which improvement could be achieved to improve patient care.

Gaps Between Self-Rated Job Importance and Abilities for Community Health Workers in Massachusetts

Introduction

Community health workers (CHWs) serve increasingly active roles in clinical care and population health. To identify priorities for training programs, we developed a training needs assessment (TNA) tool by integrating and distilling core competencies previously identified by various national and state agencies.

Methods

CHWs were asked to self-rate, using a 4-point scale, the importance to their work and their ability to perform 49 competencies categorized under 10 domains. A difference score—Ability minus Importance—was calculated to determine relative Need.

Results

The 96 CHWs who completed the TNA were mostly female (80%) and Latino (40%). While CHWs indicated training was needed for all competencies, the scores ranged from −0.04 to −0.45, on a scale running from 0 to −3, where larger negative numbers indicate higher need. In general, there was a high level of congruence between individual competencies with high Need and domains with Need, with few outliers. Competencies with high Need scores related to culture, case assessment and coordination, and behavior change. CHWs rated client-based competencies higher than population health competencies in Ability scores (3.43 vs. 3.05, respectively) and Importance scores (3.70 vs. 3.35, respectively). However, overall Need scores showed no difference between client-based and public health-based competencies.

Conclusion

CHWs can successfully rate the importance of core competencies to their work and rank their ability to perform these competencies. Training needs generally favored clinical individual client-focused skills over prevention and public health competencies. Using scales that incorporate self-rated measures of core competency ability and importance can inform priorities for CHW training programs and contribute to successful curriculum development.

Findings from a Clinical Learning Needs Survey at Ireland's first children's hospice

PURPOSE

Caring for children with life-limiting conditions places exceptional demands on health professionals. Staff require the optimal skills and expertise necessary to provide the highest quality of care and to achieve this it is essential to understand their learning requirements.

AIM

The aim is to share the main findings from a Clinical Learning Needs Survey conducted at LauraLynn, currently Ireland's only children's hospice. To date no other Irish service has conducted a formal identification of professional learning and development needs specific to the Irish context. The findings from the study assist workforce planning by providing a glimpse into the immediate study needs of staff working in a children's palliative care setting. The study had two main aims: a) Assist clinical staff within one organisation to identify their own professional learning priorities in children's palliative care and b) Inform the design and delivery of a responsive suite of workshops, programmes and study sessions for children's palliative care.

RESULTS

The study identified the key learning needs as end-of-life care, palliative emergencies, communication skill development and bereavement support.

CONCLUSION

These findings are similar to those found internationally and demonstrate the commitment of a new organisation to ensure that specific employee learning requirements are met if the organisation and wider specialty of Irish children's palliative care is to continue its evolution.

Perceptions and experiences of nurse preceptors regarding their training courses: a mixed method study

BACKGROUND

Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited.

OBJECTIVES

To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors.

DESIGN

A mixed method design was conducted.

PARTICIPANTS AND SETTINGS

Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study.

METHODS

A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach.

RESULTS

The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources.

CONCLUSIONS

The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results.

Clinical and translational research capacity building needs in minority medical and health science Hispanic institutions

A preliminary needs assessment was conducted among faculty and students of three minority medical and health science institutions comprising the Puerto Rico Clinical and Translational Research Consortium (PRCTRC). The Web-based survey was focused on evaluating the training interests in the clinical and translational research core areas and competencies developed by the National Institutes of Health-Clinical and Translational Sciences Award. The survey was the result of a team effort of three PRCTRC key function's leaderships: Multidisciplinary Training and Career Development, Tracking and Evaluation and Community Research and Engagement. The questionnaire included 45 items distributed across five content areas including demographics, research training needs, training activities coordination and knowledge about the services offered by the PRCTRC. Analysis of research needs includes a sample distribution according to professor, assistant/associate professor and graduate students. The thematic area with highest response rate among the three groups was: "Identify major clinical/public health problems and relevant translational research questions," with the competency "Identify basic and preclinical studies that are potential testable clinical research hypothesis." These preliminary results will guide the training and professional development of the new generation of clinical and translational researchers needed to eliminate health disparities.

[Psycho-oncology for speech therapists: establishment and conception of the course PSYKOL]

OBJECTIVE

Head and neck cancer patients show a high psychiatric comorbidity, yet receive only little psychosocial support. Therefore, a specific psychosocial qualification for speech therapists working with head and neck cancer patients seems necessary.

