The year 2019 brought several key issues into play related to continuing education and nursing professional development (NPD). This article highlights six of those important issues:
- The value of nursing professional development.
- Interprofessional continuing education. Outcome-based continuing education.
- Changes in the American Nurses Credentialing Center's (ANCC) accreditation program.
- Nursing residency and fellowship programs.
- Developing nurse leaders.
The Value of Nursing Professional Development
Throughout 2019, The Journal of Continuing Education in Nursing (JCEN) celebrated 50 years of advancements in nursing professional development (NPD) and continuing education. It is wonderful to see the progression and successes NPD has had over the years. Moving from a passive, seated approach to intentional learning (Bleich, 2019), RNs can take control of their career path as they create professional goals. We invite you to enjoy these free editorials at the JCEN 50th Anniversary Collection website ( https://www.healio.com/nursing/journals/jcen/50th-anniversary-collection).
The Role and Responsibilities of the NPD Practitioner
As our specialty organization, the Association for Nurses in Professional Development (ANPD) provides us with the Scope and Standards of Practice for NPD generalists and specialists (Harper & Maloney, 2016). The document clarifies role expectations and responsibilities, as well as daily guidance for job descriptions and career advancement. Pam Dickerson's (2017) Core Curriculum for Nursing Professional Development provided detailed information about the history and current focus of continuing education and professional development as well as specific guidelines for developing, implementing, and evaluating continuing education activities. The ANPD is beginning work on updates to the Scope and Standards of Practice for release in 2021.
Return on Investment
With a focus on outcomes, NPD practitioners are encouraged to look at the return on investment for educational programs (Garrison & Beverage, 2018). Several models are available for NPD practitioners to calculate financial return, but there should also be considerations for education that does not align with financial resources but supports the strategic initiatives of an organization. For example, educational activities, support group work, mentoring, and debriefing sessions can also enhance role performance, improve practice and leadership skills, and contribute to career advancements such as certification or change in position. As the ANPD notes, these may all have a positive return on investment for both the participant and the organization. Let us broaden our return on investment discussions to include financial, organizational, patient, and professional enhancements.
Interprofessional Continuing Education
The focus on interprofessional continuing education continues to grow. The Joint Accreditation program now supports optometry, physician assistants, psychology, and social work in addition to the original three professions—nursing, medicine, and pharmacy (Joint Accreditation for Interprofessional Continuing Education, n.d.). The number of organizations achieving joint accreditation is rising, and the first organizations achieving joint accreditation are now reaccrediting. Evidence from the recently published data report (Joint Accreditation for Interprofessional Continuing Education, 2019) shows that a wide variety of organizations are jointly accredited, and all are demonstrating value related to learner changes in skills and performance, as well as patient outcomes.
Outcome-Based Continuing Education
ANCC-accredited providers now have the opportunity to award outcome-based credit for individuals and/or groups of learners who demonstrate outcomes reflecting up to five levels of achievement—knowledge gain; articulation of how knowledge and/or skills will be applied in the practice setting; demonstration of knowledge and/or skills in a simulated, educational, or practice-based setting; integration of knowledge and skills into practice; and demonstration of the impact of use of knowledge and skills on practice, patient, and/or system-level outcomes. Learning experiences are developed by nurse planners using the same accreditation criteria that apply to any educational activities. In outcome-based continuing education, nurse planners typically work collaboratively with learner(s) to identify practice gaps, develop incremental and measurable outcomes, and establish educational activities and evaluation strategies to help learners close those gaps.
ANCC (2019) published a manual to guide nurse planners in accredited provider units interested in this new opportunity. Particularly for education that is focused on competency development, the escalating levels of outcome-based continuing education provide a vehicle to support validation of competency. The outcome-based credit is not intended to supplant the contact hour—the typical time-based approach to awarding contact hour credit is still used in most circumstances.
Changes in the ANCC Accreditation Program
Based on significant growth within the ANCC Accreditation Program, a major structural change occurred at the beginning of 2019. Rather than having one commission overseeing both primary accreditation and the Practice Transition Accreditation Program, the ANCC Board of Directors approved a plan to bifurcate the program into two areas: Nursing Continuing Professional Development, and the Practice Transition Accreditation Program. Separate commissions guide the work of each area.
Within the Nursing Continuing Professional Development program, several adjustments were made in August 2019:
- Providers of continuing education now have the option to round contact hours to the nearest quarter, rather than awarding credit based on the actual mathematical calculation. For example, 2.89 contact hours can now be rounded to 3; 2.81 contact hours can be rounded to 2.75. This simplifies awarding of contact hours and aligns nursing with medicine, so equal numbers of contact hours and Continuing Medical Education credit would be awarded for participants in the same activity.
- Minor adjustments have been made to language in some of the accreditation criteria. The criteria themselves have not changed (ANCC, 2015); language clarifications were designed to help applicants understand expectations and reduce the documentation burden. An updated manual will be published early in 2020 to reflect these modifications.
- Language has been changed to reflect the focus of accreditation on professional development, which is inclusive of, but more than, continuing education. Perhaps the most visible evidence of this change is a revised accreditation statement, which refers to an organization as being accredited in nursing continuing professional development rather than continuing nursing education. This change will be implemented gradually, with the expectation that all accredited organization will be using the new language by the beginning of 2021.
New criteria are now available for accredited providers seeking accreditation with distinction.
