Impact of continuing professional education on practice: the rhetoric and the reality

Continuing professional development: evaluating a masterclass for band 5 children's nurses

BACKGROUND

Continuing professional development (CPD) is an important factor in being able to recruit and retain staff. However, it is recognised that budget constraints make offering CPD difficult, and it often falls to local NHS organisations and higher education providers to develop CPD initiatives that are fit for purpose.

AIM

To evaluate the impact of a CPD masterclass on band 5 children's nurses.

METHOD

Fourteen band 5 children's nurses attended a CPD masterclass delivered as a series of workshops over one day. Participants completed questionnaires before, at the end of, and three months after the masterclass. The pre-masterclass and three-month follow-up questionnaires included the short version of the Occupational Self-Efficacy Scale.

FINDINGS

After the masterclass, all participants had a plan (or a partial plan) for their career development, compared with 79% before it. Participants felt more confident at handling challenging situations at work after the masterclass. Participants appreciated the opportunity to focus on their CPD needs and discuss them with colleagues.

CONCLUSION

Time for CPD, career development opportunities, workplace culture, learning and development, and confidence are all important factors to consider when developing CPD opportunities for band 5 children's nurses.

Attending a Blended In-Service Management Training in a Public Health System: Constraints and Opportunities for Pharmacists and Health Services

Management and public health are important domains of competency for pharmacists. In about 90% of Brazilian health departments, pharmacists manage the selection and purchase of medicines. The Pharmaceutical Services and Access to Medicines Management Course (PSAMM) was offered to pharmacists working in the public health system. The aim of this study is to analyze the impacts of the course as perceived by the students (pharmacists). Two thousand five hundred pharmacists completed the course. It is a mixed-methods study, including subscribing forms (n = 2500), evaluation questionnaire (n = 1500), focus groups (n = 10), and semi-structured interviews (n = 31). Participants reported a high level of satisfaction with the course; they considered to have developed competencies related to leadership and management, competencies needed to enhance and sustain their practices in health services. Data analyses showed important barriers to complete the course: high course workload, poor quality of Internet access, lack of support from the health services. Participants highlighted crucial features of the course that helped them develop key competencies: practical in-service activities, useful and realistic contents, tutoring. These features helped participants overcome some important constraints described by them. The educational model described in this study was perceived as having a long-term impact on their behaviors and management practices in health services.

A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners' CPD

BACKGROUND

Continuing professional development (CPD) in healthcare is fundamental for making sure frontline staff practice safely and effectively. This requires practitioners to update knowledge and skills regularly to match the changing complexity of healthcare needs. The drive towards using limited resources effectively for service improvements and the need for a flexible workforce necessitate a review of ad hoc approaches to CPD.

OBJECTIVE

To develop strategies for achieving effective CPD in healthcare.

DESIGN

A case study design drawing on principles of realist synthesis was used during two phases of the study to identify and test what works and in what circumstances.

SETTING

One National Health Service Trust in South East England.

PARTICIPANTS

CPD stakeholders including professional regulatory bodies (n = 8), commissioners of healthcare (n = 15), facilitators of clinical skills development (n = 34), NHS staff in clinical leadership positions (n = 38), NHS staff undertaking skills development post graduate programs (n = 31), service user advocates (n = 8) and an international expert reference group (ERG) (n = 10).

METHODS

Data sources included a review of scholarly and grey literature, an online survey and a consensus workshop. Thematic and content analyses were used during data processing.

RESULTS

The findings present four interdependent transformation theories comprising transforming individual practice, skills for the changing healthcare contexts, knowledge translation and workplace cultures to optimize learning, development and healthcare performance.

CONCLUSIONS

The transformation theories contextualize CPD drivers and identify conditions conducive for effective CPD. Practitioner driven CPD in healthcare is effective within supportive organizations, facilitated workplace learning and effective workplace cultures. Organizations and teams with shared values and purpose enable active generation of knowledge from practice and the use of different types of knowledge for service improvements.

Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program

BACKGROUND

Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low.

OBJECTIVE

To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program.

METHODS

A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital.

RESULTS

The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications.

CONCLUSION

Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs.

Evaluating trauma nursing education: An integrative literature review

OBJECTIVE

A review of the current literature evaluating trauma nursing education.

