Improving Critical Thinking and Clinical Reasoning With a Continuing Education Course

Background: Continuing education courses related to critical thinking and clinical reasoning are needed to improve the accuracy of diagnosis. Method: This study evaluated a 4-day, 16-hour continuing education course conducted in Brazil. Thirty-nine nurses completed a pretest and a posttest consisting of two written case studies designed to measure the accuracy of nurses` diagnoses. Results: There were significant differences in accuracy from pretest to posttest for case 1 (p = .008) and case 2 (p = .042) and overall (p = .001). Conclusion: Continuing education courses should be implemented to improve the accuracy of nurses` diagnoses. J Contin Educ Nurs 2009;40(3):121-127.

Distance continuing education for enterprises in European Universities

Proceedings of EDEN 10th Anniversary Conference, 10-13 June 2001 Stockholm, Sweden

Formation continue: comment concilier devoir et besoins [Continuing education: how to reconcile needs and wants]

La formation continue fait à l'évidence partie intégrante de la vie du médecin, elle est non seulement un devoir éthique envers les patients mais également l'expression du besoin de se maintenir «à la page» dans sa pratique quotidienne, conséquence des progrès rapides en médecine, particulièrement en oncologie médicale. Elle peut être également source de plaisir quand il s'agit d'accroître ses connaissances. Ses règles minimales ont été définies depuis plusieurs années par la FMH qui délègue aux sociétés de disciplines son application pratique. En 2008, une révision nécessaire pour différentes raisons a facilité le calcul des crédits. Même si le total des heures de formation est resté le même (50 crédits), il a été partagé par deux : 25 pour la formation spécifique et 25 qui peuvent être acquis dans une autre discipline (révision de mars 2009 du Règlement pour la formation continue, art. 5a). Cette révision n'a pas réjoui toutes les sociétés de spécialistes qui gardent la faculté de revoir à la hausse le minimum jugé nécessaire à leur discipline. La quantité des offres de formation continue pour les médecins pose le problème d'être proprement pléthorique (congrès nationaux et internationaux, e-learning, symposiums locaux, etc.), il n'en va pas de même de leur qualité. Dans le domaine de l'oncologie médicale, les offres sont abondantes dans un contexte de marketing évident : les maisons pharmaceutiques parrainent des réunions avec un orateur mercenaire, prestigieux si possible, invité à vanter un produit spécifique dans un cycle de présentations en différents lieux de Romandie (avec à chaque fois, la possibilité d'inscrire des crédits à l'actif des participants)... Elles soutiennent également, par leur logistique, de miniconférences organisées par les différentes institutions locales et auxquelles les médecins ne participent que de façon sporadique vu leur intérêt souvent très secondaire - il n'est pas rare que l'auditoire médical se résume à cinq ou dix participants. Au final, ces offres dispersées et de qualité discutable monopolisent les ressources qui se raréfient rapidement dans le contexte économique actuel et qui doivent impérativement être utilisées de manière plus judicieuse, notamment en évitant les manifestations répétitives. Devant toutes ces offres, il est souvent difficile pour la société de discipline de séparer le bon grain de l'ivraie et en conséquence d'attribuer de manière objective les crédits de formation. Partant de ce constat, un petit groupe romand de médecins oncologues praticiens installés et des centres universitaires ont réfléchi à l'idée de regrouper au sein d'une seule structure romande l'organisation d'une formation continue qui réponde à la fois aux besoins et à l'exigence de qualité. Ses tâches sont multiples : mettre sur pied annuellement plusieurs demi-journées de formation, préaviser avec un comité scientifique de la qualité de la formation continue distillée sur son territoire de compétence (sans empiéter sur les prérogatives de la commission pour la formation postgraduée de la Société suisse d'oncologie médicale - SSOM) en rapprochant les centres universitaires, les hôpitaux cantonaux et régionaux, et les praticiens. Ainsi est née l'association FoROMe (Formation romande en oncologie médicale). Sa légitimité a été établie par la SSOM et par le Comité pour la formation postgraduée et continue (nouvellement SIWF) de la FMH. Elle est maintenant en mesure de mettre en application les tâches pour lesquelles elle a été constituée. Il est évident que cela n'ira pas sans résistance et que certains diront qu'ils ne voient pas la nécessité d'une structure supplémentaire, que les sociétés de disciplines font très bien leur travail, qu'il s'agit encore là d'une atteinte à la liberté. Cependant les nécessités économiques vont tôt ou tard venir au secours de la logique pour confirmer les changements que cette démarche a permis d'anticiper. A l'avenir, il s'agira d'assurer le bien-fondé de cette initiative et de rester vigilant au bon fonctionnement de cette structure à la satisfaction de nos membres.

