Effectiveness of continuing education programmes in nursing: literature review

A game-based multimedia application to improve the ability of clinical nurses to perform geriatric care: A randomized controlled trial

BACKGROUND

Given the realities of global aging, maintaining Comprehensive Geriatric Assessment (CGA) abilities among clinical nurses is very important. Newer methods of continuing education are needed to engage nurses in CGA education. Using multimedia and game-based applications in CGA education (CGA APP) may be an effective method for continuing education.

OBJECTIVES

To test the effectiveness of CGA APP in improving nurses' confidence in their abilities to perform geriatric care.

DESIGN

A randomized, controlled trial were adopted.

SETTING

An 1343-bed tertiary-care medical center in southern Taiwan.

PARTICIPANTS

A total of 1250 nurses met inclusion criteria in 35 adult wards. We employed stratified sampling to recruit a total of 132 nurses proportional to the number of nurses in each ward, from January to March 2019.

METHODS

Based on the Octalysis gamification framework, the CGA APP was developed. Participants were randomly assigned to either an CGA APP or a control group, which received traditional classroom learning of the same content. The main outcome was improvement in confidence in geriatric care ability were measured before and end of the training session, and six months later.

RESULTS

There were no differences in baseline characteristics (except years of experience as a registered nurse), knowledge, attitudes or confidence of geriatric care between the two groups. Clinical nurses in the CGA APP group demonstrated significantly higher confidence in their geriatric care abilities than control group immediately after the intervention (75.85 ± 10.71 vs. 65.93 ± 8.49, p < 0.001) and six-months later (71.13 ± 9.69 vs. 63.57 ± 8.78, p < 0.001). After using GEE to control the confounding variable, the CGA APP group remained significantly higher confidence in their geriatric care abilities than control group.

CONCLUSIONS

Use of multimedia game-based applications my better engage and teach practicing clinical than traditional learning methods. Our findings suggest that such interventions be further developed and tested for a larger variety of continuing education needs.

Implementation issues and barriers for assessing oral health in dependent patients after stroke: A qualitative study

OBJECTIVES

To explore implementation issues and potential barriers for assessing oral health in dependent post-stroke patients.

METHODS

Semi-structured interviews were conducted with a purposively identified sample of healthcare service providers who work in two National Health Service (NHS) Trusts in the north of England. Interviews were conducted until data saturation was achieved (n = 30). Data were analysed using the constant comparative method.

RESULTS

Six themes were drawn out in this study, which described potential barriers to assessing oral health in post-stroke patients, aspects of oral health that need assessment, streamlining the oral health assessment, input methods for oral health assessment, characteristics of assessors, and how oral care should be planned.

CONCLUSIONS

Assessment of oral health for post-stroke patients has been viewed as a complex task because of several identified barriers. Several suggestions have been proposed to overcome these barriers, aiming to enable more feasible and effective oral health assessments for post-stroke patients.

CLINICAL SIGNIFICANCE

The findings from this study have the potential to contribute to developing oral health measurement instruments that might be more successfully implemented and guide oral care planning for dependent patients after stroke.

Knowledge of Diabetic Retinopathy among Primary Care Nurses Performing Fundus Photography and Agreement with Ophthalmologists on Screening

Diabetic retinopathy (DR) is one of the complications of diabetes mellitus (DM), with macular oedema being one of the leading causes of avoidable blindness among individuals with DM worldwide. Fundus screening is the only method for early detection and treatment. High-quality training programmes for professionals performing primary care screening are essential to produce high-quality images that facilitate accurate lesion identification. This is a two-phase observational, descriptive, and cross-sectional study. The first phase analysed DR knowledge in a sample of nurses. The second phase explored agreement on DR screening between referral ophthalmologists in image assessment (gold standard) and a small group of nurses involved in the previous phase. In phase 1, the agreement rate for screening results was 90%. In phase 2, the overall raw agreement on the screening of fundus photography results between nurses and ophthalmologists was 75% (Cohen's kappa = 0.477; p < 0.001). Agreement on screening with ophthalmologists was moderate, suggesting that implementing a specific training programme for nurse-led imaging screening would help develop this competence among nurses, ensuring a good level of agreement and patient safety and adding value for users, and also for the sustainability of the healthcare system. This study was not registered.

Facilitating multistate pharmacy practice: streamlining continuing pharmacy education requirements

A major regulatory impediment to achieving multistate pharmacist licensure is state-specific Continuing Pharmacy Education (CPE) mandates. States vary on CPE requirements in 6 key domains, presenting a potentially significant administrative burden for multistate pharmacists. In the short term, replicating the nursing compact model of CPE regulation is the most viable model for the pharmacy profession. In this model, a pharmacist would have to follow just the CPE requirements for the state where the pharmacist maintains primary residence, and maintenance of this home state license would be automatically recognized by other states in which the pharmacist practices.

Practical recommendations for planning and running live online education workshops for the rural health workforce

AIM

This commentary presents practical and evidenced based guidelines for the development and delivery of real-time online training workshops aimed at rural health professionals.

CONTEXT

Online learning is increasingly being used as an avenue for delivering education, particularly to rural and remote sites where barriers persist in upskilling health workers. Further, online learning has become essential during the coronavirus disease 2019 (COVID-19) pandemic. In response to the Australian 2020 COVID-19 social distancing requirements, our team rapidly transformed face-to-face educational workshops into an online format, to deliver over 20 workshops to more than 150 multidisciplinary staff across our large rural district.

APPROACH

There are no published guidelines regarding the conversion of face-to-face education programs into an online format within health care. We conducted a review of the literature regarding the implementation of online education programs. Three broad categories of evidence were identified: participant qualities, content development and content deliverance.

CONCLUSION

We present a set of practical and evidenced based recommendations, which will enhance live online workshops for a rural health workforce. These recommendations are derived both from published literature and our experience delivering our workshops. We argue that rural health professionals and organisations need relevant, up-to-date practical guidelines and more institutional support and training focused on creating and implementing live online educational programs in rural Australia.

The role of continuing medical education programs in promoting iranian nurses, competency toward non-communicable diseases, a qualitative content analysis study

BACKGROUND

Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses' vital role in improving health care. It is, therefore, imperative to explore the nurses' experience of CME courses and the extent to which such programs are effective.

OBJECTIVE

The present qualitative study aimed to explore and describe nurses' experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases.

METHODS

This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30-45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln.

RESULTS

Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency.

CONCLUSION

Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process.

Dental Continuing Professional Development - Part I: Background on Dental Continuing Professional Development in Europe

INTRODUCTION

Continuing Professional Development (CPD) is mandatory in most European countries and evidence shows a move towards mandatory CPD across all Member States in the near future. Malta is one of seven Member States where dental CPD is still voluntary.

