Graebe welcomed the April 2019 Continuing Nursing Education (CNE) Symposium participants with a call to action that all build relationships beyond their organizations—in their communities, with higher education and other industries to optimize and leverage their workforce's talent to close skill gaps, improve quality and safety metrics, and create sustainability in retention and recruitment. She highlighted that nursing continuing professional development (NCPD) is about the continual learning journey in the workforce, noting that learning does not end with graduation from high school, vocational school, higher education, or even after the first year of professional practice. Graebe closed by focusing on the idea that learning, growth, and professional and personal development are on a continuum and should be a key priority for all of us. She noted that we are servants (and servant leaders) as facilitators of learning and the growth and development of others, and that we have a responsibility to do what is right for our stakeholders, learners, and patients. As change agents, we have an opportunity to create an organization that is not only a great service organization but a great growth and learning mindset organization! Who would have thought nurses and NCPD/continuing professional development (CPD) would have been the answer to these systemic and global issues the whole time?
Bold New World of Professional Development—Donna Wright, MSN, RN
Wright began the CNE Symposium with a dynamic and thought-provoking reflection on CPD and competency. Wright focused on the relationship between meaningful and purposeful CPD and how it relates to performance management, including the expectation for performance. She emphasized that competency assessment should be fluid and ongoing, and that annual competencies and mandatory education do not make sense in today's health care environment. Wright stressed that if we make learning and competency attainment collaborative and positive, we remove the stigma that CPD and competency function as a punishment. By engaging employees in their learning, Wright noted that we have an obligation to create an environment of learning that is empowering—where learners have a sense of ownership and accountability for their own lifelong learning. In closing, Wright noted that health care organizations and leaders will need to be proactive versus reactive in identifying professional practice opportunities and providing an environment where the nurse learners can own, be engaged in, feel empowered by, and be accountable for their professional practice.
Ignite Change: Transforming the Future of Nursing Professional Development—Graham McMahon, MD; and Khurram Jamil, MD
McMahon opened with a thought-provoking message that the role of the teacher and learner in CPD is changing. McMahon asked the audience to reflect on whether their learners are really learning with traditional models of learning. McMahon stressed that CPD is a transformative journey and asked the audience to reflect on how they contribute to the strategic value of CPD. McMahon indicated that organizations have an obligation to create a culture of learning and growth in order to achieve key strategic goals. McMahon noted that rather than providing information to our learners, we must create learning experiences. CPD needs to be designed to meet the needs of learners and teams, creating an environment where learners are curious, engaging, learning, and creating change. McMahon offered tips for challenging the traditional model of learning, such as tailoring learning to individuals and teams, moving away from information transfer to engaging learners, keeping presentations short with ample time provided for questions and bidirectional dialogue, facilitating learners to reflect, and connecting feedback to growth and learning.
Jamil opened with a powerful and experiential story of learning through interprofessional collaboration. He noted that nurses have been pioneers in CPD and were the first movers and shakers of incorporating technology into learning (i.e., simulation). Jamil noted that traditional approaches to earn CNE credits do little or nothing to serve learners as individuals, and that traditional e-learning is characterized by infobesity (i.e., informational obesity) that is not readily translated to practice. Jamil underscored that we can no longer solely focus on teaching, but that we must focus on how nurses learn. It was noted that adaptive learning is a unique approach to individualize learning for learners within an e-learning platform. Adaptive learning provides the learner with a tailored experience where the technology identifies what a learner needs to know and/or do. Jamil explained that adaptive learning provides an interactive experience where learners are engaged through a variety of tools and resources where learning is individualized, relevant, and actionable.
Accred Talks: Inspiration and Innovation the Future of CPD...through CBE—Charla Long, JD; Lisa McIntyre-Hite, PhD; and Bette Bogden, PhD, RN-BC
The Accred Talks were a dynamic discussion on the impact that competency-based education (CBE) has on CPD and specifically how it aligns with the professional growth and development of the nursing workforce. The Accred Talks also spotlighted the impact of formative feedback on growth mindset and performance.