BACKGROUND

A variety of trauma nursing courses exist, to educate nurses working in trauma settings, and to maintain their continuing professional development. Despite an increase in the number of courses delivered, there appears to be a lack of evidence to demonstrate the effectiveness of trauma nursing education and in particular the justification for this resource allocation.

DESIGN

Integrative literature review.

DATA SOURCES

A search of international literature on trauma nursing education evaluation published in English from 1985 to 2015 was conducted through electronic databases CINAHL Plus, Google Scholar, PubMed, Austhealth, Science Citation Index Expanded (Web of Science), Sciverse Science Direct (Elsevier) & One file (Gale). Only peer reviewed journal articles identifying trauma course and trauma nursing course evaluation have been included in the selection criteria.

REVIEW METHODS

An integrative review of both quantitative and qualitative literature guided by Whittemore and Knafl's theoretical framework using Bowling's and Pearson's validated appraisal checklists, has been conducted for three months.

RESULTS

Only 17 studies met the inclusion criteria, including 14 on trauma course evaluation and 3 on trauma nursing course evaluation. Study findings are presented as two main themes: the historical evolution of trauma nursing education and evaluation of trauma nursing education outcomes.

CONCLUSION

Trauma nursing remains in its infancy and education in this specialty is mainly led by continuing professional development courses. The shortage of evaluation studies on trauma nursing courses reflects the similar status in continuing professional development course evaluation. A trauma nursing course evaluation study will address the gap in this under researched area.

Illuminating the process: enhancing the impact of continuing professional education on practice

BACKGROUND

There has been significant global investment in continuing professional education (CPE) to ensure healthcare professionals have the knowledge and skills to respond effectively to the needs of patients/service users. However, there is little evidence to demonstrate that this investment has had a tangible impact on practice. Furthermore, the current emphasis on evaluating outcomes has overlooked the importance of underlying processes which, when positive, are essential to good outcomes.

OBJECTIVE

The aim of this study was to identify the processes that key stakeholders perceive to be most important in facilitating a positive impact of CPE on practice.

DESIGN/METHOD

A qualitative design using two rounds of semi-structured interviews which were recorded and transcribed prior to analysis, informed by template analysis techniques.

SETTING

Two acute trusts, one primary care trust and two higher education institutions in one geographical region in England.

PARTICIPANTS

Representatives from four stakeholder groups-students, managers, educators and members of each healthcare organisation's governing board. A total of 35 interviews were conducted in the first round and 31 interviews in the second round (n=66).

RESULTS

Four overarching themes were identified that illuminate stakeholders' perspectives of the important factors affecting the process of CPE: organisational structure, partnership working, a supportive learning environment and changing practice.

CONCLUSIONS

This study suggests that a positive organisational culture, effective partnership working between key stakeholders with an understanding of each other's perspectives, aspirations and constraints, and a supportive learning environment in both the practice setting and education environment are central to establishing a culture and context where CPE can thrive and exert a positive influence on improving patient/service user experience and care. It is argued that an understanding of the processes that facilitate effective CPE is a crucial first step before it is possible to meaningfully evaluate outcomes.

Knowledge transfer from an e-learning course to clinical practice

BACKGROUND

Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work.

OBJECTIVES

To describe the transfer of knowledge gained from an e-learning course to daily practice.

DESIGN

Qualitative study design.

SETTINGS

One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards).

PARTICIPANTS

Nursing staff (N=53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009.

METHODS

The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings.

RESULTS

The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses.

CONCLUSIONS

New knowledge is easily adopted and transferred to daily practice.

A qualitative study of continuing education needs of rural nursing unit staff: the nurse administrator's perspective

BACKGROUND

This study reports perceptions of the continuing education (CE) needs of nursing unit staff in 40 rural healthcare facilities (10 hospitals and 30 long-term care facilities) in a rural Midwestern U.S. region from the perspective of nurse administrators in an effort to promote a community-based academic-practice CE partnership.

METHODS

Qualitative data collection involving naturalistic inquiry methodology was based on key informant interviews with nurse administrators (n=40) working and leading in the participating health care facilities.

RESULTS

Major themes based on nurse administrators' perceptions of CE needs of nursing unit staff were in four broad conceptual areas: "Cultural issues", "clinical nursing skills", "patient care", and "patient safety". Major sub-themes for each conceptual area are highlighted and discussed with narrative content as expressed by the participants. Related cultural sub-themes expressed by the nurse administrators included "horizontal violence" (workplace-hospital and LTC nursing unit staff) and "domestic violence" (home-LTC nursing unit staff).