DISCUSSION

Although dental CPD is a legal requirement for recertification in many countries, integral aspects of dental CPD remain under debate, like whether CPD is truly effective. This is because the methods with which CPD programmes are evaluated are not sufficiently robust to give concrete evidence to determine whether CPD will actually improve quality of care, treatment outcomes and safety for the public. Evaluating the effect of CPD programmes on the public is an extremely difficult task that would require an enormous amount of resources and logistics. The minimum requirements for the number of compulsory CPD hours imposed by regulatory bodies are not evidence-based but purely arbitrary, and the core topics selected for CPD programmes, although supported by research to some extent, may not reflect the public's and profession's needs. The Dental Association of Malta recognised need for further research on dental CPD and embarked on a 3-year Dental CPD Research Project. This project will be presented in a two-part series of articles. This first article is focused on the background of dental CPD in Europe. An understanding of the current issues with CPD and flaws in methods of evaluation formed the basis of the Malta CPD Pilot Project, which will be covered in the next paper.

The relationship between hospital ethical climate and continuing education in nursing ethics

Background

In recent years, there has been a growing interest in the importance of creating a healthy ethical climate. Although relationship with various factors and the ethical climate have been reported, understanding of the relationship between ethical education and ethical climate is limited.

Aim

This study aims to investigate the relationship between ethical climate, personal characteristics, and continuing education for ethics.

Methods

This study conducted a quantitative cross-sectional survey of 605 nurses in 3 teaching hospitals in Japan. Multiple-regression analysis was used to assess the relationship between ethical climate and demographic characteristics and continuing education. Further mean of ethical climate scores were compared between received continuing education and did not, using analysis of covariance adjusted for demographic variables.

Findings

The ethical climate showed significant association with hospital, gender, specialty of the unit, experience of ethics education, in-service ethical training, and workshops/ academic conferences on nursing ethics. In multiple-regression analysis, attending in-service ethical training increased the mean of ethical climate score (p = 0.031) and workshops/ academic conferences decreased the mean score (p = 0.028). Adjusted-mean of ethical climate score of nurses who had in-service training was significantly higher than those who had not (p = 0.038), whereas adjusted-mean of it of nurses who had attended workshops/ academic conferences was significant lower (p = 0.033).

Discussion

In-service training on ethics was associated with the positive ethical climate. Hospital should enhance ethical education.

Conclusion

Ethical climate related to the nurses’ personal characteristics and continuing education. We propose that organizational support for ethical education may be effective in raising the ethical climate of the workplace.

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Introduction&#160;: The continuing professional development of nurses remains a key issue within the health context.Context&#160;: The Questionnaire - Professional Development Nurses (Q-PDN) was developed to understand the opinions and beliefs of nurses regarding continuing professional development is essential to improving the quality of care and optimizing job satisfaction. With this in mind, researchers from the Netherlands developed the Questionnaire &#8211; Professional Development Nurses (Q-PDN).Objectives&#160;: Adapt the Q-PDN to a French-Canadian context according to recognized guidelines.Method&#160;: The six stages of the Beaton et al. (2000) cross-cultural adaptation process were followed to produce a tool adapted to the French-Canadian context.Results and discussion&#160;: This study describes the different steps necessary for the cross-cultural adaptation of the Q-PDN tool to the French-Canadian context. Following the adaptation, minor content adjustments were made to the original version. General comments have highlighted the clarity and simplicity of the questionnaire.Conclusion&#160;: This first step in the cross-cultural French-Canadian adaptation of Q-PDN has enabled the development of a tool to identify gaps and priorities for action to promote the continuing professional development (CPD) of nurses.

Self-rated familiarity with autism spectrum disorders among practicing nurses: a cross-sectional study in the palestinian nursing practice

Background

Autism spectrum disorders (ASDs) are one of the most prevalent neurodevelopmental disabilities of early childhood. Practicing nurses are in a key position to help patients with ASDs and/or their caregivers/families. This study was conducted to assess self-rated familiarity with ASDs among practicing nurses in Palestine. The study also aimed to identify the sociodemographic and practice variables that could predict high self-rated familiarity scores.

Methods

This was a cross-sectional study using a questionnaire. The study was conducted in the period between January 2019 and May 2019. The questionnaire collected: 1) the sociodemographic, pedagogic, and practice variables of the nurses, 2) their self-rated familiarity with signs and symptoms, treatment options, and community resources of ASDs, 3) their self-rated confidence in their abilities to provide counseling for parents/family/caregivers on the drugs prescribed for children/patients with ASDs and their potential adverse effects, and 4) their willingness to receive education/training on issues in ASDs.

Results

The questionnaire was completed by 357 practicing nurses. The practicing nurses self-reported inadequate familiarity with symptoms, treatment, and community resources of ASDs. The mean familiarity score was 35.8% (SD: 18.9%). The nurses also expressed low confidence in their ability to provide counseling services to caregivers/families of children with ASDs. About 75% of the nurses agreed that they could benefit from taking a continuing educational/training program in the area of ASDs and about 82% of the nurses agreed that the nursing school curriculum should include courses in the area of ASDs. The multiple linear regression model showed that higher familiarity scores were predicted by having longer practical experience, having a higher academic degree in nursing, and having a continuing educational course/program on ASDs.

Conclusion

Findings of this study highlighted inadequate familiarity with issues of ASDs among practicing nurses. Higher familiarity was predicted by the length of practical experience, higher academic degree in nursing, and having continuing educational course/program on ASDs. Specifically designed pedagogic interventions might be helpful in increasing familiarity of practicing nurses on ASDs. More investigations are still needed to evaluate if these interventions can improve familiarity and services provided to patients with ASDs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00764-3.

Factors Hampering the Participation of Nursing Staff in the Continuing Education Activities of Hospitals Centers in the Casablanca-Settat Region

Aim:

This study aimed to identify the factors hampering the participation of nurses in the activities of CE sessions at the level of hospitals in the region of Casablanca.

Background:

Continuing education (CE) for nursing staff represents a strategic asset for hospitals, identifying the constraints of nursing staff participation in continuing training could help improve the quality of care for patients and the population in general.

Objective:

This study aimed to identify the factors hampering the participation of nurses in the activities of CE sessions at the level of hospitals in the region of Casablanca.

Methods:

The study used a two-phase mixed method design. First of all, a questionnaire was administered to 930 nurses belonging to 9 hospital centers in the Casablanca-Settat region in order to explore and estimate the frequencies of the factors hindering the participation of nurses in the activities of the FC sessions at the level of hospitals, and a semi-structured interview with 9 persons in charge of continuing education from these different hospitals to complete and explain the data collected by the questionnaire.

