Explaining the real world of nurses' engagement with continuing professional development: A mixed methods study

Abstract

In a healthcare education leadership role, I observed over several years that nurses were reluctant to engage with a bespoke continuing professional development (CPD) programme. Year on year less than 20% of eligible nurses engaged. This, despite crafting a programme that accounted for best practice in teaching and learning, incorporated professional regulatory standards and on completion of which, a financial bonus became available. The programme also fulfilled many tangible benefits for the healthcare institution where it contributed to organisational initiatives promoting staff recruitment, development and retention objectives. I was curious about the factors that affected nurses’ decisions to participate in CPD programmes and I wanted to better understand the complexities that appeared to be associated with voluntary engagement.

Review of the literature showed a wide range of factors that affected nurses’ engagement with CPD as a whole e.g. time of life; associated costs; support from the employer; impact on career prospects. It was also clear from the literature review that the question of nurses’ engagement with CPD was complex and that nurses lacked voice in the completed research landscape. The research aim was to explain nurses’ decisions to participate in a CPD programme given the prospect that greater understanding may allow for programme development to promote further engagement and for patients to benefit from nurses’ CPD. Thus, an explanatory-sequential design was chosen.

Prioritisation in this way: quantitative (phase 1) then qualitative (phase 2) allowed nurses to explain their engagement with CPD. Quantitative data collection using a postal survey generated data about what nurses knew about the CPD programme. It further included measurement of nurses’ attitudes to CPD and scaled response to factors that were already known to affect decision-making about participation. Free responses were also solicited as part of the questionnaire. Questions for the semistructured interviews in phase 2 were generated from analysis of the data gathered in phase 1. Phase 2 provided the opportunity to ask nurses to explain key findings from the quantitative data in more depth where knowledge attitude and influence had affected participation with the CPD programme.

The participants in the quantitative phase were invited to self-refer to participate in the interviews meaning that the sample was nested between the phases of the research. The data also interacted between the phases where the quantitative and qualitative data gathered from phase 1 formed the basis of questions used in the semi-structured interviews. The qualitative data added greater depth, richness and meaning to the data generated in the quantitative phase of the study and importantly, has assisted in the explanation of nurses’ decisions to participate in CPD. Powerful insights have been provided into the ‘real world’ of nurses’ CPD where explanation has added nurses to voice the ‘why so’ of engagement with a CPD programme.