CONCLUSIONS

The uniqueness of nurses' developmental learning needs from a situational point of view can be equally as important as knowledge-based and/or skill-based learning needs. Psychological self-reflection is discussed and recommended as a guiding concept to promote the development and delivery of relevant, empowering and evidence-based CE offerings for rural nursing unit staff.

Continuing professional development programmes for rural nurses involved in palliative care delivery: an integrative review

PURPOSE

To review published studies evaluating the impact of continuing professional development (CPD) programmes on rural nurses palliative care capabilities in order to inform the development of targeted learning activities for this population.

DESIGN

An integrative review.

METHODS

Searches of key electronic databases and the World Wide Web was undertaken using key words, followed by hand searching for relevant articles. All studies were reviewed by two authors using a critical appraisal tool and level of evidence hierarchy.

RESULTS

The search strategies generated 74 articles, with 10 studies meeting the inclusion criteria. All of these studies evaluated palliative care CPD programmes involving rural nurses which focused on increasing palliative care capabilities. The evidence generated by this review was limited by the absence of randomised controlled trials. A level III-1 study, with a small sample size provided the highest level of evidence, but the lack of control negated the investigators' capacity to confirm causality. Few studies measured the impact of CPD on the quality of care or utilised novel technology to address the tyranny of distance. Despite, these limitations valuable insights into the barriers and facilitators to engaging rural nurses in palliative care learning opportunities were identified.

CONCLUSIONS

Evidence that CPD impacts positively on patient and families outcomes is necessary to sustain an on-going investment in learning activities. In order to optimise the opportunities afforded by emerging web-based technology rural nurses' need to develop and maintain their computer competencies. Further investigation of the impact of specialist clinical placements on rural nurses' palliative care capabilities is also indicated.

An evaluation of CPD learning and impact upon positive practice change

This paper explores positive practice change in nursing and health care practice following continuing professional development (CPD). It is derived from a commissioned evaluation study within the United Kingdom (UK). Evaluation data was gathered using semi structured discussions with CPD participants, a convenience sample of line managers and University module leaders. Findings suggest that professional peer attitudes and support, when harnessed effectively in the practice setting, strongly enhance positive change. Conversely a lack of engagement with practice peers, a lack of strategic support and not knowing how to access support hinder change. The study found that learning need was often explored through personal development planning and appraisal, however there was little systematic follow up, review and support following learning. Interestingly the individual personal drive and enthusiasm of practitioners was perceived as the strongest factor helping practice change, while policy drivers and national health targets were secondary. Possible strategies to enhance positive practice change are explored.

Access to and support for continuing professional education amongst Queensland nurses: 2004 and 2007

This paper reports on the findings of a prospective exploratory study related to nurses' self-reports of continuing professional education access and support. The data were gathered by two postal surveys undertaken in 2004 and 2007 each which sampled 3000 nurses of the 30,000 nurse members of the industrial body - Queensland Nurses' Union. The response rates were 44.9% and 39.7% for 2004 and 2007, respectively. Over 85% of the nurses reported they had access to continuing professional education activities. However, it is apparent that the majority of these activities are either partially or completely self-funded. Further, between 2004 and 2007 the amount of financial support provided by employers for continuing education and training activities has decreased significantly. While there were differences between 2004 and 2007, the major barrier to be able to attend continuing professional education were financial (could not afford the fee involved; could not afford to take unpaid leave to attend). Another major barrier in both 2004 and 2007 was having the time to undertake the activity. Analysis for differences between nurses in different geographical locations indicated that distance remains a major barrier for nurses in rural and remote areas. These quantitative findings were supported by the qualitative findings on nurses' work where 'education and training' was, overall, the fifth highest ranked issue requiring further attention.

Perioperative nurses' perceptions and experiences of continuing professional education

This article presents an overview of perioperative nurses' perceptions and experiences of continuing professional education (CPE). Four themes emerged from 23 interviews: attitudes and culture (background); deciding to study (going in); student experience (process); and outcomes (going out). My findings indicate transferability of other studies to perioperative nursing, and suggest that CPE is associated with increased social status and doctor-nurse collaboration. My work also illuminates the concept of 'secret study'.