Results:

The data analysis confirmed that the work overload is the first individual difficulty hindering the participation of nurses in CE sessions, i.e., 85.4%. The most mentioned organizational difficulties are schedule recommended in the FC not encouraging and not suitable, i.e., 23%, non-targeted content (does not meet the needs of the nursing staff), i.e., 66.7%. Finally, the absence of support measures in terms of monitoring and evaluation to maintain the knowledge and skills acquired during FC sessions in real situations at the workstation occupied is the first institutional difficulty mentioned by the interviewed (88%).

Conclusion:

Those responsible for training should take into account the factors nurse’s face in participating in continuing education sessions when designing, developing, and implementing continuing education sessions.

A study of the role and educational needs of ophthalmic specialist nurses

AIMS

To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK.

METHOD

A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018.

FINDINGS

73% of OSNs undertake more than one active role, with 59% involved in nurse-led clinics; 63% felt formal learning resources were limited, with 63% reporting training opportunities and 21% reporting time as major barriers to further training. More than 38% emphasised hands-on clinic-based teaching had a greater impact on their educational needs. Some 64% were assessed on their skills annually and 59% felt confident with their skill set.

CONCLUSION

The Ophthalmic Common Clinical Competency Framework provides a curriculum and assessment tools for OSNs to use as a structure to maintain clinical skills and knowledge. Eye departments should use this as guidance to target learning needs and improve standards of care to meet the changing needs of society.

Building Veterinarians beyond Veterinary School: Challenges and Opportunities for Continuing Professional Development in Veterinary Medicine

Continuing professional development (CPD) is an important mechanism for veterinarians to acquire, maintain, and enhance their capability to perform competently in their chosen practice area over their career. Although most licensing bodies require veterinarians to complete a minimum number of CPD hours each registration cycle, there are known issues with verifying that these activities are having the desired effects of ensuring professional competence and improving outcomes for patients, owners, and veterinarians. In this review, we summarize the literature across different health care professions to highlight three key challenges for veterinary CPD programs. These are (a) defining what it means to be professionally competent across different career stages from graduation to retirement, (b) delivering CPD activities that are effective in promoting evidence-based medicine and behavioral change in practice, and (c) developing reliable and sustainable systems to formally assess the continued professional competence of veterinarians. A common theme across all challenges was the importance of interacting with colleagues as an opportunity to receive external feedback on their professional strengths and weaknesses and to develop stronger support networks for managing common stressors in clinical practice. There was also a recognized need to develop more transparent outlines of the available and acceptable options for managing different animal health concerns as a first step toward identifying new opportunities for the veterinary profession to elevate the level of care provided. Based on these findings, we propose a new framework for defining, delivering, and evaluating CPD that promotes stronger collaboration between veterinarians to improve professional and personal well-being.

Minimizing the knowledge-to-action gap; identification of interventions to change nurses' behavior regarding fall prevention, a mixed method study

Background

The need for effective continuing education is especially high in in-hospital geriatric care, as older patients have a higher risk of complications, such as falls. It is important that nurses are able to prevent them. However, it remains unknown which interventions change the behavior of nurses. Therefore, the aim of this study is to identify intervention options to change the behavior of hospital nurses regarding fall prevention among older hospitalized patients.

Methods

This study used a mixed method design. The Behavior Change Wheel (BCW) was used to identify intervention functions and policy categories to change the behavior of nurses regarding fall prevention. This study followed the eight steps of the BCW and two methods of data collection were used: five focus groups and three Delphi rounds. The focus groups were held with hospital nurses (n=26). Geriatric experts (n=11), managers (n=13) and educators (n=13) were included in the Delphi rounds. All data were collected within ten tertiary teaching hospitals in the Netherlands. All participants were included based on predefined in- and exclusion criteria and availability.

Results

In Geriatric experts opinions interventions targeting behavior change of nurses regarding fall prevention should aim at after-care, estimating fall risk and providing information. However, in nurses opinions it should target; providing information, fall prevention and multifactorial fall risk assessment. Nurses experience a diversity of limitations relating to capability, opportunity and motivation to prevent fall incidents among older patients. Based on these limitations educational experts identified three intervention functions: Incentivisation, modelling and enablement. Managers selected the following policy categories; communication/marketing, regulation and environmental/social planning.

Conclusions

The results of this study show there is a discrepancy in opinions of nurses, geriatric experts, managers and educators. Further insight in the role and collaboration of managers, educators and nurses is necessary for the development of education programs strengthening change at the workplace that enable excellence in nursing practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00598-z.

Structure and Outcomes of Educational Programs for Training Non-electroencephalographers in Performing and Screening Adult EEG: A Systematic Review

OBJECTIVE

To qualitatively and quantitatively summarize curricula, teaching methods, and effectiveness of educational programs for training bedside care providers (non-experts) in the performance and screening of adult electroencephalography (EEG) for nonconvulsive seizures and other patterns.

METHODS

PRISMA methodological standards were followed. MEDLINE, EMBASE, Cochrane, CINAHL, WOS, Scopus, and MedEdPORTAL databases were searched from inception until February 26, 2020 with no restrictions. Abstract and full-text review was completed in duplicate. Studies were included if they were original research; involved non-experts performing, troubleshooting, or screening adult EEG; and provided qualitative descriptions of curricula and teaching methods and/or quantitative assessment of non-experts (vs gold standard EEG performance by neurodiagnostic technologists or interpretation by neurophysiologists). Data were extracted in duplicate. A content analysis and a meta-narrative review were performed.

RESULTS

Of 2430 abstracts, 35 studies were included. Sensitivity and specificity of seizure identification varied from 38 to 100% and 65 to 100% for raw EEG; 40 to 93% and 38 to 95% for quantitative EEG, and 95 to 100% and 65 to 85% for sonified EEG, respectively. Non-expert performance of EEG resulted in statistically significant reduced delay (86 min, p < 0.0001; 196 min, p < 0.0001; 667 min, p < 0.005) in EEG completion and changes in management in approximately 40% of patients. Non-experts who were trained included physicians, nurses, neurodiagnostic technicians, and medical students. Numerous teaching methods were utilized and often combined, with instructional and hands-on training being most common.

CONCLUSIONS

Several different bedside providers can be educated to perform and screen adult EEG, particularly for the purpose of diagnosing nonconvulsive seizures. While further rigorous research is warranted, this review demonstrates several potential bridges by which EEG may be integrated into the care of critically ill patients.

Nurses' continuing professional development: A systematic literature review

Nurses' continuing professional development (CPD) improves the quality of nursing care, patients' safety, nurses' satisfaction and healthcare costs. However, evidence has shown that nurses do not always participate in their CPD and that CPD does not always address nurses' real needs. To examine this issue, a systematic review of the literature on nurses' experiences regarding their CPD in the clinical context was carried out. The studies selected for this review (n = 9) were analyzed thematically, through which three themes were identified: The relevance of CPD to nurses; the intrinsic and extrinsic motivations of nurses to participate in CPD; and the specific needs of nurses to participate in CPD. The findings of this review highlight that nurses' experiences regarding their CPD is a key issue that has not been deeply studied. For nurses, their CPD continues throughout their professional career, and keeping their knowledge and skills up to date is important. The goals, motivations and needs that nurses may have to lead and participate in their CPD may vary according to their age and position. Organizations should consider nurses' specific professional situation as well as their actual needs to boost their CPD through different approaches and enhance nurses' retention at hospitals.

