1. education
2. distance learning

Sir rnft
CONTINUING PROFESSIONAL DEVELOPMENT
By reading this article and writing a practice profile, you can gain
a certificate of learning. You have up to a year to send in your
practice profile. Guidelines on how to write and submit a profile
are featured at the end of this article.
How to succeed as a lifelong learner
PHC624 Willcox A (2005) How to succeed as a lifelong learner.
Primary Heaith Care. 15, 10, 43-50. Date of acceptance: November 9 2005.
Aims and learning outcomes
Nurses are under pressure: government health
and education policies, Nursing and Midwifery
Council (NMC 2004) regulations, Agenda for
Change and employment requirements all stipulate the need for nurses to maintain their
knowledge and competence through education
(Department for Education and Skills 2005;
Department of Health (DH) 2001, 2005). The
need to be a lifelong learner and to demonstrate
continuing professional development (CPD) has
never felt more urgent. But how can we sidestep the jargon and engage in learning that
really makes a difference to ourselves and our
patients? The aims of this article are to clarify
what is meant by lifelong learning and to focus
on the CPD element for busy nurses working
in primary care. After studying this article you
should be able to:
• Define lifelong learning and continuing professional development.
• Recognise how and why lifelong learning is
important for you.
• Identify the type of learning that you need.
• Organise the factors needed to help you succeed in your learning.
• List the resources available to you• Achieve your learning goal.
Introduction
Lifelong learning (LLL) and continuing professional development (CPD) are terms that are
In brief
sometimes used interchangeably, but they are
different. Try thinking of lifelong learning as
an umbrella; it covers all the facets of your life
and represents all the things you learn. Uke
an umbrella LLL has different 'spokes'; formal,
planned academic learning might be one spoke.
There will be an experiential spoke representing all those things you have learned just in the
process of living, such as how to get on with
people, the consequences of spending all your
money before pay day, and so on. Continuing
professional development is another spoke and
it represents the learning you have done, and
will continue to do, to stay up to date in nursing and to be competent at your job. Just think,
if our learning stopped the day we qualified as
nurses, it would be detrimental to nursing and
to patient care.
We strive for holistic care for patients but
holism aiso applies to us, and CPD is just one part
of our lifelong learning needs. The difficult part
can be finding the time, money and resources to
plan, work on, and ultimately achieve the things
Author
Adrienne Willcox MA(Ed),
BSc(Hons), RNT, RGN, is
Senior Lifelong Learning
Fellow, RCN Institute. Wales.
Summary
This article examines the
concepts and practical
applications of lifelong
learning and continuing
professional development. It
explores the ways in which
nurses working in community
settings can set and achieve
learning goals.
Key words
Lifelong learning
Continuing professional
development
These key words are based
on subject headings from the
British Nursing Index, This
article has been subject to
double-blind review.
TIME OUT 1
Make a list or draw an umbrella with
spokes. What do you want and/or need
to learn? Which of these are to do
with your learning needs as a person
(for example, learning to play a sport
or musical instrument), and which are
professional development needs (for
example, that skill you need to master
or qualification you need for work)?
Online archive
For related articles visit
our online archive at:
www.primaryhealthcare.net
and search using the key
words above.
primary health care I Vol 15 No 10] December 2005 43
lifelong learning
we want to learn, and this is what the rest of this
article will help you to do.
Now do Time Out 1
Why engage in lifelong learning/CPDs?
Benefits to society
The concept of lifelong learning is recognised
as having benefits to patients, the organisation you work for, and ultimately the society
in which you live and work. Lifelong learning
moves us away from the idea that we can only
engage in education at set periods in life, for
instance attending university full time at the
age of 18, District nurses, health visitors and
some school and practice nurses have gained
their Specialist Practitioner qualification and
degree as mature students and as part of their
planned CPD, Lifelong learning benefits society
by preparing and encouraging people to be
enterprising, adaptable and employable citizens
(Scottish Executive 2003). Within the NHS, a
framework for lifelong learning appeared in
the DH document Working together - Learning
together (2001). The vision is one of easy access
to learning for NHS staff, and some examples
of recent initiatives include journal clubs, discussion groups and learning boards v^/here a
different topic is featured on a board in the
clinical area each month. Arguably, the growth
in eLearning is the most dominant and widespread development for CPD in recent years.
