INDEX

1
 CONTINUING NURSING EDUCATION

INTRODUCTION

Education is the process of bringing about desirable change in the behaviour of the learner. It
is a continuous and never-ending process of development of one’s innate powers. Nursing
education is an aimed at producing trained and technically competent nurses to work in
various health care settings and nursing training institutions. Being influenced by the
numerous changes taking place in the society, advancement in the field of medical science
and technology, the scope of nursing practice has widened. The role of nurses is expanded
and extended. This in turn, demand nurses to work in specialized areas of nursing practice.
Further, the public demand for improved health care has placed a challenge before the nurse
to work-up to the level of perfection.

DEFINITIONS

Education is the all-round drawing out of the best in child and man, body, mind and spirit.
MK Gandhi.
Education is the development of all those capabilities in the individual which will enable him
to control his environment and fulfil his responsibilities.
John Dewey.
Education is self-realization and service of the people.
Guru Nanak.

CONTINUING EDUCATION.

 Continuing education is an ‘educational activity’ primarily designed to keep the

registered nurses abreast of their particular field of interest and do not lead to any
formal advanced standing in the profession.
 Continuing education: includes all of those educational activities or learning activities
that occur after an individual has completed his basic education.

According to American Nurses Association

Continuing education consists of planned leaning experience beyond a basic nursing
educational program. These are designed to promote the development of knowledge skills
and attitude for the enhancement of nursing practice; thus, improving health care to the
public.
CONTINUING NURSING EDUCATION IN INDIA
Bhore Committee (1946) and other committees recommended the need for CNE for the
advanced study and career development for trained nurses (TNAI,2001)
- The 27th world Health Assembly in 1974 – called Member States’ to consider as a
matter of urgency.
- The development of national systems of continuing education for health professionals,
based on national and local health needs and demands, integrated with healthcare and

2
 educational systems, with full utilization of the resources of universities and schools
of health personnel.
 The promotion of systems approach in educational planning for continuing
education and the periodic assessment of the quality of performance of health
personnel in developing preventive and curative healthcare.
- Government of India (GOI) and World Health Organization (WHO) has set-up
‘department of continuing education and research centre at Raj Kumari Amrit Kaur
College of nursing, New Delhi.
- GOI established a chain of Health and Family central, regional and state under the
Child Survival and Safe Motherhood program.
- India population projects helped to strengthen infrastructure and facilities in the
existing in-service training centres in India. (ANS 2005)
- 11th and 12th Five-year plans.
 High Power Committee (1987) on Nursing was appointed by the GOI, MOHFW.
The Committee recommendations:
- Each Nursing person must attend one or two refresher courses every year State and
Centre to have budgetary provisions for continuing education.
- State to have definite policies for deputing 5-10% of the staff for higher studies.
- Compulsory higher studies after five years of service. (TNAI, 2001)

Recommendations for Strengthening Nursing and Midwifery

 Strengthening nursing councils

 Guidelines, standards and accreditation
 Continuing education system
 Practicing registrations that are applied
 Lifelong learning culture
 Needs to continue existing publications and need for National Continuing Nursing
Education Journal.
 Develop Models (inter- professional collaboration, measure the cost- effectiveness of
education and training)
 Effective networking and partnerships with organizations and communities of practice
making use of new technologies and other mechanisms. (WHO, Strategic directions

NEED FOR CONTINUING EDUCATION IN NURSING

“In sandy soil, when deep you delve, you reach the springs below; The more you learn, the
freer streams of wisdom flow” - Thiruvalluvar

Nothing is permanent in the universe. Everything would undergo a change either for worse or
for better. If we do not grow in knowledge and perception, our ideas shrink so that we were
reduced to mere frogs in the well. It is only education that enables and empowers one to meet
the emerging challenges as well as to develop the vision and meaning in life.

 To ensure safe and effective nursing care.