Umbrella review: Impact of registered nurses' continuing professional education informed by contemporary reviews of literature

This paper aims to explore and classify studies of the impact and effectiveness of continuing professional education for registered nurses, using existing reviews of literature. Four healthcare databases were searched for publications from 2010 to July 2019 and electronic keywords searches were conducted. Umbrella review methodology was applied and Kirkpatrick's Four-Level Model of training evaluation was used to synthesise results and explicate the levels of educational impact. Of 16 included reviews, 13 were of simulation-based education activities. Three reviews of experimental studies demonstrated strong positive evidence of education impact on nurses' learning. Objective evidence of transfer of knowledge and skills into practice included improved interprofessional team performance and less time taken to complete clinical tasks. Reports of practice improvements and intention to change practice provided further evidence of impact. A small number of individual studies measured impact on service delivery, reporting positive and neutral results. We conclude that nurses learn and newly acquired knowledge and skills are often transferred into practice. Collection of robust evaluative data after completion of education is limited by practical considerations such as access to learners, resources and time constraints. Further studies of translational impact are needed, specifically, of the impact on patient care.

Nurse's difficulty and their educational needs regarding pediatric cancer care in Japan

Aim

Aiming at environmental arrangements for pediatric cancer patients and their families to receive appropriate medical care and support with a sense of security, the Japanese Ministry of Health, Labour, and Welfare designated 15 hub hospitals for childhood cancer. These hub hospitals have established networks with approximately 200 centers/hospitals treating pediatric cancer. In order to promote equal access to nursing, we investigated nurses' difficulties and needs at these treatment hospitals with limited experience in pediatric cancer nursing.

Methods

In order to examine education on pediatric cancer nursing, we investigated difficulties felt by treatment hospital nurses, their educational experience and their educational needs. A total of 584 nurses (66.51%) from 52 hospitals from which written consent was received completed the questionnaires.

Results

Nurses had difficulties regarding nursing care for patients with critical conditions, such as terminal care, and actions to be taken when a patient's physical condition rapidly changes. Nurses most strongly desired education on nursing care for patients with serious problems, such as terminal care, and follow‐up provided in the form of in‐ and hub‐hospital lectures.

Conclusion

Our study suggested that in order to provide nurses in treatment hospitals with education focusing on nursing care for patients with serious problems, education systems based on cooperation between hub and treatment hospitals are needed.

Practices, preferences, and opinions of New Zealand veterinarians towards continuing professional development

Aims: To describe the current practices and preferences of New Zealand veterinarians towards continuing professional development (CPD), explore factors acting as perceived barriers to CPD engagement, and identify opportunities for reforming the current CPD regulations. Methods: A cross-sectional survey of all veterinarians registered with the Veterinary Council of New Zealand (VCNZ) was conducted in October 2019. Descriptive statistics were provided for all quantitative study variables and thematic analysis was performed on the free-text survey comments to identify key issues regarding the current CPD regulations in New Zealand. Results: Complete survey responses were provided by 222/3,484 (6.4%) registered veterinarians. Most respondents (153/222; 68.9%) were satisfied with the amount of CPD completed and spent a mean of $2,511 (median $2,000; min $0; max $20,000) on CPD activities each year. The most popular CPD formats were those involving collegial interaction including conference and skills training workshops. The choice of CPD activities was most commonly influenced by interest in the topics and the desire to become more competent in their work while the main barriers were difficulties fitting CPD around work and family commitments. There were 164 (73.9%) respondents who cited at least one occasion in the previous 12 months where participating in CPD caused them to modify their existing practices. Thematic analysis of the free-text comments revealed several major themes related to the administrative burden of recording CPD activities under the current regulatory framework, and the need to develop CPD plans tailored towards the unique circumstances and goals of individual veterinarians. Respondents also expressed concerns over the reliability of using CPD record audits for evaluating professional competency. Factors identified as being the most helpful for improving the current CPD framework were simplifying the CPD points categories and developing a mechanism to record and share CPD activities in real-time. Conclusions: While most respondents felt there was significant value in completing CPD, the current regulatory framework was perceived to be administratively burdensome and inflexible in allowing them to tailor CPD activities to match their unique employment situation, learning style and professional goals. Clinical relevance: Providing resources that could assist veterinarians to design and implement tailored CPD programmes may improve professional and personal outcomes. However, further research is needed to develop more effective mechanisms for identifying veterinarians who are not performing competently without placing excessive administrative burdens on those who are.

In-service training to enhance the competence of health and social care professionals: A document analysis of web-based training reports

OBJECTIVE

To identify and describe what professional competencies have been addressed by in-service training for health and social care professionals and what kind of teaching and evaluation methods have been used.

DESIGN

Cross-sectional descriptive study.

METHODS

A document analysis design was used to explore 7817 in-service training project documents relating to 203 projects carried out from 2002 to 2020. The project data were obtained from the websites run by the relevant health and social care organizations.

RESULTS

The most frequent competencies that were addressed were health promotion and clinical skills (17%), preventing social problems (16%) and promoting the wellbeing of children and families (15%) and older adults (14%). The main target groups were general health and social care professionals (19%). A total of 222 training interventions were used by the 203 projects and the most frequently used methods were conventional classroom education (56%), followed by coaching and orientation (12%) and theme days (9%). Only 38% of the projects measured the effects of the training and the main method was collecting feedback from participants. We also found that collaboration between projects was necessary to ensure that training was not duplicated and transparent reporting played a central role in that process.

CONCLUSIONS

In order to achieve successful in-service training for health and social care professionals, projects needed to recognize topical competence needs and provide the most appropriate training methods. Collaboration and transparent reporting helped to avoid duplication in training.

Determinants of readiness towards self-directed learning among nurses and midwives: Results from national survey

An ever-changing and challenging patient care environment requires nurses and midwives to embrace the concept of lifelong learning through a self-directed learning (SDL) approach. This study aims to evaluate nurses and midwives' readiness towards self-directed learning (SDRL) in Brunei Darussalam. A cross sectional descriptive study was conducted. Using a non-proportional quota sampling method, 700 questionnaires were distributed among nurses and midwives working in four District Government Hospitals in Brunei. Fisher's Self Directed Learning Readiness Scale was used to explore readiness towards SDL among nurses and midwives. In total, 616 completed questionnaires were returned (representing a response rate of 88%). Results indicated a high level of readiness towards self-directed learning among the participants with a total mean SDLR score of 158.44 ± 16.00. In overall comparison, the mean score of domains were: self-management (49.21), desire for learning (50.12) and self-control (59.10). This national hospital survey concludes that graduateness, workplace, age and marital status determine readiness towards self-directed learning among nurses and midwives in Brunei. Future research should focus on a theoretical framework for SDL models and the impact of these models on quality nursing practice.

