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Discussion paper, one page, APA format with references, including the article, due Sunday, Oct. 1st, 11:00 p.m. E.T. ICU model can be used as directed in the instructions.
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Learning Curve
Meeting the challenges of nursing staff education
BY MELISSA SCHNEIDER, DNP, RN-BC, CNRN, ONC, AND SANDRA GOOD, MEd, BSN, RN, CNRN
T
HE CONSTANT changes in
today’s healthcare landscape
require nurses to stay current
in technology and practice.1
According to the Code of Ethics for
Nurses, nurses have a responsibility
to “maintain competence, and continue personal/professional growth.”2
Continuing education and staff development are fundamental components
of being a professional nurse.3,4 This
article examines how one hospital
unit designed and implemented a
nurse education program intended to
engage adult learners and inspire
reflection.
Value of education
The American Nurses Association
created a system to formally measure
continuing education credits in
1975.5 Since then, much debate has
centered over how much continuing
education is needed to maintain
competency and the best way to
obtain that education. Competency is
defined most simply as the application of the skills and knowledge for
appropriate nursing practice, but it
can also be highly complex, as
nurses have diverse educational
backgrounds and practice in various
settings.6
Most nurses recognize the value of
continual professional development.7
One study consisting of focused
interviews to determine clinical nurses’
perceptions about continuing education found that most interviewees
saw continuing education as necessary to provide safe, up-to-date
patient care.8 Nurses also cite career
advancement and increased selfconfidence as reasons for professional development.7
Barriers
Unfortunately, several barriers—both
real and perceived—can stand in the
way of nurses’ involvement in continuing education and professional development. Clinical nurse educators and
education committees are challenged
to change staff perceptions to view
continuing education and professional
development in a more positive light.
One of the biggest barriers to learning
in the hospital is lack of time.4 While
protected education time is invaluable,
it’s unrealistic to think that this will
always be available as healthcare costs
continue to rise. Extra paid training time
is expensive for health systems, and
administrators don’t always see it as a
worthwhile investment.7 Other barriers
to continuing education and professional development are staff shortages,
inconvenient places/times, fatigue/
inability to concentrate after working,
family/personal commitments, lack of
interest in topics, past experiences of
negative/inadequate programs, lack of
program variety, poor planning, inappropriate teachers, and lack of manager/
administration support.3-5
Another challenge is the effort and
time required to continually update
information so it’s current.9 Creating
and analyzing needs assessments and
updating resources are time-consuming
activities. Staff may have learning
preferences based on generational
differences. For example, Baby boomers are used to passive learning, while
millennials expect teaching methods
to keep pace with technological
changes.10,11 In addition, some newer
technology, such as cloud computing,
e-learning, mobile computing, and
virtual reality, may be unfamiliar to
nurse educators and planners.
The learning environment itself
can impact nurses’ development and
education.8 In a culture that supports and values learning, continuing education is a priority. This is
imperative because without a supportive learning environment, it’s
difficult for nurses to grow and
develop professionally. Factors such
as self-directed ability, sense of
accountability, motivation to learn,
and opportunities for education
influence learning.10 Educational
planning and instructional design
must be approached like the nursing
process by assessing needs, diagnosing the issues, planning the appropriate education, implementing it,
and, finally, evaluating the results.11
A new type of program
One unit’s education committee recognized these challenges to staff
development and education and
decided to implement a new type of
nurse education program. The
patient population of this 55-bed
unit consisted of trauma/orthopedic
patients, stroke/neurosurgical
patients, and some general medicalsurgical patients. Besides general
yearly required education credits,
nurses on this unit must earn mandatory trauma and stroke credits
because the hospital has both trauma
and stroke certifications. The total
number of required credits seemed
overwhelming to some nurses, so the
education team created additional
opportunities for staff to complete
requirements while also encouraging
continuing professional development.
Adult Learning Theory states that
adult learners need to be in control of
their own learning.10 Optimal learning
16 l Nursing2018 l Volume 48, Number 8
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
www.Nursing2018.com
for this group must be learnercentered and accessible, as well as
accommodating to their needs. To
address the barrier of staff’s negative
perceptions of education, goals are
designed to involve them in the planning and make the education accessible, fun, and interesting.
By first conducting an educational
needs assessment using paper forms
and Survey Monkey, the committee
determined the areas in which the
clinical nurses wished for more education. This needs assessment also asked
about their preferred ways to learn.