MATERIAL AND METHODS

A course was developed based on a process model. Questionnaires were completed by speech therapists (self-evaluation of working situation; n = 15) as well as therapists interested in further training (collection of issues in the work with head and neck patients who are under psychological pressure assessed as problematic by the therapists; n = 27), whose competence in communication was also evaluated. In addition, a literature research was conducted and a focus group was formed.

RESULTS

High psychosocial demands within the therapists' work with tumor patients and difficulties in communication became obvious. Nearly all interviewees frequently used nonconducive communication patterns, yet implicit knowledge existed (usage of a favorable conversational style in multiple choice test: 68 %). The content and concept of the curriculum were discussed within the focus group and led to the final version of the training.

CONCLUSION

A customised psycho-social training curriculum for speech therapists has been developed.

Nursing department education needs assessment: implementation and outcome

The Education Council was interested in identifying learning needs. Previous needs assessments identified topics but did not assist in prioritizing education. A survey was developed with topics selected from quality and process initiatives. To prioritize education, a measurement scale based on Patricia Benner's skill development model was utilized, asking staff to rate their knowledge from novice to expert. Education programs have been prioritized by targeting topics with the highest novice responses. This assessment has also been utilized to measure the effectiveness of education. This is accomplished by having the staff rate their knowledge of topics the following year to evaluate learning.

A training needs analysis of neonatal and paediatric health-care staff in a tertiary children's hospital

INTRODUCTION

Despite clinical advances in neonatal and paediatric palliative care, there is limited educational provision to underpin practice. To develop appropriate educational content, the needs of staff working in this area must be identified.

AIM

To explore the educational needs of staff working with families with palliative or end-of-life care requirements.

METHODS

A training needs analysis (TNA) explored the perceived knowledge, confidence, and support of neonatal and paediatric health professionals in a tertiary children's hospital in London.

RESULTS

An online Likert scale TNA was completed by 111 participants. The results indicated that the staff did not feel educationally prepared in their working areas, despite having regular contact with families with palliative or end-of-life care issues.

DISCUSSION

Understanding the educational needs of staff can underpin the development of appropriate educational interventions. These modules require evaluation to determine their impact on health professionals' knowledge and confidence.

Continuing nursing education: a partnership between learner and teacher

Learners and educators both need to be invested in making continuing nursing education a meaningful and rewarding experience.

Learning needs assessment for registered nurses in two large acute care hospitals in Urban New Zealand

BACKGROUND

Ongoing education for the nursing workforce is necessary to ensure currency of knowledge in order to enable evidence based client care. The cost of education is high to the organisation and the individual, and must therefore be cost-effective, relevant and appropriate. According to research, education for nurses is not always systematically planned and developed and often relies on the interest area and assessment of the nurse educators.

AIM

To survey the learning needs of clinically based registered nurses within an acute care setting.

DESIGN AND METHOD

An anonymous questionnaire was used to collect the data. Two groups completed the questionnaire: all eligible registered nurses in two acute care hospitals located in urban New Zealand and their senior nurses such as clinical nurse managers, specialists and educators.

RESULTS

The study found agreement on learning needs and also noted differing opinions between the Registered Nurses (RNs), and their senior RNs, RNs initially registered overseas and between levels of practice, on selection and ranking of learning needs.

CONCLUSION

This survey identified a number of high learning needs for RNs working within acute care settings. Differences in perception of learning needs for RNs, between the nurses themselves and the Senior RNs exist, as well as among sub groups of RNs. As a result, educators and managers are encouraged to collaborate to realise the opportunity which exists for the provision of education across specialty areas and to work with the different groups and the individual to ensure unique learning needs are met.

Twenty-four hour care: implications for the role and developmental needs of nurses in acute and community settings

AIM(S)

The aim of this study was to explore the challenges of providing continuity within the 24-hour nursing service. It explored why nurses work at night and what issues this raises for them.

BACKGROUND

The manner in which new ways of working affect the work or CPD (Continuing Professional Development) requirements of ward-based nurses or their community counterparts has received little attention. The aim of this study was to explore these issues with a diverse sample of practitioners.

METHOD(S)

Twenty-seven staff from four settings (two acute trusts and two community teams) participated in this qualitative study employing focus groups and interviews.