Massive Open Online Courses for continuing education for nursing professionals in Peru

METHOD

to determine the global offer of Massive Open Online Courses (MOOCs) in health and nursing, and to know the characteristics of its content, for continuing education in nursing professionals in Peru. Exploratory study was carried out on the websites: Coursera, edX, FutureLearn, XuetangX and Udacity, Class Central and MOOC List. The courses were classified according to the five nursing areas recognized by the Peruvian College of Nurses (Colegio de Enfermeros del Perú, CEP). From each course, data was collected on institution and country of origin, hours per week and total duration in weeks, audio and subtitle language.

RESULTS

a total of 654 courses in this modality are offered in health were found, covering the five areas contemplated by the Peruvian College of Nurses. Fourteen courses were specifically developed for nursing with an average duration of five weeks (3.2 hours per week of activities). Eleven came from Anglo-Saxon institutions, with content in English. Only two courses were offered in Spanish and one in Turkish.

CONCLUSION

Massive Open Online Courses would be a useful tool for the continuing education of the Peruvian nurse given the wide offer, including some specifically for nurses, in the different areas of nursing. The content of the course is mostly in English. Expanding the range of languages or subtitles would facilitate the participation of a larger audience.

In-Service Education: Evolving Internationally to Meet Nurses' Lifelong Learning Needs

In-service education (ISE) in nursing is teaching that occurs in the workplace. Internationally, ISE activities have been evident in nursing for many years because it has been seen as a convenient and cost-effective way to deliver education to nurses with minimal disruption to staffing levels and the delivery of patient care. ISE-related literature was sought to address the aim of tracing development and focus of nursing ISE in New Zealand. A key finding of this literature review is that ISE has been adapted in New Zealand and internationally to meet the demands of evolving nursing practice, and for this reason it remains relevant and essential to nurses. The embeddedness of ISE within clinical environments also supports its relevance. Future research is called for to establish which aspects of ISE are critical to ensuring its ongoing success. [J Contin Educ Nurs. 2019;50(7):313-318.].

Knowledge, attitudes, practice and related factors of oral cancer prevention among public health nurses in Taiwan

OBJECTIVES

Public health nurses (PHNs) in Taiwan act as individual/family-based primary care providers and as population-based community care providers. A little information is currently available on the ability of PHNs to prevent oral cancer. We surveyed knowledge, attitudes and behaviour of oral cancer prevention among PHNs.

METHODS

This study recruited 400 PHNs through the Taiwan Public Health Center. A structured electronic questionnaire was used to collect PHNs' demographics and scale scores for oral cancer knowledge, attitudes and preventive behaviour.

RESULTS

Providing PHNs with oral cancer prevention education, having the supervisor's support for preventive work and receiving in-service education would improve PHNs' knowledge, attitude and behaviour for oral cancer prevention. Attitude, oral cancer-related courses arranged by current employer (major factor), supervisor's support for work and having responsibility for oral cancer prevention were associated with the oral cancer preventive behaviour of PHNs, and explain 41.1% of total variance.

CONCLUSIONS

We established a linear regression model for understanding the role of PHNs in the practice of preventing oral cancer. It may be useful for the government in improving school-based and in-service oral cancer prevention education programmes for PHNs as well as developing programmes for increasing public awareness and education of oral cancer prevention.

The Challenges of Implementing Family-Centered Care in NICU from the Perspectives of Physicians and Nurses

PURPOSE

The purpose of this study was to investigate physicians' and nurses' perspectives on the challenges of implementing the FCC in the neonatal intensive care unit.

DESIGN AND METHOD

The study employed a qualitative design to conduct five focus groups with 25 nurses and 15 physicians (n = 40). All of the nurse participants identified as female; 73% held a bachelor's degree in nursing and 59% had been working as a neonatal nurse for >10 years. Of the physicians, 55% identified as male, 43% held positions as neonatologists and 39% had a minimum of 3 years of experience in neonatal intensive care.

RESULTS

Three themes, power imbalance, psychosocial issues, and structural limitation, and related sub-themes were constructed using thematic analyses.

CONCLUSION

The implementation of family-centered care in the neonatal intensive care unit in Iran is shaped by the health care provider, cultural, legal and operational challenges. To optimize effective and sustained implementation, these influential factors must be addressed.

IMPLICATIONS

Organizational, managerial and operational changes are required for FCC implementation. Nurses and physicians are well-positioned as leaders and facilitators of family-centered care implementation within the neonatal intensive care unit.

Increasing cultural awareness: qualitative study of nurses' perceptions about cultural competence training

BACKGROUND

Nowadays, healthcare professionals worldwide deliver care for increasing numbers of culturally and linguistically diverse patients. The importance of cultural competence is evident in terms of the quality of healthcare, and more knowledge is needed about different educational models and approaches that aim to increase cultural competence. This study examines the perceptions of nurses about the content and utility of cultural competence training that focuses on increasing awareness of one's own cultural features.

METHODS

The training was conducted at one primary care hospital in southern Finland. Participants were registered nurses (n = 14) and practical nurses (n = 6) from different hospital units. Four 4-h training sessions-including lectures, discussions and short web-based learning tasks-were arranged during a four-week period. Semi-structured, small group interviews were conducted with 10 participants to examine their perceptions about the content and utility of the training. Qualitative content analysis with a conventional approach was used to analyse the data.

RESULTS

Perceptions about the training were divided into three main categories: general utility of the training, personal utility of the training, and utility of the training for patients. General utility pertains to the general approach that the training provided on cross-cultural care, the possibility to initiate an open discussion, and the opportunity to improve current practices. Personal utility pertains to the opportunity to become aware of one's own cultural features, to change one's way of thinking, to obtain a new perspective on one's own communication practices and to receive justification for carrying out particular workable practices. Utility for patients pertains to fostering better awareness and acknowledgement of patients' differing cultural features and an increased respect in healthcare delivery. Additionally, the quality of the training was highlighted, and suggestions for improvement were offered.

CONCLUSION

Training that increases healthcare professionals' awareness of their own cultural features was perceived as useful and thought-provoking. Increased awareness might facilitate the communication between healthcare professionals and patients, which is a crucial component of quality healthcare. It seems that in the future, training opportunities that allow larger groups to participate are needed, regardless of the time and place, and utilising the potential of e-learning should be considered.

Basic and Continuing Education Needs of Nurses Instrument: Development and Validation

AIM

To develop and psychometrically test the Basic and Continuing Education Needs of Nurses Instrument.

