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importance of continuing education essay

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6 Reasons Why Continuing Education Is Important

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importance of continuing education essay

What is continuing education?

Continuing education generally refers to any post-secondary learning or programs that adults pursue after formal education. This can vary from seminars or one-time classes to online courses and entire degree programs.

Some professions require continuing education in a variety of ways. Some of these requirements come in the form of yearly classes or tests to keep you up on changes in your industry.

Other professions require continuing education in the form of advanced degrees , which prepare you for new responsibilities and opportunities.

Still other professions require attendance at conferences or lectures to help employees learn from other experts in their field.

Successful business men and women, from Warren Buffett to Oprah, are huge advocates of continuing education. Barack Obama has spoken often about reading for his own learning for at least an hour a day during his time in the White House.

But can continuing education actually benefit you? Find out why it’s a good idea for you to pursue continuing education and how you can get started.

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Why is continuing education important?

importance of continuing education essay

1. Increases your chances for promotion.

Many times, employers find your pursuit of continuing education a great reason to give you a promotion. They recognize you’ve invested time and sometimes money into improving yourself and want to reward that. Your new education also makes you more qualified for advanced work and an ideal candidate for promotions.

Employers also sometimes have positions within a company that have an advanced degree as a basic requirement. Getting that advanced degree could be the factor in being picked for a promotion.

Similarly, when placed side-by-side with another candidate for a promotion, you will stand out to and impress a hiring manager if you have more education. Education qualifies you to handle more tasks and responsibilities and may have even given you specific knowledge in how to do a job better.

If you’re hoping to get a promotion, an advanced degree or other continuing education pathway could be the key to help you get there. From giving you skills and abilities, to showing your employer how dedicated you are to improving yourself, there are many reasons why your continuing education plan can help you get a promotion.

2. Increases your salary.

Continuing education often leads to a raise or a higher starting salary at a new position. Whether you will be offered a raise or promotion in your current job or will qualify for a new job that has a better salary, continuing education will have a major benefit for your income.

On average, a college degree holder will earn twice as much as someone who doesn’t have a degree. This form of continuing education often requires you to invest in yourself, but the payout at the end is usually well worth it.

WGU students are no exception. On average, WGU graduates increase their pre-enrollment income by $12,600 within two years of graduation and by $18,400 within four years. This is far higher than the national average of $12,400 after four years.

Associate’s, bachelor’s, master’s, and doctoral degrees can bring these income benefits to employees.

According to the Bureau of Labor Statistics, advanced education of every kind increases your income by thousands of dollars a year.

If you’re hoping to get a raise or move to a career with better pay, continuing education may be the way to go.

3. Increases your ability to make a career transition.

If you’re ready to move into a new career field, often the first step will be gaining education that qualifies you for that new path.

From nurses to teachers to accountants, many professions have strict requirements for licensure or degrees in order to qualify. Obtaining this education will make you prepared to move into a new career.

Many professions require continuing education because they have specific training that is crucial to your success. Without this education, there’s no way for you to qualify for or succeed in a position.

Learning new skills through continuing education is key to being prepared for a career transition.

importance of continuing education essay

4. Improves your image and marketability.

Continuing education is a valuable element to your résumé. For many jobs it is a direct qualification requirement to have a certain amount of education, but even if you meet the minimum qualifications, additional education will make you stand out.

Consider if you’re one of several candidates up for a job. If you have additional education, you will obviously be looked at more closely.

You will stand out not only because of your additional qualifications, but employers will recognize that you have the determination to take on a challenge—and succeed.

Employers will also recognize that you have new insights on the most current trends and skills in your industry, as well as having additional technology experience because of your time spent learning something new.

Overall, your image will increase, as will your job marketability, if you pursue continuing education.

5. Improves your lifestyle.

If you’re not satisfied with your current lifestyle, continuing education could be the answer to your problems.

Want to make more money? Want to switch your job? Want to feel more fulfilled? Need new skills? Continuing education can help you accomplish all these goals.

As you spend time devoted to learning, the outcomes are positive for your career and your overall lifestyle. Improving your career often trickles down to the rest of your life because you’re more satisfied with your job, make more money, etc.

Don’t wait to change your life, start your continuing education path now and get ready for the lifestyle you have wanted.

6. Increases personal development.

Even if you’re completely satisfied with your job and lifestyle, that doesn’t mean continuing education isn’t for you.

Experts agree that learning should be a lifelong process, and devoting time to continuing education can be a journey of personal development.

Whether you want to learn more about a subject that you find interesting or want some additional skills to take to your work, there are ways you can use continuing education to your advantage.

Even if your pursuit of education is purely for personal reasons, you can truly take advantage of advanced learning on your path to become a better person.

importance of continuing education essay

How do I get involved with continuing education?

So now you’re convinced that continuing education is a good path for you, what’s the next step?

There are many options for how you can pursue continuing education.

Ask within your office if there are courses or seminars specific for your company that you could take or that are recommended.

You can talk to colleagues, friends, and family about what they have done to pursue continuing education and determine if something similar is right for you.

Or, you can research places like WGU and learn how a degree could help you reach your goals.

With bachelor’s and master’s degree offerings you’re likely to find a program that meets your needs here.

Now is the time to get started on a new journey that will change your life.

Ready to Start Your Journey?


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Why is Professional Development Important?

Learn the role of professional development in advancing your career.

Lian Parsons

Professional development is an important aspect of continuing your career growth and striving to reach your goals.

This blog post will explain what professional development is, its benefits to both employers and their employees, and how to seek different opportunities out to reach your full potential.

What is Professional Development?

Professional development is gaining new skills through continuing education and career training after entering the workforce. It can include taking classes or workshops, attending professional or industry conferences, or earning a certificate to expand your knowledge in your chosen field.

Some companies offer in-house opportunities for professional development, such as training sessions or mentoring programs, but many professional development programs are done independently. 

Professional development is important because it has the potential to open opportunities for career advancement, such as promotions. It can assist you in honing existing skills and in learning new ones. 

It can also help you stand out in a pool of applicants; showing that you have completed professional development programs or additional industry certifications on your resume can go a long way in showing your expertise in your field.

Employees who show initiative in independent learning can signal to employers that you are open to new experiences and are enthusiastic about continuing to grow. 

Benefits of Professional Development for Employers

Professional development can be instrumental in growing a stronger team.

Employers who encourage their employees to seek out professional development opportunities are in turn encouraging higher productivity and job satisfaction. 

Higher Retention Rates

According to a Business News Daily article, businesses should offer professional development opportunities to their employees to improve potential turnover.

Professional development can help to bolster employees’ confidence in their work. Greater confidence can, in turn, translate into higher overall job satisfaction, employee performance, productivity, and overall morale. 

Investing in professional development training programs also shows employees that their company is invested in their success and interested in cultivating their advancement.

Attract Better Talent

It can be challenging to find — and retain — talented employees. Offering professional development opportunities can help employers fill open positions by attracting and retaining skilled employees.

According to talent management platform Clear Company, 74 percent of employees say that a lack of professional development opportunities are preventing them from reaching their full potential. Additionally, 94 percent of employees would stay longer at a company if it invested in staff development.

Employers offering these benefits are more likely to attract potential employees who are interested in striving for excellence and pursuing advancement. 

Investing in professional development for employees can grow an existing team’s skills and entice new talent to join with the incentive of a clear learning and development plan. 