Long opened by diving into defining CBE, noting that CBE is outcome driven. The Competency Based Education Network definition of competency, as presented by Long, was noted to be determined through multiple forms of assessments that address mastery of the identified knowledge, skills, and/or abilities. It is important to note that competencies can be individualized or personalized not only to a learner, but to a group or team of learners. Long stressed that in CBE, assessing competence and achievement of learner outcomes is the focus and time is the variable. Long also noted that we must be nimble in recognizing where learning occurs. A resounding theme was that how one assesses, evaluates, and measures competency acquisition is far more important than how a competency is written. It is about demonstrating through education what a learner knows and can show and/or perform. Further, evaluating competency attainment must be in direct alignment with the gap or need, the identified outcomes, and the desired state as a result of the CBE. The reasons behind CBE were noted as:
- Opportunity to serve nontraditional students.
- Respond to workforce needs.
- Improve learning outcomes.
- Engage in education innovation.
Long broke down how a CBE framework, such as the Competency Based Education Network framework, can be used in alignment with CPD and accreditation standards such as the American Nurses Credentialing Center NCPD accreditation standards.
McIntyre-Hite discussed the opportunities that exist in creating synergistic relationships between academia and employers. McIntyre-Hite noted that business model innovation is needed to grow demand and build capacity for employees who are looking to advance professionally through higher education degree attainment. It was also noted that through CBE degree attainment, employers are able to identify the competencies of their employees and that learners have tangible knowledge and skill that can be applied. McIntyre-Hite underscored the concept of the whole human in human supported learning, further emphasizing that learning experiences must be flexible, personalized, and recognize that CPD and learning cannot be based on traditional clock hours. McIntyre-Hite closed by bringing to the forefront that a competency-based learning approach allows for a learner to be viewed as a human.
Bogden (with content developed by the American Nurses Credentialing Center) drilled into the impact of formative feedback on growth mind-set. There are differences between telling and instructing and guiding and encouraging as it relates to providing performance feedback. The key ingredient to formative feedback was highlighted as the stimulation of the brain to identify opportunity for improvement or enhancement versus a fixed mindset that paralyzes growth and performance. As facilitators of learning—through formative feedback—we need to celebrate the incremental success of learners because success is the intended outcome. Formative feedback also requires that learners are provided opportunity and resources for growth. Key concepts in formative feedback are to focus on the work, not the person—feedback is rooted in evidence with resources and suggestions for growth—with less praise and more encouragement. Tips for formative feedback were noted to be transparent, actionable, relevant, consistent, and in real time.
The Human Factor in Professional Development, Teaching, and Learning—Richard Levin, MD, FACP, FACC, FAHA
Levine's endnote address closed the CNE Symposium with a powerful presentation on humanizing professional development. This was the first time Levine had the opportunity to speak in front of an audience of nurses—he felt truly humbled and honored with the opportunity. Levine discussed the connection between humanization and health care providers, highlighting that it must be a part of how we develop and grow our workforce. Levine noted that humanism is the key to optimal health care, adding that those who put the human connection at the center of what they do will succeed. Levine depicted how humanistic CPD can guide achievement of the Quadruple Aim—described by Levine as a set of aims geared to improve population health, while reducing costs and providing a positive patient and provider experience. Levine specifically focused on the provider experience, noting that this will lead to better care and better experiences at a lower cost while bringing joy to their work. It was stressed that compassionate teaching and learning can lead to compassionate practice. Levine was reflective that at the core of health care is the patient and that clinicians—nurses—are servant to each other and their patients through learning and leadership.
The growth and development of individuals and teams should be the goal of every employer and employee. NPD practitioners and any individual (e.g., preceptors, clinical instructors, faculty, coaches) who are in a position to facilitate the growth and learning of others are in a unique position to be servants and create a culture of growth and learning. There is no better time than now to pave a future where CPD is outcome driven and recognized as an opportunity to advance the profession of nursing and the health care team for strategic goal achievement.