BACKGROUND

Nurses need to keep updating their knowledge through engaging in continuing education and professional development activities. Continuing education should be based on needs assessment.

METHODS

Items generated were devised from a comprehensive literature review guided by Morrel-Samuels' guidelines. Psychometric analysis was then performed on data from 3632 registered nurses across 74 Lebanese hospitals. Two-factor structures were evaluated: the one-dimensional structure including all items and a six-dimensional structure proposed by the authors. Reliability, exploratory and confirmatory factor analyses were used. Associations between the total knowledge score and nurses' characteristics were assessed using linear regression.

RESULTS AND DISCUSSION

The total scale had Cronbach's alpha of 0.93 and the six subscales between 0.74 and 0.82. Exploratory factor analysis on the first randomly drawn sample of the data supported the one-factor structure. Confirmatory factor analysis on the second randomly drawn sample revealed that both structures were acceptable with better fit for the six-dimensional structure. Linear regression showed significant associations between total score and nurses' age, income, education and gender. The tool has satisfactory psychometric properties for registered nurses in Lebanon and demonstrated relevance to the Lebanese context of nursing practice.

CONCLUSION

We developed a locally adaptable and psychometrically sound instrument to assess the perceived learning needs of Lebanese nurses. Evidence of the validity and reliability of the instrument was provided.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

At a practice level, the Instrument allows nurse leaders to assess knowledge gaps and respond accordingly to nurses perceived learning needs at the national level thus improving practice and protecting people's health. At a policy level, this study has implications for developing policies, regulations and guidelines in support of nurses' continuing education needs and their professional development.

Analysis of Determinants of Readiness for Professional Development Among Polish Nurses

The continuous development of medical sciences and the introduction of new diagnostic methods and treatment with the use of specialized equipment means that the knowledge and skills acquired during university studies are no longer sufficient. This obliges nursing staff to raise their professional qualifications in order to provide the appropriate quality of medical services. The aim of the study was an analysis of nurses readiness for learning and development and factors determining this readiness. The study was conducted among 756 nurses. The questionnaire method adopted was the readiness of employees for learning and development (RELD) standardized questionnaire, and a questionnaire containing sociodemographic data of the respondents. For the subscales of readiness for learning and development, average results were predominant and concerned in particular the level of openness to changes in environment (A1 scale), and self-evaluation of past educational development (C5 scale). The readiness of the nurses examined to learn and develop was on an average level for all the subscales. Younger nurses, with a lower seniority, having higher education and additional qualifications had a higher readiness for learning and development.

Systematic Review of Continuing Education Interventions for Licensed Nurses Working in Psychiatry

Continuing education is an important part of nursing practice. These interventions help maintain clinical competence and are mandated by regulatory bodies. Often, continuing education interventions are created ad hoc and implemented without testing or formal evaluation of learning outcomes. In the current health care context, where resources are limited, educators are pressed to do more with less. Having access to a repository of existing continuing education interventions will facilitate the use of evidence-informed learning strategies and save valuable time by reducing duplication of efforts. Therefore, this systematic review aimed to explore continuing education interventions for licensed nurses working in psychiatry. All standard systematic review procedures were followed, including double screening, data extraction, and quality appraisal. This article presents an inventory of existing interventions, including summaries, as well as the reported effectiveness of each for nursing outcomes. Generally, the continuing education interventions result in positive nurse-related outcomes, such as increased knowledge, confidence, and skills, or improved attitudes; however, more rigorous research is needed to advance science in this area. [J Contin Educ Nurs. 2019;50(5):233-240.].

Importance of incorporating measures of attitude in planning and evaluating nursing education

Learners' attitudes towards a topic or behavior has long been recognized as an important component in the evaluation of formal education as well as in achieving desired behavior change. However, attitudes are frequently neglected and evaluation of outcomes from continuing nursing education often includes only changes in knowledge and learner satisfaction. We describe measurement of attitudes of oncology nurses towards holding discussions with patients about the option of participating in a clinical trial, in comparison to what can be learned from measuring knowledge alone. This article illustrates important insights that can be gained through inclusion of measures of attitude in both designing and evaluating continuing education using data from a larger on-going study.

Comparisons of Knowledge of Dutch Nursing Students and Hospital Nurses on Aging

BACKGROUND

Although there is a growing population of older adults admitted to hospitals, the literature demonstrates knowledge deficits of nurses regarding older patients. This study investigated knowledge levels of both nursing students and RNs about older hospitalized patients in relation to their educational level and work experience.

METHOD

First- and final-year vocational and bachelor nursing students, and associate degree and bachelor degree nurses working in the hospital setting with 0 to 5 years, 6 to 15 years, and more than 15 years of experience, have completed the Knowledge about Older Patients-Quiz (KOP-Q). The KOP-Q has a clearly described theoretical base finding its origin in knowledge regarding nursing care for older patients and shows good content and construct validity.

RESULTS

A substantial proportion of participants in all groups demonstrated insufficient knowledge about older patients. A difference in knowledge exists among nurses with different educational qualifications, and a link between years of experience and higher knowledge levels of nurses is found.

CONCLUSION

Throughout the nursing career, basic care topics in relation to care for older patients should play a key role in basic nursing education programs, as well as for continuing education programs provided in hospitals for nurses. J Contin Educ Nurs. 2018;49(2):84-90.

The importance of reflecting on practice: How personal professional development activities affect perceived teamwork and performance

AIMS AND OBJECTIVES

To examine the relationships between participation in personal professional development activities (e.g., coaching, mentoring), teamwork and performance; to investigate the mediating and moderating effects of reflective thinking and perceived usefulness of development activities.

BACKGROUND

Professional development is associated with better performance and attitudes towards one's work. This study adds to this research by focusing on understanding this effect and the conditions under which this occurs.

DESIGN

Cross-sectional survey study.

METHODS

Participants were 244 nurses working in a large, metropolitan acute public hospital. They completed a questionnaire consisting of validated measures and provided information on frequency of participation and perceived usefulness of personal professional development activities. We analysed data using regression-based moderated mediation analyses.

RESULTS

The relationship between frequency of participation in personal professional development activities and both perceived teamwork and performance was mediated by reflective thinking. Perceived usefulness of development activities moderated the relationship between frequency of participation in personal professional development activities and reflective thinking.

CONCLUSION

Our results highlight the importance of professional development activities that go beyond knowledge- or skill-based training. Activities that cater to nurses' personal professional development needs are also associated with more positively perceived teamwork and performance. Results provide insights into the mediating mechanisms: Participation in personal professional development activities encouraged reflective thinking, which was associated with better perceived teamwork and performance. This association between personal professional development activities and reflective thinking was even stronger where nurses perceived the activities as useful.

RELEVANCE TO CLINICAL PRACTICE

Personal professional development activities enhance reflection in and on practice as these activities were linked with higher perceived quality of care and teamworking. It is important to ensure that the positive effects of personal professional development activities should target nurses' professional development needs and need to be perceived as useful by those who undertake them.