Help Employees Stay Up to Date With Industry Trends to Keep Skills Sharp

Industry trends move rapidly, and it’s important for companies to keep pace with the times. Ongoing professional development can prevent potential stagnation by maintaining — and improving — employee skills. 

Look for programs that will help you stay up to date, such as those for agile leadership for hybrid work, or for innovation strategy .

Employees engaged in professional development are also more likely to stay engaged in their work and to be enthusiastic about pursuing their goals. 

Get started on your professional development journey today.

Benefits of Professional Development for Employees

From gaining confidence in your abilities to building potential for advancement, professional development offers employees many benefits for not only your career, but your personal goals as well. 

Learn new skills

Through professional development, you may hone both hard and soft skills in your work. Hard skills pertain to job-specific knowledge you can obtain through formal training or education. Soft skills are personal competencies, such as effective communication or the skills that contribute to emotional intelligence . 

Developing both types of skills is important to reaching your professional goals — and even some of your personal ones.

Boost Confidence and Credibility

Adding additional skills or certification from a professional development program to your resume is one way to boost your confidence in your skills and show your credibility to employers.

Professional development opportunities can expose both new and experienced professionals to new ideas and expertise. Seeking out these opportunities shows ambition and the space to practice those new competencies. 

Develop Leadership Skills

A confident employee is also likely an enthusiastic employee. If you take the step to grow and develop your skills, the incentive to seek out additional opportunities can continue to expand along with it. 

If you are an employee who wants to advance your career but isn’t sure how to do so, professional development can encourage you to put your hand up for leadership opportunities you may not have sought out otherwise. 

This blog post offers helpful tips on how to choose a leadership development program.

Build Your Network

Professional development can provide many opportunities for networking. Workshops, conferences, classes, and webinars are all spaces in which professionals can meet new people within their industry and make new connections.

These connections can lead to new opportunities, mentorship, and support which may provide the next stepping stone in your career. 

Advance in your career

A well-qualified employee attracts employer attention. Employees who are invested in professional development display commitment to their work and an interest in continuing to improve.

Professional development can also boost your earning potential by increasing your value through obtaining credentials, certifications, and designations. 

Where to Take Professional Development Courses

There are a broad range of professional development opportunities. 

Harvard Division of Continuing Education’s Professional & Executive Development offers dozens of courses spanning multiple industries. Your employer may even help you pay for these opportunities if you effectively show their worth.  

There are both in-person and online options available, so choose what works best for your goals and lifestyle.

Seek out programs, workshops, seminars, mentorship programs, and more within your industry. Investing in yourself is just the first step.

Take the next step to advance your career. Find the program that’s right for you.

Browse all Professional & Executive Development programs.

About the Author

Lian Parsons is a Boston-based writer and journalist. She is currently a digital content producer at Harvard’s Division of Continuing Education. Her bylines can be found at the Harvard Gazette, Boston Art Review, Radcliffe Magazine, Experience Magazine, and iPondr.

Strategic Leadership

Senior level managers must tackle complex problems using creative problem-solving and a portfolio of skills and styles. Here’s a look at how being a strategic leader can move an organization—and your career—forward.

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Institute of Medicine (US) Committee on Planning a Continuing Health Professional Education Institute. Redesigning Continuing Education in the Health Professions. Washington (DC): National Academies Press (US); 2010.

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Redesigning Continuing Education in the Health Professions.

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1 Continuing Professional Development: Building and Sustaining a Quality Workforce

T he health care system in the United States falls short of its goal of consistently providing the best possible care. The nation spends more on health care than any other country in the world—and too often receives care of mediocre quality that is too frequently unsafe. Actions taking place at the local, state, and national levels—most recently through the development of the White House Office of Health Care Reform—show some promise for providing greater access to safe, high quality care for all Americans. Such actions include promotion of systems improvement, measurement and reporting activities of health care processes and outcomes, public engagement, and realignment of payment systems. But these efforts typically overlook a critical piece of improving quality: developing and maintaining a reliable, properly trained health professional workforce. A well-educated workforce is critical to the discovery and application of health care practices to prevent disease, promote well-being, and increase the quality life-years of the public.


Health professionals serve as the bridge between patients, the knowledge generated by scientific research, and the policies and practices to implement that knowledge. As the recipients of care, the public trusts health professionals to provide care that is safe, efficient, effective, timely, patient-centered, and equitable.

The health professions covered by this report are those listed by the Bureau of Labor Statistics as “healthcare practitioner and technical occupations” with baccalaureate or higher degrees (see Appendix B ). Examples of included professions are physicians, physician assistants, dentists, dieticians, nurses, and speech-language pathologists. These health professionals undergo extensive formal education, followed by what has become known in the United States as continuing education (CE). CE lasts the duration of a health professional’s career and is therefore the model of learning that spans the longest period. It serves two functions: maintenance of current practice and translation of knowledge into practice.

Educating professionals about new theories and evidence of what does and does not work, and under what circumstances, is one part of promoting the provision of better health care. Because individual learning styles differ greatly, innovative learning methods are developed to help health professionals maintain their competencies. Over time, learning methods have evolved from a focus on professionals’ attendance at and satisfaction with a limited set of educational activities to a focus on demonstrably changing professional practice and improving patient outcomes. Better learning methods need to be developed continuously, as creating appropriate methods, processes, and contexts is imperative for professionals to provide the highest quality care possible. Health professionals also need to provide feedback to themselves and the system about what actually works in specific practice settings, as the common wisdom of what “should be” practiced continuously evolves. What is considered to be the best knowledge one day may later be found to be inadequate. Health professionals’ abilities to identify these instances and adapt is critical. With the development of the Internet and Web 2.0, the world of information has expanded at exponential rates—so much so that the breadth of information for which health professionals used to be responsible is now beyond the capacity of any one professional.

On average, it now takes 14-17 years for new evidence to be broadly implemented (Balas and Boren, 2000). Shortening this period is key to advancing the provision of evidence-based care, and will require the existence of a well-trained health professional workforce that continually updates its knowledge.


Lifelong learning is the notion that learning occurs along a continuum, from elementary and secondary education to undergraduate and graduate education, lasting through the end of one’s career. There are several stages of learning, including training, education, and professional development. These terms are used somewhat interchangeably, but clear distinctions should be made due to their varying abilities to both promote and confine learning. Training often refers to the standardization of a process to yield similar results. Education refers to the process by which people learn to apply solutions to problems and adapt to new situations. Professional development transcends both concepts and includes areas such as self-directed learning, systems changes, and quality improvement; it teaches people not only how to apply solutions but also how to focus on actual performance and how to identify problems.

Within this schematic, continuing education is largely teacher-driven, focuses on clinical education, and predominantly builds on education theory. CE often is associated with didactic learning methods, such as lectures and seminars, which take place in auditoriums and classrooms. In theory, the purpose of continuing education is to update and reinforce knowledge, which should ultimately result in better patient care. But in practice, there often are conflicting ideas about the purpose of CE. Some health professionals see CE as a means to attain credits for the licensure and credentialing they need to practice their occupations. Employers often view CE as a way to keep staff up to date and to improve quality. Many regulators believe the purpose of CE is to maintain competence and improve quality.