3
 To need health needs of population.
 To update the knowledge of the nurses and prepare them for meeting the challenging
roles.
 To help in career development.
 To develop wise leaders and competent practitioners.
 To recognize current social changes and to foresee the future ones.
 To help the person to acquire specialized skills and meet technologic adjustments.
 To develop clinical specialists for direct care and for teaching and consultative role to
help students and staff nurse to reach higher levels of competency.
 To prepare the nurses for research.
 To full-fill the requirement of a high degree of skill, knowledge, competence and
educational preparation.
 To aid in additional preparation for position that nurses are already holding or to
prepare them for other positions.
 To provide and prepare faculty who see continuing nursing education as a personal
responsibility as well as professional and university responsibility.
 To develop the practicing abilities of the nurse.
 To recognize the gaps in the knowledge of nurses.
 To improve the communication between the participants, faculty community and
health sector.
 To test the participant ability to do formal academic study.
 To shape or support university education policies and practices.
 To ensure the quality of education.
 To maintain the academic standards.
 To meet the educational requirements.

FUNCTIONS OF THE CONTINIOUS NURSING EDUCATION

 Leads to improved professional practice.

 Aids in updating knowledge and skills at all the levels of the organization.
 Keeps abreast of the latest trends and development in techniques.
 Equips with knowledge of current research and developments.
 Helps in learning in new knowledge and maintain old competencies.
 Develops interest and job satisfaction amongst the staff.
 Develops sense of the responsibility for being competent and knowledgeable.
 Creates supportive environment with opportunities for growth and communication.
 Helps in adjusting to change.
 Aids in developing leadership skills, motivation and better attitudes.
 Encourages in achieving self-development and self-confidence.

4
FEATURE OF CONTINUING EDUCATION

 Unified approach: All the institutions agree to a common definition of continuing

education.
 Relationship with other systems: Multidisciplinary approach from all fields of
health care should be made available for best results.
 Comprehensiveness
 Relevance in planning: well planned and organized content course
 Appropriateness is implantation
 Evaluation of program effectiveness and participants growth
 Competent people handle the responsibility of conducting the program.

PRINCIPLES OF CONTINUING EDUCATION

 Provision for school and nursing faculty involvement in planning and teaching the
continuing nursing education courses tends to maintain high educational standards
for the program
 An adequate staff is essential to planning, implementing and evaluating a program
which is based on learning needs and which has an impact on the quantity of nursing
care provided.
 Staff services are required with sufficient qualities and numbers to implement the
planned program.
- Advisory
- Secretarial
- Administrative
- Supportive
- Assistance with research, publicity, evaluation, tools, data analysis and computer
programming
 Continuing nursing education program maybe decentralized (i.e. faculty of an
academic department would initiate, plan , implement and evaluate its own program
of continuing education) or centralized (i.e. a separate department of extension
division is responsible for the continuing nursing education program for the entire
university) or maybe a combination of both.

ELEMENT OF CONTINUING NURSING EDUCATION

 LEARNER: Learner is identified as a nurse as a person and as a citizen All three

aspects of lifelong learning is in identified:
- Diversity as a part of of learning process which contributes to the development of
the individual.
- The learner plays different role in his life.
- Self-direct learning.
- To follow the concept of lifelong learning and encourage nurses to pursue the
same
- Being aware of the sources of information

5
 - Educator should act as a role model.
- Creative teaching is essential.
- He/she must to show interest and concern for every member of the class.
- Being aware of learning difference among individuals.
- Play multiple roles: guide, motivator, evaluator, administrator, etc.
- Help learner to discover new approaches to solve the problem.
- Instil confidence and adequacy in students.