RESULTS

The nature of night nursing is changing; expanded roles and responsibilities are common. However, CPD remains problematic, as a result of constraints around time and access. Context-specific issues shape the nature of night working in acute and community settings and should be considered when planning CPD.

CONCLUSION(S)

There is a need to re-examine what CPD is available for practitioners providing care around the clock. Traditional forms of CPD may not reflect the evolving reality of practice at night.

IMPLICATIONS FOR NURSING MANAGEMENT

There is a need to ensure CPD opportunities are reviewed regularly to reflect changing 24-hour service demands in all settings.

The relationship between continuing professional education and commitment to nursing

Nurses have a responsibility to undertake continuing professional development to enable them to keep abreast with changes in health care. Acquiring new knowledge and skills is essential for nurses to practice safely in new and extended roles. Opportunities for continuing professional development are thought to increase retention. The aim of this study was to explore the relationship between undertaking continuing professional development and commitment to the profession and the employing National Health Service trust and to explore any differences between nurses in standard and extended roles. A questionnaire survey was undertaken with 451 nurses employed in three contrasting trusts. The questionnaire incorporated a validated scale to measure organisational and professional commitment. Three hundred and eighteen (70.5%) of the nurses had undertaken continuing professional development over the previous 12 months. Ninety nine nurses (22%) had received only mandatory training over the same period. There was no evidence of a relationship between professional and organisational commitment and undertaking continuing professional development. There was no evidence that specialist nurses in extended roles had undertaken the developmental continuing professional development that would be expected in order for them to acquire new competencies and skills.

Continuing professional education for care staff: evaluation of training and development project

This study describes the "Professional Career in Arthritis Care (PCA) 2003-2005" training and development project conducted at one hospital in Finland. The project consisted of 5,194 training days for 93 participants and 13 practical development tasks. The research task is to describe (1) the level of need for additional training once the project had ended, (2) the significance of the development task from the perspective of professional development, and (3) how the development task has been introduced into the work community. The material was gathered by questionnaire. The training needs remained quite stable in spite of lengthy training when measured by the themes of the curriculum covered during the PCA. When asked about their need for further training in general in order to manage their current job, a total of 66% of participants still expressed a need for training at the end of the PCA. The development task was viewed mostly positively. The PCA project has given some support to professional development and organizational change, general empowerment, motivation, and satisfaction.

What are scoping studies? A review of the nursing literature

BACKGROUND

Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined.

AIMS

The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity.

DESIGN

This paper follows an interpretative scoping review methodology.

DATA SOURCES

An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser.

RESULTS

The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping.

CONCLUSIONS

Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

Primary prevention of violence against women: training needs of violence practitioners

Practitioners in domestic violence and sexual assault programs have been encouraged by the National Center for Injury Prevention and Control to enhance their activities in violence prevention; however, many practitioners have not been trained in prevention concepts and strategies. Therefore, a needs assessment was undertaken with practitioners in the Domestic Violence Prevention Enhancement and Leadership Through Alliances and the Rape Prevention and Education programs to determine training needs. Results show that practitioners are very interested in primary prevention. They want to learn about working at the community level (rather than the individual level), developing and evaluating prevention activities, and identifying effective primary prevention programs.

Nurses' experiences of continuing professional development

Continuing professional development is regarded as part of the nursing role in the National Health Service. Health policy in the United Kingdom is built on the assumption that nurses' roles can be extended through continuing professional development which is also considered to be a key factor in nursing retention. Previous research has considered the provision of learning mainly from the perspective of managers and education providers. The purpose of this paper is to explore nurses' experiences of continuing professional development. The results presented in this paper form part of a larger survey (n=451, response rate=64.9%) designed to examine opportunities for continuing professional development and factors encouraging and discouraging uptake. An unexpectedly high number of respondents (n=125, 27.7%) commented extensively on their personal experiences of continuing professional development. These comments were analysed inductively. Five main themes emerged: who and what is continuing professional development for?; accessing continuing professional development; one size does not fit all; managing work, life and doing continuing professional development; and making the best of continuing professional development. Most responses were positive, but the demands of taking courses were perceived to encroach on life outside work, especially the need to complete lengthy assignments. Managers were perceived to operate as the gatekeepers to course admission and opportunities to implement new knowledge and expertise. No comments were received concerning the role of education staff in continuing professional development.

Development and validation of a learning needs assessment scale: a continuing professional education tool for multiple sclerosis specialist nurses

AIM

To develop and validate a learning needs assessment scale.