Registered nurses' perceptions of factors impacting on their continuing education /

This qualitative study examined the effects of hospital restructuring on a group of nurses at a community hospital. Eleven nurses were asked questions in order to gain insight into their experience in this situation. Ten of these participants were female, and one was male. The intent was to gather information about how restructuring has affected their lives, including, their motivational factors and barriers to participation in continuing education, and their descriptions of their workplace environment. Audiotaped interviews were conducted on two occasions to obtain this data. Emergent themes included the nurses' comments about continuing education, motivational factors, barriers that included geography and time, reactions of co-workers, restructuring, the College of Nurses' Quality Assurance Program including peer feedback, and performance appraisals. The literature review compares the barriers and motivational factors to the previous research findings. Thus, this study gave voice to the experience of this group of nurses, working in a healthcare setting that is involved in restructuring. This information is important to the healthcare system, since many areas are involved in restructuring. The whole process, if it is to be successful, depends on the frontline workers, namely the nurses. Thus, if there is anything to be learned from this group of people, that could be used to improve this progression, everyone would benefit from this information, were it to be implemented. Everyone is a stakeholder in the quality of healthcare in our province. The frontline workers are the ones that hold the vantage point to be able to provide suggestions for the changes needed to successful. These nurses are not just motivated by work issues however, and educating them and motivating them will also improve the care provided through increased knowledge and enhanced self-esteem.

Research in the clinical setting : a qualitative study of the value of play research in the continuing education of occupational therapists.

Occupational therapists have always recognized playas an important part of a child's life. However, until recently play has been viewed as a medium for reaching treatment goals, rather than as an activity that is valuable in and of itself. If occupational therapists think of playas the primary activity or occupation of childhood, then play should be a very important area of focus for paediatric clinicians. In order to assist children to become as independent as possible with play and to have fulfilling play experiences the occupational therapist needs to have a clear understanding of how to assess, set goals which lead towards competence in play, and promote play. Recent play literature has placed importance on play behaviours and looking at the relationship between the child and both the human and nonhuman environment. Believing that play and playfulness can and should be promoted, for children with physical disabilities, requires that therapists learn new assessment and intervention strategies. A new assessment tool, The Test of Playfulness, was developed by Bundy in 1994. It addressed play behaviours and environmental influences. The author, a co-investigator and eight occupational therapists were involved in a playfulness study using this test to compare the playfulness of children with physical disabilities with their able-bodied peers. After the study was completed the author questioned whether or not involvement in the playfulness study was enough of a change agent to bring about transformative learning in order to further the eight occupational therapists' education about play.This study investigated changes in either the therapists' thinking about play or their behaviour in their clinical practice. The study also examined the participants' retention of knowledge about the Test of Playfulness. The eight therapists who had been involved in the playfulness study (participants) were matched with eight therapists who had not been involved (nonparticipants). The therapists were interviewed 9 to 12 months after completion of the playfulness study. They were asked to describe various scenarios of play and open ended prompts were used to elicit the therapists' perceptions of play, good play, the role or value of play, environmental and gender influences on play, play assessment and intervention, and play research, for children with and without disabilities. The participants were also prompted to discuss their experience with the playfulness study. A self-report questionnaire was also completed at the end of the interview. The results of the study demonstrated that: (a) the play research project was a good format for continuing the participants' education about play; (b) their thinking had changed about play; (c) according to self report, they had used this new knowledge in their clinical practice; and (d) the participants remembered the items on the Test of Playfulness and could use them in describing various aspects of play. This study found that participating in a play research project had been an effective method of professional development. It also highlighted the need for increased awareness of the recent literature on play and the developing role of the occupational therapist in the assessment and intervention of play.

