Explaining nurses’ decisions to participate in a Professional Development and Recognition Programme : a mixed methods study : thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Education, Institute of Education, Massey University
Loading...
Date
2018
DOI
Open Access Location
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Massey University
Rights
The Author
Abstract
Continuing professional development (CPD) has been of concern since Florence Nightingale made it her mission to improve hygiene practices to lower hospital death rates. Whilst the century may have changed, the task has not and, in an increasingly challenging healthcare environment, nurses must keep abreast of extensive technological advancements. Ongoing education has become essential rather than optional in modern healthcare. CPD is considered so important to maintaining the safety of the public, Nursing Council of New Zealand has mandated that nurses complete a required number of CPD hours every three years. Linked to renewal of Annual Practising Certificates and demonstration of Registered Nurse recertification competencies, entire education programmes have grown up around mandatory CPD.
Particular types of CPD, Professional Development and Recognition Programmes (PDRP), have been widely adopted by public and private healthcare organisations in New Zealand. Where PDRP is mandatory, engagement rates are more than 90%. In organisations where participation is voluntary, engagement rates are below 20%. Disparities between these participation rates do not deter a diverse and influential range of programme stakeholders who include the Nurse’s Union, Nursing Council and District Health Boards. Programmes are linked to financial allowances, nurses’ regulatory requirements and workforce planning. PDRP has become an ‘ecology’.
Previous research had not ascertained nurses’ views about PDRP and little is understood about their experience of participation. Considering the large personal investment required in mandatory CPD, together with the low voluntary engagement rates, it is important for nurses to contribute to the conversation about participation in programmes like these. Low participation rates also make it relevant to ask if intended organisational staff development outcomes of supporting PDRP are being met. Such a consideration is highly relevant to an organisation like New Zealand Blood Service (NZBS) where the minimisation of clinical error is essential and PDRP objectives relate to the development of expertise among its staff.
Presented in this thesis is an account of a mixed methods study designed to explain factors affecting nurses’ decisions to participate in PDRP at NZBS. The work makes use of Cross’ (1981) Chain of Response Model as the conceptual framework. Participants were 129 Registered Nurses at NZBS who were direct mailed a survey to determine their knowledge about the programme, attitude to learning and response to factors affecting engagement with CPD.
Quantitative data provided by 82 respondents showed that PDRP requirements were largely known, but their relationship with the mandatory regulatory requirements of Nursing Council of New Zealand were not. Nurses’ indicated that PDRP could meet their education needs and it was felt to be within their capability. Nurses were positively disposed to engagement with it.
In the qualitative phase, 14 semi-structured interviews were conducted with volunteers who had participated in the survey. Interviews with participants revealed significant differences between the nurses’ and educators’ understanding of the programme purpose and its connectedness to mandatory regulatory requirements. Nurses explained how a personal landscape of factors affected their decision to participate in PDRP including the significant impact of career-long exposure to vicarious learning experiences about PDRP. Nurses also explained the critical importance of their direct manager in creating a workplace culture of completion, promoting a narrative of encouragement and in supporting nurses to navigate the complexities of the employment/regulatory context in which PDRPs operate. However, PDRP was not seen as a legitimate tool for professional development among the nurses in this study.
Recommendations include the need for NZBS to consider whether the presentation of mandatory regulatory and professional education requirements should become distinct from one another until a nurse chooses to submit a professional portfolio for assessment. Key stakeholders need to consider supporting all programmes to be compulsory at entry level. Stakeholders should also review areas of incongruence between the needs of the regulator, the employer and the nurse regarding CPD. The intention should be to ensure clarity about these relationships, making mutual benefits transparent. It would be advantageous too, to consider the implementation of personalised education assessment for PDRP participants to promote the ongoing development of the workforce. For the regulator, Nursing Council of New Zealand, the resources available to assist nurses understanding the link between their professional and regulatory accountabilities need to be refreshed as a matter of urgency since this is the fifth piece of work that has raised issues about nurses’ understanding of continuing competence requirements.
Description
Keywords
Nurses -- New Zealand -- Attitudes, Nurse practitioners -- Education -- New Zealand, Nurse practitioners -- Rating of -- New Zealand, Career development -- New Zealand -- Case studies