FORMS OF CONTINUING NURSING EDUCATION

Continuing education programs can be formal and informal, in service or outside the organization.
India it is not mandatory for all registered nurses to undergo CEs in specific areas for getting
relicensure.But in Kerala, it become mandatory to undergo CEs for reregistration.Journal clubs, ward
libraries, discussion forums, online certification programs, case report studies are kinds of continuing
education programs and informal learning includes self-learning, subscribing to journals, etc.
Formal and Informal
Formal
• Staff development programs
• Short term courses related to professional areas
• Recognized forms of post-secondary learning activities
• Degree credit courses by students
• Under degree career training
• Work force training
• Formal personal enrichment courses
• Experimental learning as applied to problem-solving
Informal
• Self- direct learning
• Online certification programme
• Case report studies
THE PROCESS OF CONTINUING NURSING EDUCATION
• Continuing education must achieve coalition between nursing, medicine, dentistry
and other health care fields in the development of new structures for administration and
financing. Interdisciplinary program must be established to avoid duplication of effort, time
and money as well as to assist in the creation of team approach to health care.
• It is common belief seen among nurses that they feel their education finishes when
they complete the basic nursing program. Once a nursing always a nurse. But with fast
changes in medical technology nurse has to keep updating her knowledge. Continuing nursing
education program should be planned on regular basis.
• While planning CONTINUING EDUCATION OR IN- SERVICE EDUCATION
the followings steps needs to be followed:
1. Identify the learning needs of the nursing person.
2. Setting goals and defining objectives.
3. Planning and organizing course and designing
4. Learning experience
5. Establishing a workable budget.
6. Implementing plan of teaching.
7. Evaluating the program.
8. May restart the process.

6
 1. Identifying learning needs
To identify the learning needs of the individuals survey, slip technique (writing opinion on a small
piece of paper) meeting, skill assessment studies, interviews, consultant meeting, achievement test
maybe used. The need maybe individual, organizational or community.
2. Setting goal and defining specific objectives
It is important to establish goals/purpose and define the specific objectives, which will give direction
in planning and assist in the determination of appropriate objectives. They should state on behavioral
terms and serve different factors.
3. Planning and organizing course and designing learning experiences
Planning and organization is the relation of efforts and capacities of individuals and groups engaged
upon a common task in such a way as to secure the desired objective with the least friction and the
most satisfaction for whom the task is done.
PLANNING PROCESS
Nurses identify most closely with planning for client care, but the principles of planning for client
care, but the principles of planning apply to wide variety of situations various approaches maybe used
in planning for continuing education.
Establishing goal, the purpose or philosophy of the organization: purpose gives direction in planning.
It identifies the reason for existence. Purpose is based on learning needs and societal needs, so it has
to be reviewed from time to time in estate as appropriate.
The planning formula: It provides a framework for program planning:
- What is to be done?
- Get a clear understanding of what your unit is expected to do in relation to work assigned to
it? Break the unit's work into separate jobs in term of the economical use of men, equipment, space,
materials and money you have at your disposal.
- What is it necessary?
- When breaking the unit into separate jobs, think of the objectives of each job, this may
suggest alternate methods or the possibility of eliminating parts f jobs or whole jobs.
- How it is to be done?
- In relations to each job, look for better ways of doing it in terms of utilization of men
materials, equipment’s and money.
- Where is it to be done?
- Study the flow of work and the availability of the materials, equipment’s and best suited men
for doing job.
- When is it to be done?
- Fit a job into a timetable schedule that will permit the maximum utilization of men, materials
equipment and money, and the completion of the job at the wanted time.
- Who should do the job?
- Determine what skills are needed to do job successfully, select and train the man best fitted
for the job.
Establish goals and objectives: planning and moves towards goals which are significant and
realistic, which can be attained. An objective is specific; it is a desired end or accomplished to be
sought.
- Objective:
- To assist the nurse identifying and meeting current learning needs and those needs generated
by changing professional practice.
- To encourage the nurse to identify and influence societal change which have implications for
nursing and to modify practice accordingly.