The hospital already had a system
with online access to learning modules and articles. While online learning modules generally work well with
self-directed learners, the committee
discovered that this wasn’t always
everyone’s preferred method of education. Based on this information,
several different methods of education were incorporated into the learning options. For example, staff
development sessions were planned
and held right on the unit at various
times convenient to both day- and
night-shift staff. Physicians associated
with the unit were invited to present
at some of these sessions, which
helped strengthen nurse-physician
relationships and collaboration. In
addition to the live educational sessions, several webinars were made
available and viewed by groups of
nurses for credits.
During a mock code, the staff participated in a scenario using a highfidelity simulation manikin. Staff had
to demonstrate CPR skills, use of the
defibrillator, and team dynamics
during the mock code. To add some
fun to the offerings, the team also
included educational games, such as
crossword puzzles and “Stroke Jeopardy!” Some staff even completed
adult coloring pages on brain anatomy and functions of the different
brain areas. Another idea involved
using some of the empty bulletin
boards throughout the unit to post
topics from current journal articles
and other information with quizzes
that could be completed for credit.
One innovation that proved very successful over the last 2 years was the
planning of an Education Week in
the beginning of the year to help staff
get a jump start on the yearly education requirements.
After any program development,
outcomes measurement is essential.9
This involves performing a comprehensive evaluation of the information
presented and assessing how it was
received, if it was retained, and if it
was applicable to current practice.11
Self-reflection and self-assessment are
needed to evaluate competency and
determine ways to improve.6 Once
again, the unit education team utilized
paper evaluations as well as Survey
Monkey to get staff feedback.
Staff members stated that they
really liked the bulletin board quizzes
because these were readily accessible
and easy to do. They said this activity
helped them learn new information
while reinforcing previous knowledge. The games were also well
received. Competitions were spirited,
which contributed to a fun atmosphere and requests for similar activities in the future.
Many staff members joined in education week offerings in varying
degrees and stated that they liked the
variety of activities. Some requested a
longer time frame (such as 2 weeks)
in the future to give them additional
opportunities to participate. The education team plans to use the feedback
to plan future activities.
Planning pays off
Maintaining staff education and professional development is challenging
in today’s busy healthcare landscape.
The first step to building a successful training program is an assessment of staff needs and preferred
learning strategies. Using this information, clinical educators and unit
education teams can create educational offerings using various delivery methods to try to improve
staff participation and satisfaction.
While this planning takes some
time, the result makes the extra
effort worthwhile. ■
REFERENCES
1. Schweitzer DJ, Krassa TJ. Deterrents to nurses’
participation in continuing professional development: an integrative literature review. J Contin Educ
Nurs. 2010;41(10):441-447.
2. American Nurses’ Association. Code of Ethics
for Nurses. www.nursingworld.org/practice-policy/
nursing-excellence/ethics/code-of-ethics-for-nurses.
3. Eslamian J, Moeini M, Soleimani M. Challenges
in nursing continuing education: a qualitative study.
Iran J Nurs Midwifery Res. 2015;20(3):378-386.
4. Summers A. Continuing professional development in Australia: barriers and support. J Contin
Educ Nurs. 2015;46(8):337-339.
5. Russell SS. If you ever stop learning, you might
as well stop nursing: the challenges of continuing
nursing education. Med-Surg Matters. 2011;20(1):6-7.
6. Alien P, Lauchner K, Bridges RA, Francis-Johnson
P, McBride SG, Olivarez A Jr. Evaluating continuing
competency: a challenge for nursing. J Contin Educ
Nurs. 2008;39(2):81-85.
7. Pool IA, Poell RF, Berings MG, Ten Cate O. Motives
and activities for continuing professional development:
an exploration of their relationships by integrating
literature and interview data. Nurse Educ Today. 2016;
38:22-28.
8. Govranos M, Newton JM. Exploring ward nurses’
perceptions of continuing education in clinical
settings. Nurse Educ Today. 2014;34(4):655-660.
9. Awad NI, Bridgeman MB. Continuing-education
program planning: tips for assessing staff educational needs. Am J Health Syst Pharm. 2014;71(19):
1616-1619.
10. Elliott B, Dillon CA. Online learning: an innovative solution to meeting the challenges of staff
education. J Nurses Staff Dev. 2012;28(6):285-287.
11. Yoder SL, Terhorst R 2nd. “Beam me up, Scotty”:
designing the future of nursing professional development. J Contin Educ Nurs. 2012;43(10):456-462.
Melissa Schneider is a clinical nurse educator at
WellSpan York Hospital in York, Pa., and a nursing
faculty member at York College of Pennsylvania in
York, Pa. Sandra Good is a clinical nurse at WellSpan
York Hospital.
The authors have disclosed no financial relationships
related to this article.
DOI-10.1097/01.NURSE.0000541402.97845.2f
August l Nursing2018 l 17
www.Nursing2018.com
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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