Exploring ward nurses' perceptions of continuing education in clinical settings
Introduction
The role of the Clinical Nurse Educator (CNE) in Australia is considered to be a provider of educational services for nurses, linking with the organizational and patients' needs. The UK role of Practice Education Facilitator (PEF) is similar although PEFs' role also includes mentoring and preceptorship training. Perceptions about education and the role of the CNE vary. There is uncertainty about the extent of the role, how education is delivered, and varying and competing needs of the individual, ward and organization. These elements impact on the culture of learning, and vicariously on patient care. The CNEs' role is therefore complex, with little to guide practice (Conway and Elwin, 2007). Misconceptions from ward nurses and managers create further difficulty for CNEs to lead change (Conway and Elwin, 2007, Manley and McCormack, 2003).
Nurses are required to be flexible, critical thinkers striving to deliver safe and effective patient centered care. Hence, fostering lifelong learning and educational opportunities within clinical practice is important. Facilitating this learning requires gaining nurses' acceptance and integration of education into their everyday practice and the ward team. There is, however, a scarcity of literature that examines nurses' needs and values of education provision and how this might contribute to nurses' professional development. Continuing education (CE), defined as post registration activities that facilitate learning within the workplace, can augment the professional self (Billett, 2004, Osmond, 2003).
Section snippets
Background
The current global challenges of economic downturn, cultural shifts, technological advancements and overpopulation have impacted on all workplaces, where adaptable, skillful workers engaged in continuous professional development are required (Bastable, 2008, Health Workforce Australia, 2011, Watson, 2003). The demanding, complex health care system of today has seen the nurse's role in Australia extended and expanded to a recognized professional, offering an essential element in managing patient
Aims
This qualitative, descriptive study sought to explore clinical ward based nurses' values and perceptions towards continuing education (CE) and professional development. Within one acute ward in a major teaching tertiary hospital in Victoria, Australia, the research sought to examine:
- 1.
In what ways is education valued by nurses and how do they perceive their role in CE?
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What factors, if any, impact on CE in the ward? and
- 3.
What aspects of CE would nurses like to see developed in their ward?
Study Population
Permanent
Method
The study utilized the theoretical framework of case study (Anthony and Jack, 2009, Baxter and Jack, 2008, Yin, 2009). The focus of the case was to examine ‘how’ nurses view and perceive CE, their experiences and ‘what’ they see as CE within the real-life context of their ward environment.
Both focus groups and individual interviews were used as data collection methods. Four interactive focus groups with 23 nurses were held initially, followed by individual interviews (n = 6). The focus group
Findings
Three themes were identified: culture and attitudes, what is learning, and being there–being seen, that encapsulate the central focus of clinical nursing staff's values and perceptions of CE. These themes offer insight into the nurses' values and perceptions and while they highlight a desire for a learning culture, the factors that impact and impede CE within the ward are also illustrated. To enable the participants' comments to be read in context, they are grouped according to broad categories
Discussion
Working within the current complex health care system is proving difficult for nurses and is impacting on the assimilation of CE and learning. For nurses to maintain professional development they need CE to be integrated into the workplace. The findings of this study indicate that CE is seen by the majority of participants as a necessary element to being able to provide appropriate patient care. Yet, some nurses appeared apathetic to CE along with some inconsistency between many nurses'
Conclusion
In considering CE it is important to acknowledge the learning possibilities that participation in everyday practice does or does not generate (Boud and Hager, 2012). Certainly in this study, the values clarification exercise challenged many nurses to uncover their beliefs within their practice setting, and how CE is integrated into their workplace culture. The role of the CNE was debated and questioned; illustrating the need for CNEs to have a clear role definition and be comfortable with their
Acknowledgments
The authors would like to thank the nurses who so willing participated in this study and all those who supported the first author through the progression of this research.
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