Participation of registered nurses in continuing education

This correlational study investigated the psychological types, learning style preferences, readiness for self-directed learning, demographic and continuing education participation data of 154 registered nurses at two different Southern Ontario hospitals. One hospital was a large tertiary care university-affiliated teaching centre (Cityview) and the other was a smaller secondary care community hospital (Waterview). The instruments used in the study were the PET Type Check, Kolb's Learning Style Inventory, the Self-Directed Readiness Scale (SDLRS), and a Nursing Survey developed by the researcher. Descriptive statistics, crosstabulations and correlational analyses were calculated. The most common psychological types identified among this sample of nurses were extraverted thinking, introverted intuitive and extraverted intuitive. There were no significant differences between the two hospitals. The accommodator learning style was preferred overall, with more nurses at Waterview Hospital preferring the diverger learning style, and more nurses at Cityview Hospital preferring the accommodator learning style. The majority of nurses scored in the average and above average categories on the SDLRS, indicating that they perceive themselves as ready to engage in self-directed learning. At Cityview Hospital there were more nurses in the average and high readiness categories, whereas at Waterview Hospital more nurses scored in the below average category. No significant correlations were found for learning style with psychological type, or for learning style with SDLRS scores. A positive correlation was found to exist between SDLRS scores and each of the psychological types extraverted feelings, extraverted thinking, and introverted intuitive.The only significant correlation for psychological type and continuing education activity was a positive correlation between extraverted thinking types and participation in informal discussion or study groups. Positive correlations were found for SDLRS scores with each of the following continuing education activities; number of hours per month spent reading journals; journal reading; attendance at credit courses; watching videos; using reference texts. Further details of the results are included as well as a discussion of the findings and implications for future research.

What motivates registered nurses to participate in continuing education activities?

The study was undertaken to identify what motivates registered nurses to participate in continuing education activities. The primary questions were whether basic nursing education, employment status, clinical area, and position, as well as readiness for selfdirected learning influenced Canadian nurses' motivational orientations when deciding to participate in continuing education activities. Other individual differences (e.g., age) were also examined. The sample included 142 registered nurses employed at an urban community hospital. Three instruments were used for data collection: the Education Participation Scale, the Self-Directed Learning Readiness Scale, and a nursing survey consisting of demographic questions. Basic nursing education and employment status did not effect motivational orientation or self-directed learning readiness. Clinical area and level of position significantly influenced nurses' decisions to participate in continuing education activities. Motivational orientation had a significant relationship with selfdirected learning readiness. Implications for practice as a result of this study involves program planning and delivery. The identification of the motivational orientations of participants may assist in the development and delivery of continuing education programs that are beneficial, relevant, and address the identified learning needs of participants. Implications for future research also exist in relation to studying different groups of nurses, for example, registered nursing assistants, and investigating related issues, for example, what are the deterrents to participation in continuing education?