Distance learning for maternal and child health nurses and midwives in Mongolia: a qualitative evaluation

BACKGROUND

Continuing education is vital for the development of the competencies of nurses and midwives. We analysed the effectiveness of a distance education programme for maternal and child health nurses and midwives in Mongolia, assessing its strengths and limitations and ways in which it could be improved. The aim of this research is to provide an analysis of the successes and failures of the programme, in order to improve future versions of this and similar programmes in Mongolia and elsewhere.

METHODS

We carried out a qualitative descriptive study in Mongolia in August 2015. This consisted of three semi-structured interviews and two focus groups in the Second National Hospital, Ulaanbaatar, and three semi-structured interviews and one focus group in Dornogovi Provincial Maternal Hospital, Sainshand, Dornogovi Province. In total, there were 22 participants in our research. Data from the interviews and focus groups were thematically coded and analysed using NVivo version 10.

FINDINGS

The distance education programme is well received by participants. They suggest that it has improved their clinical practice and education in a number of areas, and are anxious for the programme to continue. A number of alterations would be necessary to improve both the quality of the programme and the ability of participants to foster change on the basis of what they have learnt. This provides challenges for both the programme organizers and the providers of maternal and child health services in Mongolia.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

The success of the distance education programme suggests that collaborations of this type are a cost-effective method of disseminating best practice in policy and practice to improve the quality of care provided to mothers and children in low-resource settings.

CONCLUSIONS

A distance education programme is vital to link maternal care providers in Mongolia to new trends in care. Mongolia's relative isolation means that this programme is particularly valuable there. However, the programme could work equally well in other developing country settings.

[How can employers support home care nurses’ continuing education and nursing professional development at workplace? Results of a Canadian qualitative survey.]

INTRODUCTION

this article provides a new knowledge on employer's support for home care nurses' continuing education.

CONTEXT

so far, literature has sustained that providing support to nurses in continuing education is mainly a matter of money. However, only few researchers have been interested in home care, especially in continuing education.

OBJECTIVE

one of the objectives of the survey was to identify factors that could influence nurses' commitment, participation and choice in the matter of continuing education activities.

METHODS

a qualitative survey was conducted with eight nurses, coming from one clinical home care setting (Québec, Canada), who participated in a semi-structured individual interview. Thematic analysis was used. Results were validated by intra- and inter-rater controls. Furthermore, participants were involved in the process of validation. Results have shown that support given by the employer in the matter of continuing education can be seen into five different aspects : financial, training, affective, instrumental and normative. Despite a lack of financial and training support, most of home care nurses have a positive perception of their employer's support.

DISCUSSION

nevertheless, employers should pay more attention to nurses' needs. To do so, nurses should be involved into the process of continuing education at their workplace.

Lifelong learning strategies in nursing: A systematic review

Background

Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood.

Objective

The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience.

Methods

In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions.

Results

In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data.

Conclusion

Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient care.

Role of clinical practice educators in an integrated community and mental health NHS foundation trust

Clinical practice educators (CPEs) aim to provide support and education to clinical staff and students to improve their professional practice. This article examines the work of a team of six CPEs, who were employed by one large integrated mental health and community health NHS foundation trust that incorporates both mental and physical health services. It explores how the role of the CPE can have positive effects on clinical settings, and can improve the provision of evidence-based care for clinical staff and students on placement in the trust. The article provides examples of the work undertaken by the CPE team and considers the plans for its future development.

[Narrative pedagogy in nursing sciences : learning activities and challenges.]

Active learning strategies have proved effective in changing behaviours and encouraging continuing professional development (CPD) in nursing. Narrative pedagogy in particular has demonstrated its usefulness in this regard. This article describes narrative pedagogy through the lens of learning activities conducted in the classroom and in the course of practicum and CPD experiences. It also examines the challenges associated with implementing such activities and how to meet them. This includes not determining the content of activities completely in advance, specifying that the content to be discussed is not entirely known, that additional research could be required and that different options are to be explored, allowing students to express themselves freely, and tolerating moments of silence. Current and future teachers are urged to experiment with this novel teaching and learning approach that is grounded in phenomenological research and shows strong potential for the development of nursing science.

Workplace continuing education for nurses caring for hospitalised older people

AIMS AND OBJECTIVES

To develop, implement and evaluate a workplace continuing education programme about nursing care of hospitalised older people.

BACKGROUND

The healthcare system cannot rely solely upon nurses' prelicensure education to prepare them to meet the evolving needs of hospitalised older patients. Over the past decade, there has been a dramatic rise in the proportion of older people in hospitals, yet many nurses do not have specialised knowledge about the unique care needs of this population.

DESIGN

A multimethod pre-to post-design was employed.

METHODS

Between September 2013 and April 2014, data were collected via surveys, focus groups and interviews. Thirty-two Registered Nurses initially enrolled in the programme of which 22 completed all data points. Three managers also participated in interviews. One-way repeated-measures ANOVAs were conducted to evaluate the effect of the programme and change over time. Qualitative data were analysed using thematic analysis.

RESULTS

Survey results indicated improvements in perceptions about nursing care of older people but no changes in knowledge. Themes generated from the qualitative data focused on participants' experiences of taking part in the programme and included: (i) relevance of content and delivery mode, (ii) value of participating in the programme and (iii) continuing education in the context of acute care.

CONCLUSIONS

This study illustrated the potential role of workplace continuing education in improving care for hospitalised older people, particularly the potential to change nurses' perceptions about this population. Nurses prefer learning opportunities that are varied in delivery of educational elder-focused content and accessible at work. Organisational leaders need to consider strategies that minimise potential barriers to workplace continuing education.

IMPLICATIONS FOR PRACTICE

Workplace continuing education can play a key role in improving quality of care for hospitalized older adults and ought to be a priority for employers planning education for nurses.

Growth Trajectories and Detrended Intraindividual Variability to Assess Case Managers' Competency in Continuing Education

Tracking the effectiveness of CE over time beyond simply confirming its efficacy in continuing education (CE) in nursing is crucial. However, research evidence on the analysis of change of the effectiveness of CE over time is limited, particularly in the context of case management. This methodological study aimed to introduce both a growth curve modeling and an intra-individual variability index and demonstrate step-by-step procedures and interpretations of those analyses to assess case manager competency over time, using secondary data analysis. Data were collected from 22 case managers affiliated with the Korean National Health Insurance Corporation who attended three series of CE to improve their competency between May 2008 and August 2009. Unexpected results revealed a negative fixed effect of education level in the overall estimation of case managers' competency trajectory and a negative correlation between education level and case managers' intra-individual competency inconsistency over time. J Contin Nurs Educ. 2017;48(5):230-238.