This approach is not without critics and raises
issues about the purpose of learning for society.
Is it to provide healthcare staff with skills to
meet management and NHS agendas, the real
drive being for a more productive and adaptable NHS workforce, or should the individual
needs of workers and their desire for self-fulfilment have a higher profile? Does a pool of
well-educated employees mean that they are
more likely to be recruited and retained by the
NHS, or could nurses become complacent about
education because jobs are plentiful and nurses
are in short supply? CPD has the potential to
address these issues through enabling nurses to
improve patient care while enhancing their abilBox 1. Qualities of lifelong learners
(Hull and Redfern 1997)
Innovative in their practice
Flexible to changing demand
Resourceful in their methods of working
Able to work as change agents
Able to share good practice and knowledge
Adaptable to changing healthcare needs
Challenging and creative in their practice
Self-reliant in their way of working
Responsible and accountable for their work
44 primary health care | Vol 15 No 10 | December 2005
ity to obtain their desired post, gain promotion
or engage in work of particular interest to them.
Hull and Redfern identify the qualities of lifelong
learners in healthcare (Box 1).
Benefits to you
Take a moment to think about all the things
you know and can do now that you couldn't
do when you first started out in nursing. Some
parts of your work now might not even have
existed then. Perhaps there were techniques or
tasks you used to do that are now obsolete and
not carried out today. Your ability to learn new
things, and to unlearn old things, is essential to
your job. Continuing professional development
is the means to keep you up to date, safe and
competent as a practitioner. It can keep you
interested and satisfied in your work, and it can
certainly keep you in employment. Developing
yourself professionally can be the passport to
your future career, opening the way to different
jobs or promotion prospects. But maintaining
professional competence can also be a huge
challenge, due in part to what Atack and
Rankin refer to as '.--the continuous influx of
new knowledge in the context of rapidly changing health care systems' (2002: 457), There is
gradual recognition that individuals cannot hold
all the skills and knowledge they need in their
head at one time; 'just-in-time' learning is of
growing importance (Hoyle 2004:21).
Now do Time Out 2
TIME OUT 2
Work through Hull and Redfern's
qualities listed in Box 1, Identify an
example of your work that demonstrates
each quality. How did you learn to do
that? Describe who benefited from your
activities. Make sure you write this down
Of record it in your RCN Learning Zone
portfolio; it could be useful for your next
staff appraisal or Knowledge and Skills
Framework job matching.
Tip: nurses tend to be overly modest so
ask a work colleague to identify how
you have met these qualities if you are
having difficulty
Deciding what to do
Learning needs analysis
How did you get on with Time Out 1 ? Sometimes
immediate or 'gut' reactions can help you to
articulate just what you want, or need. But take
time to think this through carefully because the
time and resources you spend on learning are
valuable, and you won't want to waste them.
Talk though your initial plans with the people
who matter. Do you have the encouragement of
lifelong learning
family or friends for that new hobby you want
to take up? Has an appraisal with your manager
achieved agreement on how to develop your
skills at work? Take a look at the Knowledge
and Skills Framework (KSF) to plan for professional development (DH 2004). The KSF is a
framework for describing a range of healthcare
roles and consists of core and specific role
dimensions. The descriptions of the different
levels within each dimension will help you to
identify what you will need to know or do to
fulfil that role. Sometimes a Learning Needs
Analysts tool can help to clarify your decisions
about what to learn. Your employer may have
one for you to use, or you could ask an RCN
Learning Representative for help (RCN 2005
- see Resources), or see an example from the
TUC (2005).
Planning the next steps
Most plans will need a bit more organisation if
they are to be developed, so now is the time
to write your Learning Plan. It can take many
forms, but it should be flexible enough for you
to add, change or remove parts as your decisions
take shape. You could use an electronic system
such as the action plans in My Portfolio in the
RCN Learning Zone (see Resources), or simply
use paper and a ring binder Your Learning Plan
has three parts:
• Your learning NEEDS, List the knowledge
and skills you want or need to iearn in the
immediate, medium and longer term. Now
put them in order of importance. What are
the priorities?