In recent years, a broader concept, called continuing professional development (CPD), has been emerging that incorporates CE as one modality while adding other important features. CPD is learner-driven, allowing learning to be tailored to individual needs. CPD uses a broader variety of learning methods and builds on a broader set of theories than CE. CPD methods include self-directed learning and organizational and systems factors; and it focuses on both clinical content and other practice-related content, such as communications and business. Although CPD is a relatively new term to some U.S. health professionals, the term is used widely in Canada, New Zealand, and the European Union, including the United Kingdom (see Appendix C ). CPD encompasses more diverse learning formats than those in CE (e.g., clinical reminders and academic detailing, where practitioners learn about drug prescribing from noncommercial sources) (Davis et al., 2003), and takes place in more diverse settings, such as clinical settings. CPD can be defined as the system for maintaining, improving, and broadening knowledge and skill throughout one’s professional life. CPD is focused squarely on promoting effective practice, and is better positioned than other stages of learning to effect change because it occurs when professionals are most likely to be aware of their needs. It also integrates content and educational design for individual practitioners in the practice setting.

Given its narrower focus, CE can limit a health professional’s learning, as it does not seem to offer the broader opportunities for learning that CPD does. As some groups have already done (e.g., Accreditation Council for Pharmacy Education, American Medical Association), this report adopts the term CPD to recognize the importance of more comprehensive, lifelong learning. In the context of this report, CPD is used to address the future state and CE is used when addressing past and current continuing education efforts, even though some elements of CPD are being used in limited contexts. Table 1-1 illustrates the various features of training, education, and professional development, including continuing professional development.

TABLE 1-1. Comparing Training, Education, and Professional Development.

Comparing Training, Education, and Professional Development.


Continuing education has long been a core part of being a health professional, beginning with Florence Nightingale encouraging nurses to continue to learn (Gallagher, 2006) and the first recorded continuing nursing education course dating back to 1894 (Stein, 1998). In medicine, CE was often confused with graduate medical education in the 1920s and 1930s as a way to address the issue of improperly trained physicians, but this ended with the advent of internship and residency, which extended formal physician training. After World War I, medical faculties became increasingly concerned with the need to spur professional growth of physicians in practice, and continuing medical education (CME) was used as a way to help well-trained practitioners keep up to date with the advancing knowledge. Although reports from the 1930s and 1940s called for the continuation of medical education beyond undergraduate and graduate level education, it was not until after World War II that these calls were acted on (Commission on Graduate Medical Education, 1940; Shepherd, 1960). Today’s construct of using CME to improve performance began in the late 1970s when CME was suggested to be a continuous process based in practice settings (Lloyd and Abrahamson, 1979).

Calls for the professionalization of medicine have also significantly impacted medical education. One of the first studies about physicians’ preferred continuing education methods crystallized the need to better identify effective CE methods and courses (Vollan, 1955). The objectives and competencies needed to be learned by medical students and other health professionals that shape today’s health professions education were not clearly delineated until recently (AAMC, 1998; IOM, 2003).

In addition to the changing context and goals of CE, its structure has also evolved. In medicine, changes to residency programs required greater faculty attention, and there arose a growing sense among faculty that teaching CME was less than prestigious. In the 1950s, studies showed that pharmaceutical sales representatives were the most important sources providing physicians with new information; this trend led to the development of a new industry tying together pharmaceutical companies, advertising, and physician behavior. This new industry soon became subject to criticism about the potential conflicts of interest between pharmaceutical companies and physicians, and such issues have been the focus of periodic congressional hearings since the 1960s (Randall, 1991; United States Senate Committee on Finance, 2007; United States Senate Subcommittee on Antitrust and Monopoly, 1962). Regulation of CME began largely as a method for the American Medical Association, and eventually state medical societies, to monitor pharmaceutical influence on physician education. As a result, CME increasingly came to be provided by a combination of specialty societies, state and local medical organizations, and pharmaceutical companies (Ludmerer, 1999; Podolsky and Greene, 2008). Health professionals are currently regulated by state health licensing boards; providers of CE are regulated by national accrediting organizations (e.g., National League of Nursing).

The CE industry has grown rapidly over the past 10 years and has increasingly involved commercial support from the medical education and communication companies that began appearing in the early 1980s. Continuing medical education activities have become increasingly extravagant (Podolsky and Greene, 2008), raising questions not only of the effectiveness of the education being provided but also of the level of influence commercial entities should have on physician learning. Currently, financial support, accreditation mechanisms, and CE methods are intertwined and difficult to analyze separately in medicine. Limited data also suggest that similar trends are taking place in nursing and pharmacy but not in the allied health professions.

Significant change in health professions education is not unprecedented. Specific to medicine, the report Medical Education in the United States and Canada , better known as the Flexner Report, was published in 1910. The report dramatically changed the culture and landscape of medical education and became the basis of undergraduate medical education in the United States. At the time of the Flexner report, many observers were concerned that there were too many medical schools and that physicians were being poorly trained. There also were concerns about the perceived lack of standardized prerequisites and curriculums across medical schools; the reliance on education through lectures and memorization, not at a patient’s bedside; and the proprietary nature of medical education. These concerns about undergraduate medical education in the early 1900s mirror today’s concerns about the continuing education of all health professions, as highlighted in the report Work and Integrity (Campbell and Rosenthal, 2009; Cooke et al., 2006; Flexner, 1910; Sullivan, 2005).


Continuing education differs widely among and within health professions in terms of content, delivery or learning methods, regulation, and financing. Currently, CE is largely driven by state requirements and regulatory bodies that often focus on number of hours spent in CE courses, calculated in terms of some units for all professions. But even this basic measure differs markedly across states. For example, physicians in Alabama are required to have 12 CME credits per year, while those in Michigan need 50 credits per year, and many states have no requirement at all. Some states require a minimum number of credits in ethics, while others require mandatory content such as courses in infectious disease and patient safety. Depending on the state, annual hours or credit requirements differ among professions: nurses generally need 5-15 contact hours, pharmacists need 10-60 hours, and when required, social workers need anywhere between 3 and 25 hours. A greater problem, however, compounds the variations in CME requirements among states and professions: current data is insufficient to determine how much CE is really needed to maintain competence, to support learning, or to affect performance. This gap brings into question the current regulatory focus on credits and hours.

How learning is best achieved is another question to be addressed when evaluating CE. Potential sources for better learning methods may lie in the field of adult education research and theory. Research in such areas as andragogy, experiential learning, self-directed learning, lifelong learning, and critical reflection may offer information that can be incorporated in designing CE delivery methods. Methods for delivering CE vary widely and include more traditional methods such as conferences, grand rounds, and published materials. As technology has improved, the various types of computer-based and Internet-based learning modes have evolved to include interaction with CD-ROMs, webinars, and videoconferences. CE is now also delivered within the context of care, often termed practice-based learning and point-of-care learning. Maximizing learning is critical to developing a better system of continuing professional development.

Regulation of how much and what type of CE health professionals must obtain is conducted at the federal, state, and local levels through licensure and certification, which set the minimum standards of competency for a profession. In most cases, professionals must receive a license before they are allowed to practice. Licensure and relicensure requirements vary by profession and generally vary by state. Certification is provided by professional societies and boards, which acknowledge competence in a particular specialty, often requiring more in-depth knowledge than licensure. Credentialing occurs at the level of the health care organization and veri fies that a health professional has received training up to the level required by the organization. Accreditation is provided by organizations often associated with professional organizations that evaluate programs delivering CE to individual health professionals.