BACKGROUND

Learning needs analysis is a central component of continuing professional development but there is a lack of psychometrically developed learning needs assessment tools. Self-assessment questionnaires are emerging as a key method. The development of a learning needs analysis scale for multiple sclerosis specialist nurses is described.

DESIGN

A psychometric approach comprising the three phases of the development and testing of the scale are outlined.

METHOD

Phase 1: Item identification using a literature review; postal survey of stakeholders (n = 320), 20 nurse interviews; four nurse focus groups; five telephone interviews with people with MS. Phase 2: Refinement of draft scale and establishing face and content validity testing using an expert panel. Phase 3: Testing of draft scale using data from a postal survey (n = 47 MS specialist nurses) to assess the feasibility and effectiveness of scale, internal consistency and construct validity. Test-retest reliability was assessed using data from 17 MS specialist nurse respondents to calculate intra-class correlation coefficients.

RESULTS

The data from the different study phases informed scale refinement. The validity and reliability of the scale was confirmed through testing.

CONCLUSION

The study provides an example of how a robust learning needs assessment scale may be developed for a specialist area of nursing practice to be used in conjunction with more subjective approaches.

RELEVANCE TO CLINICAL PRACTICE

High quality nursing care depends upon a competent nursing workforce that engages in continuing professional development. This study provides an example of a psychometrically developed learning needs assessment scale to inform continuing professional development needs of nurses working in a specialist area of practice.

Addressing the learning deficit in breastfeeding: strategies for change

This paper summarizes the findings of the learning needs assessment described in this issue. Limitations and strengths are discussed. The paper describes a national, multi-sectoral, multidisciplinary picture. Our respondents may over-represent those with an interest in breastfeeding; if so, the true picture may be even more problematic than described here. Major deficits were identified in the knowledge and skills of practitioners from all backgrounds and all sectors. Many professionals report poor knowledge about breastfeeding and have low levels of confidence and clinical competence. Organizational constraints and barriers to effective education and practice include fragmentation of care and education, lack of facilities, and a low priority being given to breastfeeding. There is a range of current educational provision, although not all is fit for purpose. Voluntary organizations seem to have higher standards than do some current professional learning opportunities. Preferred methods of training include practical observation and mentorship, volunteer counsellor involvement in training programmes, as well as self-study and online opportunities. Recommendations include: a funded, mandatory, interagency and multidisciplinary approach; appropriate content; support at local and national levels; breastfeeding education to be included in clinical governance and audit mechanisms; and further research and evaluation to examine optimum ways of providing education and training. Organizational barriers could be addressed through a public health policy and evidence-based approach.

The National Health Service Knowledge and Skills Framework and its implications for continuing professional development in nursing

The National Health Service Knowledge and Skills Framework has been introduced as part of the Agenda for Change Reforms in the United Kingdom to link pay and career progression to competency. The purpose of this paper is to consider the implications for nurses, their managers and the impact on university departments delivering continuing professional development for nurses. The new system has the potential to increase the human resources management aspect of the clinical nurse managers' role and could have legal implications, for example if practitioners perceive that their needs for continuing professional development have been overlooked to the detriment of their pay and career aspirations. The new system also has implications for providers of continuing professional development in the universities and is likely to demand closer liaison between education providers and trust staff who commission education and training. The Knowledge and Skills Framework is of interest to nurses and nurse educators internationally because the system, if effective, could be introduced elsewhere.

Assessing learning needs for breastfeeding: setting the scene

Breastfeeding has a major contribution to make to public health, yet the UK, like many other developed countries, has low rates of breastfeeding. A contributing factor is that practitioners are ill-prepared to support breastfeeding women. There is a mismatch between the care professionals provide and the support women desire. A national breastfeeding learning needs assessment (LNA) was carried out in England to provide a comprehensive picture of professional and practitioner learning needs and existing training opportunities and resources. The LNA comprised five elements, and sought the views of service users through consumer organizations and voluntary breastfeeding supporters. Two elements of the LNA are reported here. A search of RDLearning, a web-based national resource, provided details of existing accredited courses in the UK for practitioners. Ten short courses provided by higher education institutions were identified, along with a range of courses offered by voluntary and other organizations, such as the National Childbirth Trust and UNICEF Baby Friendly Initiative. Second, an e-mail survey of 28 key stakeholder organizations was undertaken, with a response rate of 68% (n = 18). All but one acknowledged that their members could benefit from further breastfeeding knowledge and expertise and were supportive of a national breastfeeding education initiative. The most popular forms of education provision were workshops and seminars, online and written information. The topic considered most important for all practitioners was the health outcomes of breastfeeding. Other contributions which stakeholder organizations felt they could make were the provision of information resources and setting up specialist interest groups.

