When you convinced Slack Incorporated in the late 1960s to publish a new nursing journal, I am sure you envisioned it lasting forever. Thus, the 50th anniversary of The Journal of Continuing Education in Nursing (JCEN) would not be a surprise to you, its founding Editor-in-Chief. I am dedicating this editorial to you for your visionary leadership in helping us all provide and value learning throughout our careers.
I had numerous subtitles for this editorial. For example, “Learn and Lead.” We cannot move along the follower–leader continuum unless we are constantly learning. Or, “Never Stop Learning.” Those words were another idea suggesting that if we are not constantly learning, we aren't merely standing still—we are falling behind. And then there was, “Growing and Going,” which acknowledges that continuing our professional education allows us to grow and keeps us moving ahead with the work we must do. You can see why I didn't choose a subtitle—too many are too relevant!
Most of us who currently provide continuing education or participate in such activities may be able to recall how we felt when we completed our initial education. Some of us may even have said something related to being through with learning. What a surprise life had in store for those who said (or thought) that!
Maybe it was the positions we held or the rapid changes (what we used to consider as rapid, I might add) that allowed us to value the need to continue to learn. Some of our learning was through additional formal degree-granting situations, some through formal continuing education, some that offered no credit, some that didn't even relate to nursing or health care, and some that could be viewed as serendipity. (I have a lot of all those experiences!)
Rath (2007) asked the question, Do you have the opportunity to do what you do best every day? The idea behind StrengthsFinder is that we make huge differences when we have the opportunity to use our top talents. One of the 34 themes is that of Learner, and one of the descriptors of that theme states: “The outcome of the learning is less significant than the ‘getting there’” (Rath, 2007, p. 133). Thus, just loving to learn is a strength, and that can lead to new ways of conceptualizing problems, new strategies for creating solutions, or new insights into something we hadn't thought of in years. Learning can change practices and the work environment and, in each case, contribute to our understanding of ourselves. The point is that learning makes a difference, and it is the journey of learning that is highly valuable to us.
Whenever I hear the question about whether continuing education makes a difference, I think of two things. One is the Mitsunaga and Shores article from 1977, and the other is how we demonstrate impact in many instances. The Mitsunaga and Shores article proposed a model that resulted in varying degrees of evaluative outcomes, starting with what many of us call the happiness factor (the immediate response to a learning activity experience—Mitsunaga and Shores called that learner satisfaction) and ending with change in practice that affects the quality of service (the long-lasting difference learning can make). This model was one of the first to clarify levels of outcomes as a result of participating in a continuing education activity. The outcomes could be many, and each was valued.
We have all engaged in happiness evaluations—both as providers and as learners—and some of us have actively sought the impact level of learning. That brings me to the constant question, what difference, if any, does continuing education make? One by one, we could challenge various learning encounters. As a whole, however, we have to say that continuing education has made a lasting impact on the nursing profession. If this weren't true, we still would be totally reliant on doing what the physician said, following orders, and performing what today would be considered minimal skills. In other words, if we haven't been learning, we wouldn't have intensive care units and the exquisite care that is rendered there. Nor would we have any advanced practice roles. Nor would we be able to say we have a better understanding of safety and quality. Fifty years ago, we probably wouldn't have resuscitated anyone—we would have called the physician, but our bed linens would have been tight as a drum! Hence, the real key about developing ourselves professionally is when learning leads to a change in practice to the extent that the quality of the service we provide increases. That is where our real focus in program planning is—what difference will this make for the individual, for the organization, and for the people we serve?
Numerous changes have occurred in whatever clinical or functional role consumed our professional time. If you were a clinical leader of some nature, phrases such as head nurse and director of nurses would be common. If you were an educator, you would still be the “sage on the stage” and not the facilitator of lifelong learning. If you were a direct care provider, you would most commonly work in a hospital and in a medical–surgical unit where patients stayed for days, if not weeks. Those descriptions are part of our past—including the sage on the stage part.
Today, all of us are integrators of knowledge, sifting through too much information to find the gems we need to improve whatever it is we do. We learn from successes and failures. Using Sinek's framework (2009), educators focus on the why (the difference we can make) as much as the how (the process of learning) and the what (the content). Educators have learned the complex, evidence-based approach to debriefing a learning event and how to ask important questions. Just as Kouzes and Posner (2016) told us, we learn through reflection. Sometimes that occurs in an immediate debrief, and other times it might occur by examining a failure to drill down to how to prevent the failure from occurring again. We have learned from mentors, preceptors, coaches, teammates, and others.
Dorothy, did you know that educational organizations are beginning to redirect their efforts (Selingo, 2018)? For example, the Georgia Institute of Technology commissioned a study about the future of higher education, which led to the thought that learners would be affiliated with a college as lifelong learners, as opposed to individuals who spent a defined period of time and earned a degree (Selingo, 2018). That concept of educational programs being centers for lifelong learning has great meaning for us. Educators' roles would be reshaped, as would curricula. Flexibility and just-in-time learning would be prevalent.
Some clinical agencies have established large, well-developed programs of learning for the nurses (and others) in the organization. Others still tend to think of education as an afterthought. And, yes, education is still one of the budgetary items that is seen as not critical to the mission in some organizations. As you might suspect, the agencies that value education and provide the appropriate support have solid thinkers and learners. They are the ones Peter Senge (1990) referred to as learning organizations.
What nurses who are responsible for facilitating others' learning must do is constantly think about what's next and how we entice learners to engage with us in creating positive learning experiences that lead to continued impact. Actually, that statement brings me to another issue that has waxed and waned over the years—personal development. Learning how to take care of oneself is currently in vogue. That is not because helping us as nurses makes us feel as if someone cares about us, too. It is because when we feel someone cares about us, we are more engaged, and a more engaged workforce means better care for the people we serve.
Finally, Dorothy, throughout the year, we will recognize and make free to access some of the classic articles and statements that appeared in JCEN over the past 50 years, some of which you and your colleagues on the Editorial Advisory Board had a heavy hand in developing. This year, some of our current Editorial Advisory Board members have taken on the task of writing guest editorials about the meaning of continuing education to them. Some of the ones I have read thus far made me nod my head in agreement. Others made me wonder why everyone hasn't had such a great experience. Still others made me celebrate the obviously great learning experiences we have had. If readers have a great story to tell about the personal meaning of continuing education, I hope they will e-mail it to me! (Please e-mail me at
As you can see, we continue to take what you left as your legacy and make it relevant for today and for the future. Here's to your legacy! Thank you for being so brilliant and dedicated 50 years ago. You have made a difference!
Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAAN
- Kouzes, J.M. & Posner, B.Z. (2016). Learning leadership: The five fundamentals of becoming an exemplary leader. San Francisco, CA: Wiley.
- Mitsunaga, B. & Shores, L. (1977). Evaluation in continuing education: Is it practical?The Journal of Continuing Education in Nursing, 8(11), 7–14.
- Rath, T. (2007). StrengthsFinder 2.0. New York, NY: Gallup Press.
- Selingo, J.J. (2018, July6). The future of college education: Students for life computer advisers and campuses everywhere. The Washington Post. Retrieved from https://www.washingtonpost.com/news/grade-point/wp/2018/07/06/the-future-of-college-education-students-for-life-computer-advisers-and-campuses-everywhere/?noredirect=on&utm_term=.eab762344b34
- Senge, P. (1990). The fifth discipline: The art & practice of the learning organization. New York, NY: Doubleday.
- Sinek, S. (2009). Start with why: How great leaders inspire everyone to take action. New York, NY: Penguin Books.