A major problem that stems from this fragmented system is that many of the regulatory agencies do not work together, although there is a recent trend toward collaboration among some professions. The regulatory system ought to consider placing emphasis on the relationship between quantity of hours or CE activities, practitioner performance, and clinical outcomes, both for individual professionals and for organizations.

The CE industry is funded in part by professionals, professional societies, professional schools, publishing/education companies, and the health care delivery system. Medicine is the largest of the professions in terms of CE income, with more than $2.5 billion of total income in 2007. Commercial funds represent more than 50 percent of total CME income, or $1.5 billion. Physician membership organizations, publishing/education companies, and schools of medicine have the largest profit margins of all CME organizations, with profit margins of 46.6 percent, 34.9 percent, and 13.8 percent, respectively (ACCME, 2008). In social work and allied health, continuing education is often paid for by professionals themselves and not reimbursed by employers, although data are scarce about the many allied health professions.

A critical assessment of the effectiveness of CE on the performance of health professionals is needed at the individual and aggregate discipline levels, on the various modes of CE delivery, and on the ability of health professionals to close the gap between current and optimal health system performance. This assessment is made difficult, however, by the relative lack of high quality studies in the published literature. Importantly, no evidence exists to determine exactly how much CE is needed for professionals to, at a minimum, maintain competence and practice at the highest level.


In 2007, the Josiah Macy, Jr. Foundation held a conference to discuss the future of continuing health professions education (Hager et al., 2007). The conference, which brought together a diverse set of stakeholders, concluded that CE in the United States is currently inadequate. The conference summary states that CE currently is more focused on numbers of credits than on health professionals’ actual performance, is funded in large part by organizations with conflicted interests, is not focused on learning based in practice and patient care, does not provide incentives for interprofessional care, and does not take advantage of advances in Internet technology. Conference attendees recommended that a continuing education institute be created for the purpose of “advancing the science of CE” and that the Institute of Medicine (IOM) appoint a committee to discuss the development of such an institute. The Macy Foundation subsequently asked the IOM to review issues in continuing education and consider the establishment of a national interprofessional continuing education institute (see Box 1-1 ). In response, the IOM convened the Committee on Planning for a Continuing Health Professional Education Institute.

Statement of Task. An ad hoc IOM committee will undertake a review of issues in continuing education (CE) of health care professionals that are identified from the literature and from data-gathering meetings with involved parties to improve the quality (more...)

In accordance with its statement of task, the IOM study committee reviewed a variety of issues surrounding the state of continuing education for health professionals, but did not try to identify specific educational methods or approaches to be used in CE. The committee focused only on postlicensure learning, although it recognizes the importance of strengthening the entire continuum of health professional learning. Using its review findings as a basis, the committee considered issues that would relate to the establishment of a national CE institute, including how such an institute might best be established and how it should operate. Despite the inclusion of “Institute” in its name, the committee examined a number of possible alternatives to establishing an institute and considered whether the objectives of the institute could be met with a different organizational structure.

The Macy Foundation approved two other grant proposals at the same time it approved the IOM study. The first of these grants was awarded to the Association of American Medical Colleges (AAMC), in collaboration with the American Association of Colleges of Nursing, to hold a stakeholders workshop to discuss the translation of CE research findings into practice. The workshop, held in February 2009, resulted in a paper made publicly available in fall 2009 (AAMC and AACN, 2010). The second grant was awarded to the Institute for Health Policy at Harvard University to conduct economic modeling for alternative financing models for continuing medical education, and the researchers presented their findings in a white paper (Campbell and Rosenthal, 2009). The IOM committee considered in its deliberations the information presented in both papers, but the committee developed its conclusions and recommendations independently and reported its findings to the Macy foundation separately.

IOM Committee Methods

The committee met three times during the course of the 12-month study and conducted a literature review on the effectiveness of continuing education methods (see Appendix A ). The committee also received public statements from a large variety of stakeholders, including regulatory bodies, funders, health professionals, and consumers. Representatives from medicine, pharmacy, nursing, social work, and allied health professions provided statements to the committee at a public workshop (see Appendix E ), sharing their perspectives on the purpose of CE and the need for change. These statements and others received during the committee’s process were instrumental to the development of this report.

Previous IOM Reports

This report builds on and is consistent with previous IOM reports that have emerged from a 10-year quest to identify ways to improve the quality of care that patients receive, improve patient outcomes, and better protect patient safety. The call to improve quality and patient safety was sounded by To Err Is Human: Building a Safer Health System (1999) and expanded by Crossing the Quality Chasm: A New Health System for the 21st Century (2001a) . As a central theme, these reports cited the need to improve the quality of the health professional workforce. Other IOM studies dealing with the health care workforce have focused on specific care set tings (e.g., long-term care [IOM, 2001b]), specific populations (e.g., aging [IOM, 2008], children and family [IOM, 2000]), and specific disciplines (e.g., mental health and substance use [IOM, 2006], rural health [IOM, 2005], and public health [IOM, 2007d]). A number of studies on nursing and emergency care professionals also concluded that their workforces must be strengthened (IOM, 2004, 2007a, 2007b, 2007c).

The current report also draws in important ways on the IOM report Health Professions Education: A Bridge to Quality (2003), which identified five core competencies that all health professionals should have and made recommendations for improving the testing and assurance of health professionals’ competencies. The five core competencies include being able to provide patient-centered care, work in interdisciplinary teams, employ evidence-based practice, apply quality improvement strategies, and use health informatics.


Across its breadth, this report illustrates the importance of changing the current CE system and provides principles that will help in moving to a broad-based continuing professional development system over the next 10 years.

The report is organized into seven chapters, of which this introductory chapter is the first. Chapter 2 discusses the scientific foundations of continuing education and includes a critical assessment of the effectiveness of CE methods. Chapter 3 explores CE regulation and financing. Chapter 4 builds a case for improving continuing education and explores the various alternatives to a CE institute. Chapter 5 discusses what a better CE system would look like in 10 years. Chapter 6 describes the function and structure of a continuing professional development institute, and Chapter 7 explores steps toward the implementation, research, and evaluation of such an institute. Recommendations and conclusions are embedded within each chapter.

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  • Research article
  • Open access
  • Published: 14 April 2021

Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature

  • Mandlenkosi Mlambo 1 , 2 ,
  • Charlotte Silén 2 &
  • Cormac McGrath 2 , 3  

BMC Nursing volume  20 , Article number:  62 ( 2021 ) Cite this article

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Continuing professional development (CPD) is central to nurses’ lifelong learning and constitutes a vital aspect for keeping nurses’ knowledge and skills up-to-date. While we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses’ experiences of continuing professional development.

A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed.

We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards.


Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.

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Health care professionals need to update their skills regularly and continuing education, or continued professional development (CPD) enables the renewal and updating of skills in health care settings. While we know about the need for CPD, less is known about how nurses experience and perceive CPD, and currently, there is no comprehensive global picture of how nurses view and experience CPD. A metasynthesis of the qualitative literature on nurses’ experiences of CPD may provide a basis for planning future CPD interventions more effectively and take advantage of examples from different contexts. This paper is organised in the following way; first we present the notion of CPD, we then use the United Kingdom, (UK) as a setting to offer an overview of the different mechanisms that exist in one specific health care setting, which may impact engagement with CPD. We acknowledge that similar mechanisms may exist in other health care settings and countries too, and identify the UK context, merely as a way to frame the paper. Subsequently, we conduct a metasynthesis of the qualitative literature addressing the topic of how CPD is experienced by nurses.