• Your learning GOALS. These will motivate
you to be successful and they should be
observable, measurable and obtainable. Use
very positive and personalised language
when you write your goals, and set a timescale. For example, I will be a District Nurse
by October 2006 is better than I'd like to be
a District Nurse,
• Your ACTION PLANS. These identify a route
towards particular goals that you might want
to achieve, they demonstrate how you are
developing competencies and highlight gaps
in your learning that you may want to
address. Break big goals down into manageable steps; I'll get my manager's support,
apply to the University, brush up my study
skills while waiting. Add a start date and a
completion date. List any resources you need.
TIME OUT 3
Sorted out what you want or need to
learn? Decided on a priority? Now set
your goals and draw up an action plan.
Be realistic and make them achievable.
or tasks to be done. Re-visit your action plan
often to update it and to add evidence of
completion.
Now do Time Out 3
How and where will you study?
Now you know what you need to learn and
why, so how and where will you study? This is
sometimes referred to as your mode of study in
course literature.
Attendance
It may be that you have little choice in the matter if, for instance, you want to be a health
visitor. You will have to undertake a recognised
programme of studies at an institute of higher
education, and it is likely that your employer and
sponsor have a contract with one particular university or college within the region. The provision of education is fixed, so your task is to find
out what is reguired, where and when, and to
take a look at your lifestyle to see what adjustments are needed in order for you to accept a
place. Can you cope with the travel? Organise
childcare? Balance your life events with terms or
semesters in the academic year? Try to find out
as much as possible before you commit yourself,
and use formal resources such as the university prospectus, and informal resources such
as talking to a current student; together you
will gain invaluable information (Cottrell 2003),
This advice applies if you plan to study a shorter
course, perhaps organised by your employer or
a training company, which also requires you to
attend in person. Attendance mode has many
advantages. You can talk and network with
other students, ask questions directly of the
teaching staff and, for a short while at least, you
can study away from the demands of work and
home. Attending a classroom setting is familiar
to us; it's how most of us went though school,
but that may or may not have been a positive
experience. There are, however, other ways to
learn.
Distance teaming
Studying at a distance also has advantages
and drawbacks that you will need to consider.
It may involve a combination of study modes,
for instance the Open University programmes
use 'blended' learning materials such as books,
audio-visual recordings, face-to-face tutorials
and residential summer schools within their
programmes (OU 2005). Other programmes
deliver paper-based learning materials to your
door, and your learning is entirely at a distance.
The Royal College of Nursing Institute works in
this way, offering diploma, degree and Masters
degree programmes (RCN Institute 2005).
primary healthcare | Vol 15 No 10 | December 200545
lifelong learning
Box 2. The power and the pitfalls of eLearning
eLearning is powerful because it can:
Beware of these eLearning pitfalls:
• Bridge geographical distances
• Reduce the costs of time and travel
• Put the learner, not the teacher, in control
of learning
• Offer interactive learning
• Cater for different learning styles
• Be undertaken anytime, and almost anywhere
• Be used for delivery of programme content,
e-tutorials, e-library access, self-assessments,
submission of assessed work
• Empower learners to communicate with each
other and with tutors, e.g. e-mail, Net-meetings, discussion rooms, blogs (web diaries)
• Blend with other modes of delivery
• Be updated at a speed not possible with
paper-based resources
• Bridge the divides between practice and
academic settings for students
• e-reading is not eLearning
• Material that doesn't account for the needs of
people with a disability or learning difficulty
• Over-use of technological 'whizz-bang' gimmickry
• Dependence on hardware, software and bandwidths that are not available (yet) to many users
• Hidden costs of using your own eguipment, e.g.
printer, to access or produce content
• Time-ownership - are employers expecting you
to undertake even mandatory updates in your
own time?
• Your attitudes - is technophobia or habitual
practice a barrier to your learning?
• Loneliness/lack of discipline in studying without
'classroom' contact
• Anxieties about exposing your reasoning online
to strangers
Box 3. Jenny's Case Study - Part One
Jenny is a praaice nurse, well trained and
experienced in the principles and practice of
vaccination. The practice decides to buy in a
combined hepatitis A and B vaccine, in addition to the single vaccines they already use.
