Dr Jane Wray, Senior Lecturer in Nursing, Director of Research, Faculty of Health Sciences, University of Hull. @livinginhope
Dr Giuseppe Aleo, Research Assistant, Faculty of Nursing & Midwifery, Royal College of Surgeons in Ireland. @GiuseppeAleo66 @EuropeanCpd
Engaging in CPD is central to the professional development of nurses and midwives and necessary to deliver high quality, safe, effective and person-centred care1,2. CPD has been defined as “Systematic maintenance, improvement and continuous acquisition and/or reinforcement of the life-long knowledge, skills and competencies of health professionals. It is pivotal to meeting patient, health service delivery and individual professional learning needs.”3. CPD is inclusive of formal learning activities (e.g. practice-related training, seminars, lectures, courses, conferences, workshops) and informal learning relevant to role and scope of practice (e.g. reflection on practice, reading journals, clinical teaching, huddles, searching online resources, journal clubs, self-directed learning).
Whether formal or informal, the purpose of CPD is to enable nurses and midwives to continually update and renew their knowledge and skills, enhance evidence-based practice and ultimately ensure that they are able to meet patient needs and service delivery in a constantly changing practice environment. In some countries the requirement to engage in CPD is mandated by the professional regulator and is thus necessary to continue to practice as a nurse and maintain registration (for example UK, Spain, Australia and some US states). In others, CPD is voluntary and not mandated (for example, Sweden, Ireland)4.
In the UK, the requirement to engage in CPD for the duration of your professional life is embedded in the Nursing and Midwifery Code5 (6.2 maintain the knowledge and skills you need for safe and effective practice) and necessary for continuing to practice – known as revalidation6. For nurses and midwives to meet these requirements and fully realise the benefits of CPD in their practice, they need organisational support in terms of funding, time to attend, and access to suitable opportunities2,7. In the UK, significant budgetary cuts to CPD funding have been reported8, and whilst financial support from employers is key; funding isn’t always the issue. Time to attend and take part continues to be hampered by workforce shortages and staff workloads7. For employers, ensuring suitable staff cover when colleagues are ‘away’ presents significant challenges, a situation further exacerbated by pressures on staff and services as a consequence of COVID199.
Engaging in CPD has clear benefits for individual nurses, midwives and other health healthcare professionals10,11, limiting opportunities impacts job satisfaction and turnover intention12. Despite an abundance of research evidence on CPD in healthcare, knowledge on the impact on healthcare outcomes remains modest. CPD evaluation is crucial, because there is evidence that increased knowledge for healthcare professionals does not automatically translate into improvements in clinical practice or patient outcomes4,10. There is a need for CPD to go beyond knowledge accumulation, capitalizing on staff preferences for workplace related learning11, to produce recognisable patient and organisational benefit. There is, however little agreement as to the most appropriate methods of evaluation and analysis, the quality of CPD undertaken, and cost and cost-effectiveness of providing CPD7,13. Without explicit commitment from employing organisations to ensure equitable access, time, funding and support for CPD, some nurses and midwives risk failing to meet the requirements of their regulatory bodies. This places staff in a difficult position of trying to reconcile their commitment to patient care and safety with a professional responsibility and desire to be a lifelong learner.
With thanks to colleagues [Cathy Fitzgerald, Witold Orlik, Paul Mahon, Thomas Kearns] at the European Centre of Excellence for Research in Continuing Professional Development European Centre of Excellence for Research in Continuing Professional Development – Royal College of Surgeons in Ireland (rcsi.com) for comments and feedback.
- Broughton W & Harris G. (2019) (Eds.) on behalf of the Interprofessional CPD and Lifelong Learning UK Working Group. Principles for Continuing Professional Development and Lifelong Learning in Health and Social Care. Bridgwater: College of Paramedics 12.18_CPD_Principles_FINAL_Jan_2019.pdf
- Jackson C, Manley K. Contemporary Challenges of Nursing CPD: Time to change the model to meet citizens’ needs (2021). Nurs Open.;00:1–12. https://doi. org/10.1002/nop2.941
- Executive Agency for Health Consumers (2013). Study concerning the review and mapping of continuous professional development and lifelong learning for health professionals in the European Union. European Union: http://ec.europa.eu/health//sites/health/files/workforce/docs/cpd_mapping_ report_en.pdf
- Mlambo M, Silén C, & McGrath C. Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature (2021). BMC Nurs; 20(1): 1-13. Doi: 10.1186/s12912-021-00579-2
- Nursing and Midwifery Council (NMC) (2018). Professional standards of practice and behaviour for nurses, midwives and nursing associates. nmc-code.pdf
- Nursing and Midwifery Council (NMC) (2021) Continuing professional development Continuing professional development – The Nursing and Midwifery Council (nmc.org.uk)
- Glasper, A. (2018). Problems affecting the continuing professional development of nurses.Br J Nurs. 2018; 27(12): 714-715. Doi: 12968/bjon.2018.27.12.714
- House of Commons Health Committee. The nursing workforce, second report of session 2017–19. London: House of Commons; 2018. https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/353/353.pdf
- Enback, S (2020). COVID-19 Insights Impact on workforce skills. Skills for Health Covid-19-Workforce-Survey-Key-Insights.pdf (skillsforhealth.org.uk)
- Allen LM, Palermo C, Armstrong E, & Hay M (2019). Categorising the broad impacts of continuing professional development: a scoping review. Med Edu; 53(11): 1087-1099. doi:10.1111/medu.13922
- King R, Taylor B, Talpur A, Jackson C, Manley K, Ashby N, Tod A, Ryan T, Wood E, Senek M, & Robertson, S. (2021). Factors that optimise the impact of continuing professional development in nursing: A rapid evidence review.Nurs Edu Today. 2021; 98: 104652. Doi: 10.1016/j.nedt.2020.104652
- Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: systematic review.British Journal of Nursing, 30(5), 302-308.
- Foo, J., Cook, D. A., Walsh, K., Golub, R., Abdalla, M. E., Ilic, D., & Maloney, S. (2019). Cost evaluations in health professions education: a systematic review of methods and reporting quality. Medical education, 53(12), 1196-1208.