Continued professional development

This section aims to unpack the notion of CPD, which exists in different forms and is driven, in part, by top-down requirements, but also, bottom-up, from the needs of practitioners. Continuing professional development (CPD) programmes are central to nurses’ lifelong learning and are a vital aspect for keeping nurses’ knowledge and skills up-to-date. The requirement for nurses to participate in CPD differs between European countries and elsewhere in the world and can be mandatory or voluntary [ 1 , 2 ]. For example, CPD is mandatory in the U. K, Belgium, Spain, Australia and in some states in the United States of America, [ 2 , 3 , 4 ]. In these countries, nurses engage in CPD because it is a mandatory condition by nurse regulators for remaining registered to practice. However, in Sweden, Netherlands and Ireland nurses participate in CPD of their own volition [ 1 , 3 , 4 , 5 ]. Table  1 provides an overview of some of the European countries which provide mandatory and non-mandatory CPD.

In jurisdictions where CPD is mandatory, nurses engage in continuing education by participating in professional development that is relevant to their areas of practice. Mandatory CPD, refers to “… the process of ongoing education and development of healthcare professionals, from initial qualifying education and for the duration of professional life, in order to maintain competence to practice and increase professional proficiency and expertise” ([ 6 ], p.1). CPD can sometimes refer to a learning framework and activities of professional development which contribute to the continual professional effectiveness and competence [ 7 ]. Broadly, CPD is related to continuing education, and continual learning, both formal and informal, which results in the acquisition of knowledge and skills transfer by the practising nurse with the aim of maintaining licensure and competent practice [ 8 ]. Learners can utilise a mixed style approach to learning depending on the circumstances and context of the learning environment [ 9 , 10 , 11 ]. To succeed in providing comprehensive care for their patients, nurses need to utilise the best evidence available to them [ 12 , 13 , 14 ]. This requires different modes of learning and ways of knowledge acquisition and construction. To achieve this, nurses can engage in different approaches of acquiring knowledge through CPD, through formal learning, courses or workshops as well as workplace informal learning, through self-reflection, appraising literature for best evidence through journal clubs and giving feedback to each other [ 5 , 7 , 15 ]. Informal learning is often volitional and is largely initiated and controlled by individual nurses with the intention to develop their knowledge and skills [ 16 , 17 , 18 ]. Due to its unstructured and, at times, unintentional manner, such learning is often acquired during interactions with colleagues and patients [ 19 ]. One of the advantages of on-site learning, both formal and informal is that learners can utilise expertise which are already available on the ward [ 5 , 15 ]. On-site learning occurs often at the discretion and the willingness of managers to facilitate by providing time and space for learning to occur within the clinical areas. Even so, the fact remains that informal on-site learning is not an event but a continuous process, which draws from daily professional experiences. Lack of CPD trained nurses and ward needs, coupled with poor staffing levels, are cited as main barriers to informal workplace learning [ 5 , 15 ]. Evidence from CPD literature indicates that many nurses prefer informal work-based methods of learning, noting that most meaningful learning occurs through interactions with their colleagues [ 20 ]. From a study by Clarke [ 21 ], it was noted that nurses found informal learning methods such as supervision, attending team meetings/briefings, mentoring and observations to be important. Ultimately, whichever delivery method is used for CPD, continuous professional development extends the practitioner’s professional ability beyond pre-registration training, qualification and induction, thereby potentially enhancing the practitioner’s practice.

Continued professional development: the UK example

This next section aims to illustrate the different mechanisms that arise in one specific health care setting when implementing CPD on a national scale. We recognise that other mechanisms will exist in other contexts, and in places where CPD is not a formal requirement.

Today, nurses in the U.K. are required to engage in continuous learning in order to maintain competence as a means of keeping their licensure with their professional body, the Nursing & Midwifery Council (NMC) [ 22 ]. Since the 1980s, UK nurses and other allied health care professionals such as physiotherapists and occupational therapists have been required to engage in continuous professional development [ 23 ]. A justification for CPD has been the need to maintain professional registration to practice. For registered nurses in the UK, the requirement to engage in CPD came to the fore of continuing education in 1995. It was introduced by the then licensing body, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) as post registration education and practice (PREP) [ 24 ]. Further to that, the Agenda for Change Reforms in 2003 introduced a system for linking pay and career progression to competency called the National Health Service Knowledge and Skills Framework [ 25 ]. The framework is linked to the individual nurse’s ability to demonstrate that they possess the necessary knowledge and skills to get promoted and be remunerated accordingly [ 25 ]. In the UK, further reforms to CPD were introduced in 2012 through the introduction of the Health Education England (HEE) in England [ 27 ]. Its mandate was to equip the NHS (National Health Service) workforce, including nurses with appropriate knowledge and skills to deliver high standard care to patients. The HEE’s role was to support workforce development by providing funding largely for nurses’ CPD. In 2016, PREP was replaced with revalidation, which still requires nurses to attend 35 h of CPD every 3 years [ 24 , 26 ]. Revalidation is the process through with nurses and midwives continue as registrants with the Nursing and Midwifery Council (NMC) [ 25 ]. However, comprehensive HEE budget cuts have had a negative effect on nurse CPD initiatives [ 27 ]. CPD funding in UK was cut from 205 million pounds in 2015–16 to 83 million in 2017–18 [ 28 , 29 ]. Consequently, nurses have struggled to fulfil revalidation requirements due to some authorities freezing access and refusing to give nurses time to attend CPD activities [ 27 ].

This previous section offers an insight into different push-pull mechanisms, in the UK alone. Statutory requirements are underpinned by the need for nurses to maintain and develop the knowledge and skills to meet the expected competence standards of practice in response to expanding nursing roles and global trends. Our experience suggests that local governing bodies may enforce similar measures in contexts where CPD measure are not formalised. Nurses may find themselves caught between a patchwork of statutory requirements and a need to develop their skills and knowledge. Consequently, while we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. Therefore we propose that a metasynthesis of the qualitative literature could be a part of forming such a comprehensive view and use the following three questions to examine the literature What is the reported value of CPD for nurses’ lifelong learning and its impact on nursing knowledge?, What are the conditions necessary for CPD?, and, What are the challenges faced by nurses when engaging in CPD?

In this study, a metasynthesis was used to investigate the qualitative literature [ 30 , 31 ]. Metasynthesis is a form of systematic review method used to review qualitative studies in order to develop theory, to explore and understand phenomena or generate new knowledge, thereby creating meaning from that knowledge [ 32 , 33 , 34 , 35 , 36 ]. In this review, we present a metasynthesis based on the interpretation of qualitative results from topically related qualitative reports. In doing so we strive towards theoretical development, which according to Zimmer refers to the synthesis of findings into a product that is ‘thickly descriptive, and comprehensive’ and thus more complete than any of the constituent studies alone ( [ 30 ] p.313).