Jenny has not administered it before, and
recognises that she needs to learn about it
before use. She therefore sets time aside to
read the data sheet and the British National
Formulary to familiarise herself with the
indications, contraindications, precautions,
side-effects, dosage, schedule, presentation,
administration and storage of the vaccine.
When Jenny considers herself competent to
use this product, she ensures a Patient Group
Direaion is in place to enable her to legally
administer it. Jenny records what she studied,
the date and how iong it took her, and what
she can now do in practice, in her portfolio.
Her independent study contributed two hours
towards her Nursing and Midwifery Council
re-registration requirements (NMC 2004).
eLearning is expanding, and offers great choice
and flexibility in the range of iearning available,
from very short updates to fuliy accredited academic programmes, eLearning refers to the use
of any electronic media to aid learning, teaching
or assessment. It can be delivered offline by CDRom and online via the Internet, and has even
been delivered by mobile phone (Attwell 2004).
An example of eLearning that supports nurses
in their continuing professional development
and to be lifelong learners is the RCN's Learning
Zone {see Resources). It offers bite-sized chunks
that are interesting, motivating and fun, with
learning organised into sections on personal
development, clinical skills, skills for learning,
together with the ePortfolio that enables you
to record and use your studies. Like any other
46 pnmary health care | Vol 15 No 10 | December 2005
form of study, eLearning has the potential to
offer good, bad or indifferent resources to the
learner, and you will need to judge any eProduct
for its ability to meet your wants and needs. Box
2 outlines the factors to be considered when
engaging in eLearning.
Independent study
The learning needs you identified earlier may not
need formal resources or academically accredited
courses. Perhaps you thought of a practical skill
you should acquire, or a topic you need to know
more about. These could be learned independently, with you organising your own study. See
Box 3 for just such an example.
Now do Time Out 4
TIME OUT 4
So far you have decided what to learn
and how to plan for it But where and
how will you study? Do you have a
choice in this? If not, start to find out
all the requirements so that you can
make practical arrangements and be
confident that these are in place before
starting your studies. If you do have a
choice, make a list of the pros and cons
for each option and reach a decision
about what is best for you.
Factors to help you succeed
Before you get under way with your studies it
is worth spending time on the factors that will
help you to succeed in achieving your goal.
Indeed, not paying enough attention to any single one of these factors is the main reason why
learners fail, drop out, give up or get low marks.
lifelong learning
eLearning is expanding, and
offers great choice and flexibility
in the range of learning available,
from very short updates to fully
accredited academic programmes
Some are about you and how you learn best,
others are about practical measures you can
take to maximise your chance of success, and
some are about you as a person, and how to fit
study into the wider context of your life.
Motivation
People learn best when they are motivated to do
so, perhaps because the subject is interesting,
or the tutor is charismatic or fun. Sometimes
the motivation is extrinsic; perhaps you know
you have to pass a module in order to progress,
and it's this that keeps you going, rather than
the subject of that particular module. Intrinsic
motivation is when the urge to learn something
comes from within, when you have a burning
desire to be able to know or do something,
and it is a very powerful motivation that will
keep you going through the tough times (Quinn
2000). So what's your motivation to learn?
Learning styles
Adult learning theory, andragogy, pays heed to
the different ways in which we learn. By understanding your own teaming style you can select
the courses that you are most iikely to enjoy and
succeed at. By adapting your preferred learning
style you will have access to a wider range of
learning opportunities. For instance, it is generally accepted that we have a tendency towards
being either an active iearner (someone who
likes to wade straight into trying something
new), or a reflective learner (someone who lil<es
to think about what they've learned before having a go). In reality, whatever our tendency, we
can recognise it and deliberately decide to go
against our tendencies occasionally. A reflective
person who wants to learn to swim might therefore decide to trust their teacher and get straight
into the water rather than read any more of their
'how to swim' book. Find out your learning style
in the RCN Learning Zone (in Skills for Learning
you'll find it in You and Your Learning), or in
Cottrell (2003) or in Quinn (2000).