Modernising cancer and palliative care education in the UK: Insights from one Cancer Network

This article reports on a scoping study into cancer education provision in one UK Cancer Network. A range of professionals (nurses, allied health professionals (AHPs), health care support workers and educationalists) were invited to participate in focus group or individual interviews, or to return questionnaires regarding their perceptions of training needs and current opportunities. This yielded data from a total of 94 participants. In addition, curriculum documents from local universities were subjected to thematic analysis. Findings from the relevant section of The National Cancer Patient Survey were also considered to provide insight into the expressed needs of local service users. Most cancer and palliative care education was directed towards nurses employed in specialist oncology settings. Some groups appeared to be poorly served (including community nurses, senior nurses and AHPs). No evidence could be found of inter-professional cancer or palliative care education within the university sector. Curriculum content did not appear to reflect the ethnic diversity or socio-economic deprivation that characterised the local heath economy. Further research is needed to determine how best to ensure that continuing professional education reflects the needs of all practitioners involved in cancer and palliative care.

Learning needs analysis: the development of a tool to support the on-going professional development of multiple sclerosis specialist nurses

Continuous professional development (CPD) is essential in modern day nursing. Learning needs analysis (LNA) is an important element of CPD. This paper describes the development of a LNA tool for multiple sclerosis specialist nurses. The tool contains an empirically developed LNA schedule and uses a blend of both subjective and objective exercises to help the nurse formulate a comprehensive learning plan. The tool is organised into four phases: phase 1, focuses on the knowledge and skills necessary to the fulfillment of work-based objectives; phase 2, involves a more in-depth assessment of particular areas of professional knowledge; phase 3, examines learning strategies; and phase 4, involves the development of a learning plan. The tool has been implemented throughout the UK via local trainers. While the tool was developed for a specialist nurse population the principles upon which it is based are likely to be transferable to other nursing contexts.

Assessing the educational needs of community sexual healthcare practitioners

There is wide variation in the quality and nature of community sexual health service delivery in the UK, which has led to a number of professional and Government-led directives to improve service provision. One key target is the provision of appropriate training and updating of staff in order to maintain an appropriate skill level. To identify the educational development needs of community sexual health nursing and medical staff, preparatory to commissioning appropriate educational provision, a training needs analysis survey was conducted. This involved using a customised psychometrically valid and reliable instrument, which was administered to all relevant staff for self-completion. Fifty-four (67.5%) of all doctors and nurses working in a community sexual health directorate responded. For the whole sample, the following categories of development need were identified: professional development; research; legal issues; clinical practice; and communication/interpersonal skills. When the nursing and medical subsamples were analysed separately, the same generic training needs emerged, although the nurses and doctors identified 22 and 25 significant training needs, respectively. The reported skills deficits cluster into super-ordinate groups which resonate with other available literature. This suggests that each category could be reliably used to inform a short course or series of modules, either for the whole sample or for each professional group. The results also suggest that the instrument is viable for use with healthcare professionals working in this specialty. Consequently, if this approach to identifying skill deficits was adopted, limited educational budgets could be used to provide courses which would meet the real training needs of staff, and if offered as a shared learning opportunity, could promote multidisciplinary team-working. In this way, improved local healthcare provision could be readily realised, with the potential for reducing current variations in the quality of community sexual health provision.

Assessing community nurses' level of knowledge of lymphoedema

As part of a major project to develop a primary care trust-based framework of lymphoedema management, the educational needs of community nurses regarding the care of patients with lymphoedema were assessed using focus groups and questionnaires. Community nurses assessed their current knowledge and skill in the care and management of patients with lymphoedema as adequate or poor. They were concerned about their lack of knowledge and skill and were uncertain regarding their role relative to other professions involved in the care of this patient group. At the same time they understood the importance of their role in providing ongoing care, recognizing problems, offering sound advice and referring on to a specialist practitioner when necessary. Any education provision that prepares community nurses for their role within a framework of lymphoedema management should emphasize the important place they occupy in providing long-term care for this patient group.