The results from metasynthesis studies may be used to underpin and inform healthcare policy, nursing practice and patient care. Furthermore, such information can be utilised by health care professionals involved in nursing education to inform planning and designing of training and educational programs. A number of steps are taken when conducting a metasynthesis [ 36 ] and involve;

a) bringing together a multidisciplinary team, in our case the team of three people includes two skilled medical education professional researchers with extensive experience in qualitative studies, including systematic reviews, moreover these two authors have more than 40 years of comprehensive experience of CPD in health care settings, two of the team are registered nurses and afford the team key insights into the context of nursing CPD, the team is spread across three institutions in two countries, finally, the team consisted of a search engine expert,

b) defining inclusive but manageable research questions, see the questions above;

c) conducting the systematic search, in our case this was conducted by the search engine expert, see Table  2 for the search criteria,

d) quality assessment of the studies, this was done using the CASP (Critical Appraisal Skills Programme) criteria, weighting three levels (not met, partially met, totally met) where assessment was done by all three authors see Table  4 , e) extracting data from the studies, see Table  3 ,

e) data analysis, which is explained in more detail below, and.

f) expressing the details of the synthesis which is done in the findings sections below.

Search strategy

A comprehensive systematic search of literature was subsequently conducted on Medline (OVID), PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science (Clarivate) and ERIC (ProQuest). The literature search was conducted by a librarian. The literature search was conducted in December 2019 and was limited to articles published in English from 2010 to 2019. Inclusion and exclusion criteria for the literature search were established and are presented below in Table 2 . The inclusion criteria comprise of articles from empirical studies (using qualitative methods), discussing nurse continuing learning and education, professional development, lifelong learning, CPD, motivation and barriers.

Data analysis

A total of 1675 records were identified, and following de-duplication, 1395 articles remained. All 1395 articles were screened. Articles had to address nurses’ CPD and continuing education, using qualitative oriented methods. After the first screening 72 articles remained. These articles were divided into three batches and were divided among the researchers. Each author read one batch to further identify if the articles were to be included. For each batch, a second author read the articles, meaning all articles were read by at least two authors. Any remaining ambiguities were discussed and resolved among the team. Figure  1 is a summary of the literature search and screening and Table 3 presents an overview of each study with its citation, location, cohort size and data collection method. 25 articles were identified for the final metasynthesis. All authors read the final 25 articles. Quality assessment using CASP criteria as outlined by Lachal et al., [ 36 ] is reported in Table 4 . In the quality assessment we assess the following components; Was there a clear statement of the aims of the research?, Is a qualitative methodology appropriate?, Was the research design appropriate to address the aims of the research?, Was the recruitment strategy appropriate to the aims of the research?, Were the data collected in a way that addressed the research issue?, Has the relationship between researcher and participants been adequately considered and reported?, Have ethical issues been taken into consideration?, Is there a clear statement of findings? We also introduce the question of whether the texts are available in Open Access form or not. We introduce this question, as we believe the outcomes on research on nurses’ perceptions and experiences of CPD is potentially important for their practice, and access via Open Access channels could act as a quality dimension. However, without access to the data and the process of interpretation we choose not to assess; How valuable is the research?, Was the data analysis sufficiently rigorous?

figure 1

Overview of the steps in the literature screening

For the final analysis enabling the synthesis of the studies in this metasynthesis the articles were read carefully, findings related to the research questions; What is the reported value of CPD for nurses’ lifelong learning and its impact on nursing knowledge?, what are the conditions necessary for CPD? And what are the challenges faced by nurses when engaging in CPD?, were identified. In the next step of the analysis, study findings were examined using constant comparative analysis. The findings and conceptual categories were coded, compared, and sorted, focusing on conditions, strategies, and consequences. Finally, the synthesis, the interpretation of the findings, were described as themes, and these were revised several times until a coherent whole was formed [ 30 , 36 , 37 , 38 ] Before the final description of the synthesized themes, all the three authors discussed the content of the themes until consensus concerning credibility was reached.

From the metasynthesis we present five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. Each theme is further explained below with references to the relevant literature.

Organisational culture shapes the conditions

Organisational culture played an important role towards the professional development of staff. Organisational commitment and support to personal and professional development of its staff was seen as an indication that staff were valued [ 5 , 15 ] Moreover, CPD initiatives contributed to attracting and retaining staff [ 39 ]. Additionally, a culture that was flexible and adaptable to change was perceived by some participants to be favourable towards CPD [ 40 , 41 , 42 ]. Flexibility extends to matters such as CPD availability, and also location, but related also to creating opportunities in the work schedule for the nurses to participate [ 43 ]. Other organisational factors such as funding for CPD programs, staff access of CPD learning, role of management in staff CPD, manageable nursing workloads, the design & delivery of CPD activities, communication and collaboration between CPD providers and management are specifically organisational factors seen as crucial to effective staff development [ 44 , 45 ]. Developing a strategy for CPD was also acknowledged as a key element of organisational culture as a way of enabling participation [ 46 ]. In a similar fashion, it was argued that the organisation needs to be focussed on incremental, but constant development of practices, and here CPD was seen to play a key role [ 47 ]. This sentiment was expressed elsewhere too, but from a re-skilling, or keeping up-to-date perspective, where the organisation is seen to have great importance [ 48 , 49 ]. The value of partnerships and shared understanding between managers and nurses as key enabling factors was identified in several studies [ 46 , 50 ]. In a related fashion, Jantzen argues that organisations should actively avoid fragmentation of CPD initiatives [ 51 ]. As more CPD training is digitised IT/ICT (information communication technology) skills were seen as key to successful CPD implementation [ 46 , 52 ]. It was acknowledged that the transformation to online learning does not only affect nurses, it involves change for the whole department [ 52 ].

Supportive environment as a prerequisite

An environment that supports learning was seen as a necessary prerequisite for CPD. Conditions had to include, flexible off-duty patterns to allow time for staff to study, availability of workplace learning, workloads were not excessive and CPD was fully funded or a shared responsibility between employer and staff [ 46 , 52 ]. Other indicators of a supportive environment included staff access to different CPD activities relevant to their career goals, while at the same time meeting organisational goals and where staff felt free to study openly and not secretively [ 15 , 41 ]. Moreover, the development of local and contextual CPD was seen as something that supported and made participation possible [ 43 , 53 , 54 ]. Participants indicated that nurses required financial support and practical support in the form of adequate time to participate in CPD activities and suitable staff cover when colleagues were away attending CPD activities [ 47 ]. Jantzen et al. [ 51 ] suggest there are three catalysts in a supportive environment; mentors, workplace camaraderie and a highly functional workplace team. Moral support or encouragement was identified in more than one study, where it was articulated that learners want to know there is an appreciation for the time and dedication needed to engage in CPD [ 44 , 46 , 50 ]. The value of learning from other health professionals other than nurses, in the day-to-day work was highlighted for professional development [ 54 ]. Similarly, the sense of a supportive environment with a strong team spirit is communicated elsewhere [ 39 ]. Explicit support is noted in several studies; support for novice nurses [ 39 ] but also the importance of explicit managerial support [ 55 ]. Conversely, in one study, respondents noted that there was less support for experienced or late career nurses [ 56 ].