Time management
The skills of managing time effectively will
reward you hugely in both your personal and
professional life. They are arguably the most
important skills you need to study and learn
effectively. After all, most of us learn through
hard work and life experience, not through
primary health care I Vol IB No 10 | December 2005 47
lifelong learning
Box 4. Study skills
i Reading
Taking notes
Summarising
Proposing /refuting an argument
Synthesising
Quoting
Group work
Presentations
Poster creation
Information search and retrieval
Brainstorming
Reflection
Preparation for objective structured
clinical examinations (05CE)
Listening
being a genius. The first skill is to recognise how
you spend your time. Keep a log for a week,
then analyse it. What was planned and what
was unexpected? Be honest, can you identify
any time 'thieves' such as procrastination, poor
planning, interruptions or diversions from what
you should have done? If so, the next skill is
to go back to your goals and plan in the steps
needed to achieve them. Then think about how
to use the time you have effectively so that your
learning, if only for the duration of a course,
is moved up your agenda. Learn to delegate,
to say no, to prioritise and plan your tasks and
time. More help is available in the RCN Learning
Zone (in Personal Development you'll find Time
management), or in Cottreli (2003).
A place to work
You've thought about where to study, but now
it's time to identify a personal space to read,
think, write or do whatever other tasks your
learning requires. For many primary care nurses
this means finding a space at home that you can
use at the time of day when your concentration
is best, whether that is late at night or first thing
in the morning. Avoid a family space such as the
kitchen table if it means that you are constantly
packing and unpacking your books, or will have
your ordered notes 'tidied' by a well-meaning
person. Try to find a space where you can keep
all your things together, somewhere well lit,
comfortable and conducive to study.
Study Skills
This list could almost be infinite but the most
common ones are listed in Box 4. Try ticking off
the ones you feet confident about, then find
out which of the others are needed for your
proposed learning. There is no point in learning
techniques for examination success if you are to
be assessed via a reflective portfolio. You can
brush up on your study skills in the RCN Learning
Zone (Skills for Learning section) or by using The
48 primary health care | Vol 15 No 10 | December 2005
•
•
•
•
•
•
•
•
•
•
•
•
•
Critical analysis
Writing for different purposes and styles
Evaluating
Critiquing others' work
Referencing
Concept mapping (also called mind
maps or spider diagrams) to generate
and organise ideas.
Using IT
Interpretation
Organising ideas and information
Examination techniques
Paraphrasing
Memorising
Calculations
Study Skills Handbook (Cottreli 2003).
Your work-life balance
Primary care nursing is often demanding of you
physically and emotionally, and any learning
should be to the benefit of you and your patients.
This won't happen if you end up burnt out and
exhausted. You will need to balance the needs
of your family and friends with your own needs.
Make sure they understand what your learning
involves, and how they can help you. Build in time
for the things that give you pleasure and that you
find relaxing. And see what your employer can
contribute in terms of study leave. The DH document Improving Working Lives (DH 2005) proposes that recruitment and retention in healthcare
will be improved if the NHS is a more accessible,
fulfilling, family-friendly, flexible and enjoyable
place to work in. There is more information about
your work-life balance in the RCN Learning Zone
(in the Personal Development and Activist Skills
seaions, where you will also learn about RCN
Learning Representatives and how they can help
you in all aspects of lifelong learning).
Paying to leam
The costs of study vary, depending upon the type
of learning you undertake and whether your
employer arranges any funding/sponsorship. Even
if this is the case, take care to estimate any hidden costs such as travel, books, childcare, computer consumables and stationery. Information
on scholarships and bursaries is available to RCN
members (RCN Direct 2005), and these are frequently advertised in nursing journalsNow do Time Out 5
TIME OUT 5
The section on factors to help you
succeed has covered some of the most
important influences on successful
study. Make a list of how you will
address all of those that are likely to
have an impact on your learning.
lifelong learning
Achieving your goal
With all this preparation there will eventually
come the day when you have achieved your
goal and met those learning needs- Just before
the cycle of identifying the next one begins,
take a little time to pause and reflect. You have
worked hard to achieve your learning, so put it
to good use and get the most out of it that you
can. Do Time Out 6 after you have read the second part of Jenny's case study in Box 5.
Box 5 Jenny's Case Study - Part Two
Jenny's learning about the new vaccine
improved patient care and demonstrated
her legal and professional accountability.