Continuing education learning preferences and styles of legal clinic lawyers /

The purpose of this qualitative research was to study the learning preferences and styles of management lawyers who work in Ontario's legal aid clinics. Data were gathered from two sources and analyzed using the constant comparison method. A preand postconference survey provided the principal data on clinic lawyers' learning preferences. Follow-up interviews were then conducted with 3 purposefully selected survey participants to explore their personal learning styles. Kolb's experiential learning theory provided the theoretical framework for discussing personal learning styles. The findings showed a general consistency among the lawyers to learn by listening to lectures and experts. This preference may suggest a lingering influence from law school training. The lawyers' more informal learning associated with daily practice, however, appeared to be guided by various learning styles. The learning style discussions provided some support for Kolb's model but also confirmed some shortcomings noted by other authors. Educators who design continuing education programs for lawyers may benefit from some insights gained from this exploratory research. This study adds to a limited but growing body of work on the learning preferences and styles of lawyers and suggests new questions for future research.

Wellness and balance: perceptions amongst female health care professionals negotiating career, family, and continuing education /

The purpose ofthis study was to explore the perceptions of wellness and bidance amongst female health care professionals negotiating career, family aiul continuing education commitments. Five women who met the criteria of having a family (with children), holding a full-time professional career in health care, and who were presently pursuing continuing education were interviewed. This paper begins with the introduction to the topic of research and the questions to be answered. The review of literature explores the theory and research A^ch precede this study and addresses the surrounding areas of: wellness, balance, multiple roles, stress and continuing education. < This study has assumed a qualitative, phenomenological approach. The data collected through the use of individual interviews were analyzed using a two-part process. Analysis using both (a) methodological interpretation and (b) The Listening Guide method has allowed for the uncovering of major themes, and the portrayal of each participant's unique experience. Some of the major themes which emerged from this research include: wellness as multidimensional and fluctuating, making personal sacrifices, the presence of stress, professional as a vital role, and continuing education as something for me. Perhaps the most significant finding this research has identified is the positive role continuing education can hold in the lives of women already negotiating multiple commitments. The notion that continuing education can act as a means of enhancing perceptions of wellness and balance holds a number of implications in theory, practice, and for future research.

Research in the clinical setting : a qualitative study of the value of play research in the continuing education of occupational therapists.

Occupational therapists have always recognized playas an important part of a child's life. However, until recently play has been viewed as a medium for reaching treatment goals, rather than as an activity that is valuable in and of itself. If occupational therapists think of playas the primary activity or occupation of childhood, then play should be a very important area of focus for paediatric clinicians. In order to assist children to become as independent as possible with play and to have fulfilling play experiences the occupational therapist needs to have a clear understanding of how to assess, set goals which lead towards competence in play, and promote play. Recent play literature has placed importance on play behaviours and looking at the relationship between the child and both the human and nonhuman environment. Believing that play and playfulness can and should be promoted, for children with physical disabilities, requires that therapists learn new assessment and intervention strategies. A new assessment tool, The Test of Playfulness, was developed by Bundy in 1994. It addressed play behaviours and environmental influences. The author, a co-investigator and eight occupational therapists were involved in a playfulness study using this test to compare the playfulness of children with physical disabilities with their able-bodied peers. After the study was completed the author questioned whether or not involvement in the playfulness study was enough of a change agent to bring about transformative learning in order to further the eight occupational therapists' education about play.

Examining and describing professional development and continuing education in the personal training and fitness industry : sites and issues of disconnect

The following phenomenologically oriented study examines and describes the relevance and effectiveness of professional development and continuing education programs for real-world situations of personal trainers. The participants were personal trainers, facility managers, and persons involved in the accreditation process. Data collection took place in 3 phases. The first phase consisted of the participants completing the PUMP Questionnaire, followed by focus groups with personal trainers and interviews with managers. The study's 3 data sets required reduction via a content analysis by question, content analysis by existential categories, and further thematic analysis using the lived relation existential dimension. The discussion contains the salient sites and issues of disconnect between clients, personal trainers, and facility managers and how they might affect the personal training experience. The intergenerational disconnect emphasized between Boomers as clients and Millennials as personal trainers requires further exploration and dialogue and underscores the need for different approaches to content and delivery of professional development and continuing education experiences for personal trainers and managers of fitness facilities.