Attitudes and motivation reflect nurse’s professional values

The value and importance of CPD was discussed in many of the studies. In some, CPD was perceived to be key in defining nurse professionalism [ 6 , 15 , 40 , 47 , 49 ]. Engaging in CPD was also viewed by new nurse graduates as an important element of their individual professionalisation in nursing [ 6 , 15 , 40 ]. In addition, CPD was perceived to be important for enhancing and up or re-skilling, keeping knowledge and skills up-to-date, considering that nursing practice has become more evidence based [ 6 , 43 , 46 , 51 , 54 , 56 ]. Furthermore, nurses stated that CPD was important for maintaining licensure, and felt that the responsibility for enrolling and participating in CPD activities was with the individual nurse, not with the employing organisations [ 53 ]. On the other hand, participants felt more motivated to learn if they could easily access CPD programs, if they felt supported and if there were a variety of CPD activities on offer. Here, bedside and informal learning was emphasized as important [ 57 ]. Similarly, contextualising learning and placing it in close proximity to practice was seen to enhance motivation and engagement [ 42 ]. CPD was also viewed as a way to start networking with other peers [ 44 ]. In one study, a competency framework was introduced, here participants felt that such a framework could help them reflect on their own practice and, as it provides a systematic approach to assessing a patient, look at their own strengths and weaknesses [ 58 ]. Such competency frameworks help to harness scarce training more effectively and encourage individuals to take more responsibility for their own development [ 58 ].

Participants’ attitudes towards CPD funding were mixed, with some stating that funding for CPD was the employer’s responsibility, while others felt that the individual practitioner was responsible or that the burden ought to be shared between the organisation and the nurse [ 5 , 15 , 40 ].

Nurses’ perceptions of barriers

Poor staffing levels, heavy workloads, lack of funding, lack of study time and anti-intellectualism were some of the perceived barriers to CPD brought out by this review. Participants in the studies reviewed felt that a lack of organisational support, especially from their managers, was an indication that the organisation did not take professional development of its staff seriously [ 46 ]. Some respondents reasoned that an anti-academic culture and lack of relevant CPD programs was further indication of this [ 5 , 15 , 40 ]. Seeing a connection to patient care was identified as a strong driver and nurses identified that CPD initiatives would be filtered out unless there was such a clear connection to patient care [ 43 , 51 ].

Additionally, some studies indicated that as role models, managers had to show interest in their own CPD, in order to motivate other nurses. In other words, the manager’s knowledge of CPD activities was reflected by their attitude towards work-based study, acceptance of staff who studied openly, the way the manager prioritised funding support and managed staff shift schedules to allow study release time [ 5 , 39 , 54 , 56 ]. Fatigue was identified as a major barrier. For example in Jho et al. [ 53 ], in a context of mandated CPD, respondents felt tired due to the heavy nursing workload in conjunction with CPD. Lack of strategy, and financial initiatives in terms of money, or time off to study was also acknowledged as a barrier [ 5 , 39 , 54 , 56 ]. Lack of transparent career trajectories were also acknowledged as an area of concern [ 44 ].

Other barriers, or de-motivating factors were identified; difficulties in attending CPD and keeping a life-work balance [ 48 ]. Barriers included: formal CPD courses away from the clinical areas were perceived to lack in authenticity [ 47 , 49 ] and a mis-match in expectations and outputs, where nurses viewed themselves as agents of change, but where the organisation was unable to offer means to capitalise on this perception and desire to bring about change [ 50 , 59 ]. As much as competency frameworks were viewed positively in offering a sense of direction, a divergent view was that they were limiting or created set boundaries that participants experienced as limited, for example, if used as prescriptive, hindering nurses to define their own learning needs [ 58 ]. Lack of IT competence was also perceived as a barrier [ 52 ] with more CPD being conducted online.

Perceived impact on practice as a core value

The impact of CPD on nursing practice was perceived as important and valuable in different ways. The impact could be both direct and indirect depending on the organisational culture [ 41 , 45 ]. This mixed perception could be due to the complex nature of health care organisations which can make knowledge sharing difficult [ 45 ] and that some CPD learning was done secretly, results of which were difficult to evaluate [ 41 ]. In the case where a competency framework was studied, participants felt that using the competency framework helped them organise their work and their thought processes [ 58 ]. A common sentiment was that CPD would benefit health care organisation through the provision and enhancement of practitioners’ knowledge and skills [ 46 ]. Sentiments articulating expectations of an impact of CPD could also be seen elsewhere too [ 52 , 55 , 56 , 60 ]. Moreover, CPD is expected to rely on better communication between managers and nurses as a way of informing each other about needs and means of fulfilling those needs [ 48 ]. Direct impact was realised through improved interprofessional collaboration and the idea that new methods could be directly translated into practice [ 47 ]. Others however, raised concerns that CPD programmes or courses may not translate into new practices [ 50 ]. This sentiment was echoed elsewhere too, where a need to situate CPD in close proximity of patients was seen as important for CPD to impact practice [ 49 ] While indirect impact happened through dissemination of knowledge and skills from CPD learning to other nurses at ward level, arguments were put forward that there will be no difference to practice unless organisational processes support and evaluate its effect on practice [ 46 ]. Participants reported that their professional confidence was enhanced, they felt they could challenge medical decisions and the status quo [ 41 ]. Furthermore, participants felt that CPD enhanced their professional knowledge and skills for better patient care through improved care standards, how they communicated and collaborated with other professionals. Participants also believed that learning increased their chances for career progression and reduced work-related anxiety because of enhanced knowledge [ 40 , 41 ].

The aim of this paper is to conduct a metasynthesis investigating the qualitative research on nurses’ experiences of continued professional development. As a result, this metasynthesis revealed a number of overarching themes, which synthesize the findings of previous qualitative oriented research during the period 2010–2019. 2010 was chosen to include the last 10 years of CPD research. The themes are; Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. The themes put focus on important issues that were recurrently put forward by the nurses in the studies reviewed. However, the themes are not isolated from each other, rather, the content of the themes is interrelated. Some of the themes mainly mirror an overarching perspective at the organisational level of health care, while other themes describe the nurses’ experiences and needs on a personal level. The following discussion explores the above themes in relation to the three questions posed earlier; what is the reported value of CPD for nurses’ lifelong learning and its impact on nursing knowledge? What are the conditions necessary for CPD? What are the challenges faced by nurses when engaging in CPD? While we acknowledge that the questions and themes overlap, we have endeavoured to frame the discussion around the three research questions individually.

What is the reported value of CPD for nurses’ lifelong learning and its impact on nursing knowledge?

Nurses reported that CPD raises professional standards through competencies gained, thereby increasing professional performance with positive benefits for patients, organisations and individual nurses [ 40 ]. These outcomes were seen most prominently in the themes Attitudes and motivation reflect nurse’s professional values, and Perceived impact on practice as a core value. Closely aligned to CPD are the nurses’ clinical effectiveness and competence. Maintaining both requires nurses to keep their practice up-to-date highlighting the importance of CPD for nurses. The knowledge and skills gained by nurses through CPD advances the professional status of nursing, which was an idea that was prevalent in some of the studies in this review [ 15 , 40 , 47 , 50 ], but is also illustrated elsewhere in the literature [ 8 , 21 ]. Nurses acknowledged that expectations of professional accountability meant that standards of practice ought to be kept high in order to pass public scrutiny [ 15 , 40 ]. Furthermore, skills acquired through CPD, such as the ability to conduct systematic peer-reviews [ 45 ] and appraise literature for best evidence, provide nurses with essential professional competencies, embeds values such as caring behaviours, influences beliefs and attitudes which in turn shape nurses’ professional conduct [ 61 ]. As such CPD is seen as a tool for nurses to update their skills, and in doing so deliver safe and high-quality health care. As revealed in this review, nurses were willing to fully fund or part-fund their CPD as long as CPD programs were captivating, easily accessible, there was fair allocation of study time and their efforts towards CPD were recognised. The latter implies that nurses want time and space to transfer their CPD learning into practice and for their CPD to be recorded [ 5 , 45 ]. The belief is that, consequently, patient care will improve with positive impact from organisational change [ 15 , 45 ]. However, it is clear that the organisation is key in making CPD work for nurses. The issues brought up in the theme organisational culture shapes the conditions is thus very important in stimulating nurses to engage in CPD. The nurses’ attitudes and motivation to engage in CPD also depends on a supportive environment and engagement may in turn influence the organisational culture.