Nursing Residency and Fellowship Programs
There continues to be a large amount of research—and a resulting increase in the number of articles—regarding nurse residency programs (new graduate nurses) and RN/advanced practice registered nurse (APRN) fellowships (including RNs moving from one area of expertise to another). Most of these initiatives are within the realm of creating healthy work environments while improving patient safety. Key components of a successful nurse residency are still being investigated—one key aspect is that a well-educated and engaged preceptor is necessary, with ongoing resources and support provided to both the preceptor and the preceptee. Preceptor role development is so important that a strong preceptor– preceptee relationship can make or break the transition experience for RNs (Shinners & Franqueiro, 2015).
To ensure transition programs follow guidelines and minimum standards, there is a recommendation that organizations obtain accreditation for their transition programs (Goode, Lynn, McElroy, Bednash, & Murray, 2013). Currently there are four accrediting bodies: the ANCC has over 110 accredited residencies and fellowships, the Commission on Collegiate Nursing Education has 30, and the Accreditation Commission for Education in Nursing has just announced they will also provide Transition-to-Practice program accreditation. The National Nurse Practitioner Residency and Fellowship Training Consortium (NNPRFTC) offers accreditation for APRNs in primary care or specialty areas. There are currently nine accredited organizations on NNPRFTC's website.
Mandating New Graduate Residency Programs
We continue to closely follow the American Academy of Nursing (AAN) policy statement regarding mandating new graduate RN programs (Goode, Glassman, Ponte, Krugman, & Peterman, 2018; Shinners, 2019). Although there is agreement that a nurse residency is a “must have” work needs to be done on how this would be operationalized and paid for during fiscally challenging times. According to the policy brief, AAN is committed to further communication with “CMS [The Centers for Medicare & Medicaid Services], state, and nongovernmental agencies to discuss requirements for accreditation and hospital funding for implementing a post licensure, new graduate NRP [nurse residency program]” (Goode et al., 2018, p. 331).
Developing Nurse Leaders
It is no surprise that the continuing exodus of experienced RNs as they age out of their careers is putting a strain on academia, clinical practice, and NPD from local to national settings. All nurses need to be provided with opportunities to develop their leadership skills. This begins in the academic setting and continues throughout our years of practice. Clinical leadership speaks to the nurse at the point of care. It is critical that frontline caregivers are supported and given a voice to question, advocate for safe patient care, and engage in the creation of a healthy work environment. As RNs progress to other roles (mentor, preceptor, charge nurse, or nurse manager) they need the education and support to develop necessary leadership skills. Likewise, moving to a specialty area with a focus on NPD is a calling that needs nurturing and support. There are several strategies for RNs interested in developing their role as NPD practitioners and leaders. There are classes, workshops, and mentoring opportunities, as well as the ANPD leadership academy that focuses on developing the knowledge, skills, and behaviors needed to manage an NPD department. Finally, joining ANPD and taking advantage of its many offerings may be the first step on the journey to a role in NPD leadership.
- American Nurses Credentialing Center. (2015). 2015 ANCC primary accreditation provider application manual. Silver Spring, MD: Author.
- American Nurses Credentialing Center. (2019). Awarding credit for outcome-based professional development. Outcome based CE© model manual. Silver Spring, MD: Author.
- Bleich, M.R. (2019). Our GOLDEN anniversary: Guiding, orienting, leading, developing, educating, nurturing. The Journal of Continuing Education in Nursing, 50, 383–384. doi:10.3928/00220124-20190814-01 [CrossRef]31437291
- Dickerson, P. (Ed.). (2017). Core curriculum for nursing professional development (5th ed.) Chicago, IL: Association for Nursing Professional Development.
- Garrison, E. & Beverage, J. (2018). Implementing a process to measure return on investment for nursing professional development. Journal for Nurses in Professional Development, 34, 8–11 doi:10.1097/NND.0000000000000419 [CrossRef]29298222
- Goode, C.J., Glassman, K.S., Ponte, P.R., Krugman, M. & Peterman, T. (2018). Requiring a nurse residency for newly licensed registered nurses. Nursing Outlook, 66, 329–332. doi:10.1016/j.outlook.2018.04.004 [CrossRef]29724451
- Goode, C.J., Lynn, M.R., McElroy, D., Bednash, G.D. & Murray, B. (2013). Lessons learned from 10 years of research on a post-baccalaureate nurse residency program. Journal of Nursing Administration, 43, 73–79. doi:10.1097/NNA.0b013e31827f205c [CrossRef]23314789
- Harper, M.G. & Maloney, P (Eds.). (2016). Nursing professional development: Scope and standards of practice (3rd ed.). Chicago, IL: Association for Nursing Professional Development.
- Joint Accreditation for Interprofessional Continuing Education. (2019). Joint accreditation data report: Scope and diversity of accredited continuing education for healthcare teams—2018. Retrieved from https://www.jointaccreditation.org/sites/default/files/822_20190716_2018_JA_Data_Report.pdf
- Joint Accreditation for Interprofessional Continuing Education. (n.d.). About joint accreditation. Retrieved from https://www.jointaccreditation.org/about-joint-accreditation
- Shinners, J. (2019). Will new graduate nurse residencies be a mandate of the future?The Journal of Continuing Education in Nursing, 50, 341–344. doi:10.3928/00220124-20190717-02 [CrossRef]31356669
- Shinners, J.S. & Franqueiro, T. (2015). Preceptor skills and characteristics: Considerations for preceptor education. The Journal of Continuing Education in Nursing, 46, 233–236. doi:10.3928/00220124-20150420-04 [CrossRef]25955427