But later that year Jenny used this clinical
learning to secure a post as a lecturerpractitioner at a university- The interview
required a presentation on how a learning need had been identified and met,
and Jenny used her portfolio page as
an example. This new post has allowed
Jenny to retain her clinical practice
part-time while opening up new career
opportunities in teaching.
Now do Time Out 6
TIME OUT 6
Think about what you have achieved:
Make sure it is recorded in your
portfolio. Showcase it in your CV
The RCN Learning Zone My Portfolio
will help you to do this. Think about
your personal and professional
development. Can your learning help
with your career planning?
How have you used your learning in
practice? Can it be shared with others
such as your manager and colleagues?
Why not write an article on your
specialist topic for publication in Primary
Health Care? Or disseminate your
learning at a conference or study day?
Conclusions
Lifelong learning refers to all the planned and
unplanned, formal and experiential learning
we acquire throughout life, and for primary
care nurses continuing professional development is an important part of our total learning. The modern context of care demands
that nurses stay up to date and competent in
practice, and there are many official drivers to
this end. In responding to these it is important
not to lose sight of what we are doing it for.
Better patient care certainly, but there also
exist wonderful opportunities to stay moti-
vated, to stretch ourselves, to grow personally
and professionally, and to really enjoy the jobs
that we do. The illiterate of the 21st century
will not be those who cannot read and
write, but those who cannot learn,
unlearn, and relearn.' (Alvin Toffler, Futunst,
cited in RCN Learning Zone, 2005) •
Now do Time Out 7
TIME OUT 7
Now that you have completed the
article, you might like to write a
praaice profile. Guidelines to help you
are on page 50.
References
Atack L, Rankin j (2002) A descriptive study of registered
nurses' experiences with web-based learning. Journal of
Advanced Nursing 40, 4, 457-465.
Attwell J (20041 Presentation at Mobile Learning conference.
Hammersmith, October 19 2004 Organised by www
bizmedia.co.uk
Cottrell S (2003) The Study Skills Handbook. Second edition.
Basingstoke, Palgrave Macmillan Ltd
Department for Education and Skills (2005) Lifelong
Learning. www.Iifelonglearning.co.jk/archive.htm (Last
accessed on August 25 2005.)
Department of Health (2001) Working Together - Learning
Together a Framework for Lifelong Learning for the NHS.
London, DH.
Department of Health (2004) The NHS Knowledge and
Skills Framework and the Development Review Process.
London, DH.
Department of Heafth (2005) Improving Working Lives.
www.dh.gov.uk/PolicyAndGuidance/HumanResources
AndTraining/ModelEmployer/lmprovingV^orkingLives/fs/en
(Last accessed on October 13 2005 )
Hoyle R (2004) What works, what doesn't eLearning Age.
October 20-22, p21.
Hull C, Redfern I ()997) Profiles and Portfolios: a Guide for
Nurses and Midwives. London, Macmillan.
Mursing and Midwifery Council (2004) The PREP Handbook.
London, NMC.
Open University (2005) www.open.ac.iik (Last accessed on
October 13 2005.)
Quinn FM (2000) Principles and Practice of Nurse Education.
Fourth edition. Cheltenham, Stanley Thornes Publishers.
RCN Direct (2005) Scholarships and Grants, www.rcn.org.
uk/members/getinvolved/grantsawards (Last accessed on
October 13 2005.)
RCN Institute (2005) Distance Learning, www.rcn.org.uk/distancelearning (Last accessed on October 13 2005.)
Scottish Executive (2003) Lifelong Through Learning,
Learning Through Life. The Lifelong Learning Strategy
for Scotland Edinburgh, Scottish Executive.
Trade Unions Congress (2005) Learning needs analysis questionnaire, www learningservices.org.uk/extras/tna.doc
(Last accessed on August 25 2005.)
Resources
RCN Learning Zone (2005) www.rcn.org uk/learningzone
Access for RCN members only.
Sections include:
My Portfolio for recording of learning and CV building.
Personal development for time management and career
development.
Clinical skills for interactive learning on nursing topics.
Skills for learning for study skills and your learning.
Activist skills for more information on learning and the role
of the union learning representative.
primary health care | Vol 15 No 10 [ December 2005 49