Training needs assessment of health care professionals in a developing country: the example of Saint Lucia

BACKGROUND

Continuing education (CE) is crucial for quality improvement in health care. The needs assessment of CE helps ensure effectiveness. However, such an assessment necessitates certain techniques that are unfamiliar to health care communities in developing countries. This study identifies the needs of providing CE to health care personnel in Saint Lucia.

METHODS

This study was designed as a questionnaire survey to investigate the demographics, training needs, and preferred approaches to improve performance of the target population. The study population included the health care professionals of major public health care facilities in Saint Lucia. We used the World Health Organization-adopted Hennessy Hicks Training Needs Analysis Questionnaire, a self-reported close-ended structured questionnaire with a core set of 30 items. These items refer to tasks that are central to the role of health care professionals and are categorized into six superordinate categories: research/audit, communication/teamwork, clinical skills, administrative, managerial/supervisory, and continuing professional education.

RESULTS

In total, 208 questionnaires were distributed; the response rate was 66.8%, and most respondents were nurses. The need for continuing professional education was rated the highest priority, followed by research/audit activities. The evidence suggests that most respondents required training in communication skills, management, clinical skills, and research methods.

CONCLUSIONS

Providing training according to the needs is vital, particularly in developing countries. The present research methodology and findings offer perspectives on how to conduct needs assessment and offer reference points for developing countries whose background and health care environment are similar to those of Saint Lucia.

Malaysian nurses' evaluation of transnational higher education courses

The internationalisation of higher education has led some UK and Australian universities to deliver transnational higher education (TNHE) post-registration top-up nursing degree courses in Malaysia. These are bridging courses that allow registered nurses to upgrade their diploma qualifications to degree level. What is not sufficiently explored in the literature is nurses' evaluation of these courses and the impact of TNHE qualifications. A hermeneutic phenomenology approach was used to explore the views of 18 Malaysian nurses from one Australian and two UK TNHE universities. Semi-structured interviews were conducted to enable the Malaysian nurses to evaluate the courses. Data were analysed by thematic analysis. Findings showed a gap between Malaysian and Western teaching and learning outlook, professional values and clinical practices. The data give important insights at a time when the aim of Malaysia's investment in TNHE courses is to attain a graduate workforce with changed mindsets and enhanced patient care.

A competency-based performance appraisal for nurse leaders

Introduction: An employee performance appraisal is used internationally to improve employee performance, productivity, efficiency and effectiveness in nursing care. The purpose of the study was to assess the performance and efficiency of nurse leaders at all levels of leadership, identify deficient areas for each individual leader and propose improvements. Methods: Two surveys were conducted in 15 Slovenian public hospitals. The sample from the first survey included 1311 nurses who assessed the level of competencies of their immediate superiors. The sample from the second survey included 236 nurse leaders. Data envelopment analysis is used in this study to develop a model of practice outputs and inputs to help identify the most efficient nurse leaders. Results: Significant differences exist in the performance appraisal among the leaders in nursing. A total of 203 (86 %) nurse leaders are defined as inefficient and could improve their leadership performance. On average, inefficient leaders could improve their behaviour most in the areas of generic leadership competencies (by 51.7 %) and interprofessional relationships (by 47.7 %). Discussion and conclusion: The areas with the worst performance are generic leadership competencies and interprofessional relationships where also the most significant improvements are possible. Nurse leaders and hospital managers can use the analysis results to determine in which areas the leaders in their organisation should improve the levels of their competencies.

Motives and activities for continuing professional development: An exploration of their relationships by integrating literature and interview data

BACKGROUND

To effectively enhance professional development, it is important to understand the motivational factors behind nurses' engagement in particular types of learning activities. Nurses have various motives for professional development and utilise different learning activities. Not much is known about how these relate.

OBJECTIVES

The aim of this study was to explore the relationship between nurses' motives and activities for continuing professional development, by examining in which types of learning activities nurses engage, with which motives, and whether certain motives are associated with certain learning activities.

DESIGN

A qualitative study using semi-structured interviews.

SETTINGS AND PARTICIPANTS

Twenty-one nurses in academic and general Dutch hospitals participated.

METHODS

Interview data on nurses' learning biographies were analysed using a literature-based framework on motives and learning activities for continuing professional development. As recent classifications of nurses' motives for professional development were absent, the literature was reviewed for motives, using three databases. The interview transcripts were analysed for motives, learning activities and their relationships.

RESULTS

Nine motives and four categories of learning activities for continuing professional development were delineated. Increasing competence was the primary motive that stimulated nurses to engage in self-directed learning during work, and in formal learning activities. To comply with requirements, they engaged in mandatory courses. To deepen knowledge, they registered for conferences. To develop their careers, they enrolled in postgraduate education. Five other motives were not mentioned as frequently.

CONCLUSIONS

Specific motives were found to be related to engagement in particular learning activities. Nurses could use these findings to increase their awareness of why and how they develop professionally, and managers and human resource development professionals could develop approaches that would better suit nurses' needs.

"The ABCs of AD": A prospective evaluation of the efficacy of an educational intervention to increase knowledge of autonomic dysreflexia management among emergency health care professionals

CONTEXT/OBJECTIVE

Despite the availability of consensus-based resources, first responders and emergency room (ER) health care professionals (HCPs) have limited knowledge regarding autonomic dysreflexia (AD) recognition and treatment. The purpose of this study was to assess the efficacy of "The ABCs of AD" educational seminar for improving HCPs' short- and long-term knowledge of AD recognition, diagnosis, and management.

DESIGN

Multi-center prospective pre, post, and follow-up questionnaire study.

SETTING

Level I trauma centers with emergency departments in British Columbia, Manitoba, and Ontario.

METHODS

ER professionals completed measures immediately before and after (n = 108), as well as 3-months following (n = 23), attendance at "The ABCs of AD" seminar.

OUTCOME MEASURES

AD knowledge test; seminar feedback.

RESULTS

Following the seminar, participants had higher ratings of their AD knowledge and had significantly higher AD knowledge test scores (M ± SD pre = 11.85 ± 3.88, M ± SD post = 18.95 ± 2.39, out of 22; P < 0.001, d = 2.21). Most participants believed the seminar changed their AD knowledge, and rated the seminar information as having the potential to influence and change their practice. AD knowledge test scores significantly decreased between post-seminar and 3-month follow-up (M ± SD 3mo = 17.04 ± 3.28; P = 0.004, d = -0.70); however, 3-month scores remained significantly higher than baseline.

CONCLUSION

"The ABCs of AD" seminar improves HCPs' perceived and actual AD knowledge in the short-term. To enhance knowledge retention in both the short- and long-term, the inclusion of additional active learning strategies and follow-up activities are recommended. The seminar is being translated into an online training module to enhance the dissemination of the AD clinical practice guidelines among first responders, ER staff, and SCI practitioners.