What are the conditions necessary for CPD?

A disconnect could be seen in relation to the conditions for CPD, where access to CPD training came to the fore as problematic in some of the studies. Nurses had to travel long distances to attend courses [ 15 , 62 , 63 ]. To avoid these challenges, nurses settle for CPD as long as it fulfils mandatory requirements for registration [ 53 ]. If intentions of CPD are to provide a basis for the continual updating of skills, then authentic learning as an expected outcome is seen as a prerequisite for nurses to engage in CPD, whether it occurs at the bedside, at a training facility or through an IT mediated interaction. This calls for accessible CPD, improved design and delivery methods for all nurses [ 52 ]. Nurses’ experiences described in the themes Organisational culture shapes the conditions, Supportive environment as a prerequisite, show that structural and moral support are both important. Structural support in the form of availability, time to engage in CPD, as well as clear expected outcomes [ 46 , 49 ], but also moral support in the form of an understanding management and environment, and also peers and leaders who themselves also prioritise CPD [ 58 ]. Organisational support and commitment towards CPD should mean allocation of study time, support of nurses who study privately, by creating space for knowledge and skills integration and managing poor cultural practices that hinder open study. Funding is seen as a key factor across many of the studies, both in terms of enabling nurses to participate, but also as a way of acknowledging nurses who engage in CPD. Further studies may need to look more closely at how nurses perceive different aspects of funding. For nurses’ lifelong learning to endure, CPD programs need to be more accessible and kept interesting by making them more relevant to nurses’ practice contexts. Here the importance of the organisation for creating a CPD conducive environment is emphasized [ 46 , 51 , 52 ]. As role models, managers need to lead by example and engage in CPD themselves, but also demonstrate explicit support. They also need to influence policy to create environments conducive to CPD. If funding situations do not improve, work-based CPD learning could be one of the alternative ways of CPD delivery for nurses. To promote CPD engagement and cost reduction, eLearning approaches could be utilised for education and training. However, poor IT skills among nurses, but also within organisations continues to be a potential weakness [ 52 ]. A challenge remains here in enabling nurses to get recognition from informal on-site learning [ 16 , 17 , 18 ], where elements of meta-cognitive reflection can be used to acknowledge nurses’ continued professional development.

What are the challenges faced by nurses when engaging in CPD?

In some of the literature reviewed, participants lamented their current conditions for CPD, and identified clear barriers and challenges in the form of concerns related to lack of funding for CPD, staffing levels, time allocation for study, lack of organisational support because of negative cultural practices, CPD design & delivery and limited choice of CPD activities. This is articulated within the themes: Organisational culture shapes the conditions, Supportive environment as a prerequisite, Nurses’ perceptions of barriers [ 2 , 11 , 34 , 41 ] . However, studies did not explore the views of nurses on recruitment and retention and its impact on accessing a variety of CPD activities. Evidence from this review indicates that modernising healthcare and simultaneously cutting CPD funding for nurses could lead to a limited number of nurses attaining the skills and competences needed for the modernisation process. In view of the understaffing that is reported elsewhere [ 5 , 15 ], we identify a cause for concern. These perceived barriers may undermine nurses’ professional development [ 23 , 59 ]. Moreover, the findings presented here revealed that nurses face a number of challenges in relation to their CPD participation. The challenges include limited CPD activities to choose from, poor CPD delivery methods, negative organisational culture practices such as anti-intellectualism and lack of support. As a result, nurses were less motivated to participate in CPD training [ 57 ].

It is clear from the review, that IT concerns are becoming more and more prominent, given that more CPD programmes are being offered through digital platforms [ 47 ]. This is a concern for both the individual nurses, but also their organisations. On concerns regarding CPD delivery methods, nurses indicated that they preferred different styles. With these concerns comes the view that learners learn in different ways depending on the context and subject of study [ 61 , 62 ]. This supports the notion that individuals have different learning preferences [ 61 ], where some adult learners learn better in a structured and teacher guided context, while others prefer self-direction.


The search was conducted by an experienced search engine expert. Even so, we may still have been unsuccessful in finding all the relevant articles. The study was focussed on qualitative studies, which means that studies using predominantly quantitative or mixed methods were not included, but could hold important insights. In the introduction to the study we used the UK as an example for how CPD might be regulated. However, we have conducted a comprehensive search of the literature and our analysis was not conducted with a UK-centric perspective. While each study needs to be understood in terms of local rules and regulations, the similarities in the findings are striking.

The metasynthesis indicates that differences exist between the nurses’ CPD needs and expectations and organisations’ approaches to nurses’ professional development. The review lays bare a disconnect between the rhetoric of identifying CPD as a way to enhance nurses’ skills, and the reality of CPD interventions, where nurses do not feel support within their organisations or from their immediate supervisors. The review also revealed that CPD is an important element of nursing practice and nurses’ lifelong learning. Furthermore, it suggests that nurses are motivated to take part in CPD to enhance their knowledge, improve skills and keep up- to -date with recent evidence. While evidence from this review indicates that nurses believe that CPD has a positive impact on patient care, there is lack of contemporary research to qualify this claim and there is limited evidence from this review to support this assumption. However, evidence from the review suggests and confirms, that the greatest barriers for CPD in nursing are a lack of funding and time to participate in CPD activities, which are clearly related to organisation structure. It is difficult to envisage how such conditions could be conducive for nurse CPD to flourish. Such perceived barriers undermine nurses’ efforts to keep knowledge and skills up-to-date and provide better patient care while meeting the ever-changing needs and expectations of their patients. This is further exacerbated by negative organisational cultural practices and lack of knowledge on how to facilitate, design and deliver CPD for their staff. We conclude that policy makers and relevant stakeholders need to put in place strategies to support nurse CPD in long term and in doing so tear down the barriers of CPD.

Availability of data and materials

The data in the study is comprised of previous research articles. A full list of articles is included in the Table 3 .


Continued Professional Development

United Kingdom Central Council for Nursing, Midwifery and Health Visiting

Post registration education and practice

Nursing & Midwifery Council

Health Education England

National Health Service

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We would like to thank Gun Brit Knutssön, at Karolinska Institutet’s University Library, Stockholm, Sweden for the systematic search.

Open Access funding provided by Stockholm University.

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Mandlenkosi Mlambo

Department of LIME, Karolinska Institutet, Stockholm, Sweden

Mandlenkosi Mlambo, Charlotte Silén & Cormac McGrath

Department of Education, Stockholm University, Stockholm, Sweden

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MM, CS and CMG designed the study. MM, CS and CMG defined the inclusion and exclusion criteria for the search. MM, CS and CMG conducted an equal share of the analysis work. Versions of the manuscripts were shared, revised and written by all three authors. All authors have read and approved the submitted manuscript.

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Mlambo, M., Silén, C. & McGrath, C. Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nurs 20 , 62 (2021).

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Received : 03 November 2020

Accepted : 31 March 2021

Published : 14 April 2021


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The Importance of Continuing Education

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