7
- To promote the development of leadership potential for nurse.
- To identify nursing problem and in seeking solution to them.
- To develop varied teaching methods and for extending nursing knowledge and competency.
- To facilities return to practice.
- To assess the health needs of nurses, hospitals and community to plan, implement and
evaluate education program in hospitals and health facilities.
- Determining needs and priorities (the course of action required to meet the specific objective):
- Assessment of need the will be done by survey, through mailed questionnaire, interview
formal and informal discussions with participants (feedback) and checklist. After assessing the need
of prioritization of need has to be done.
4. Assess the available resources for establishing the program:
- Careful assessment of the way and means to meet the established program goals. Faulty,
finances and facilities maybe seen as the major resources required for a continuing nursing education
program.
- A board survey of major resources is necessary to the total Continuing education program and
a more detailed assessment for any specific course or activity.
5. Plan the budget operate for the program: separate budget is required for each specific
activity and each individual offering is expected activity and each individual offering as expected to
be self – supporting. Budget requires ascertain all the anticipated cost of the offering.
• Selection of resources: Resources are categorized as financial resources, human resources,
facilities, equipment and supplies.
6. Implementing the program: The program must be implemented as per the set objective and the
resources available:
- Develop the agenda
- Prepare correspondence to guest speaker
- Conduct the education program
7. Evaluating the program: Evaluation must be done at the end of the program to identify the
successful implementations of skills and questionnaire, pre and post- test and audio or video tapes.
• Evaluation is a process of finding out how the development or training process has affected
the individual, team and the organization.
• Evaluation is a value judge on an observation, performance test ‘or indeed any data whether
directly measured or inferred.
EXAMPLES OF CONTENT AREAS FOR CONDUCTING CNE
• General programs
- Nursing process, Intravenous injection, Communication, Ethics
• Hospital specific program
- Maternity, Paediatrics, Surgical, Orthopaedics.
• Area specific program
- CVP care, Neonatal CPR, Ventilator dialysis
ADULT LEARNING
Introduction
• Adult learning is the practice of teaching and educating adults at workplace during in service
education program. The field of adult learning was introduced by Malcolm knowles. It is a new area
of study which involves understanding how adults learns best as compared to children and teens team.
Adult education is a normal education is a normal and informal instruction and aid to study grown-up
people. Effort are made towards the self -development of the people who takes initiative to solve day-
to – day life problems.

8
• Malcolm Knowles (1978. 1990) a pioneer in the study of adults learning observed that adults
learn best when:
- They understand why something is important to know or do.
- They have freedom to learn in their own way.
- Learning is experimental.
- The time is right for them to learn.
- The process is positive and encouraging.
Need of Adult Learning
• To enlarge the cultural span of the individuals.
• For healthy reaction and relaxation. Properly planned program of social education will be
provided.
• Social efficiency and cooperation.
• Economic betterment and self- sufficient.
• For promotion purposes.
• For skill development.
Philosophy of Adult Education
• Adult education does not imply only to make adults literate. In fact, it means to educate to
total personality of adult literacy is of fundamental importance for the all – round development of the
country. We make them literate, i.e. in other words we help them to acquire command over the tools
of knowledge or reading , in acquiring this command, we strive to educate them into economic, social
and political problems of the day in order that they maybe come intelligent citizens for taking right
decision when they are faced with a number of alternatives. If they fail to acquire this skill, the mean
and self-centred people will exploit them for their own interests. Consequently, the demand s will fail
and will yield place to dictatorship.
• From above it is clear that the purpose of adult education is not only to impact bookish
knowledge. In fact, it aims at the education of the total personality of the adult. This will possible only
when we try to develop in them various type of skills with a view to make them successful and
socially useful members of the society. We have to help the adults to acquire useful knowledge in
professional, political, economic and social spheres. The main philosophy of adult education is need
based and adult education is based on the prior experience and knowledge.
Scope of adult learning in nursing
There are rapid scientific and technological changes which have greatly affected the learning process
of individuals. The purpose of adults learning is improved one's competency and knowledge due to
the following factors:
• Changing social trends: As the trend is changing at a faster pace it helps to keep an individual
updated with the new technology.
• Population mobility: it helps the migrating population to adapt themselves with the new trend.
• Changing role of hospital: The hospitals are not only concerned with the providing medical
treatment they are also engaged in other activities like research. This helps the individual to take-up
new challenges and roles.
• Health statistics: Adult learning helps in updating and individual’s knowledge regarding
various health related aspects, e.g. morality, morbidity, crude birth rate, specific rates, and other rates
and ratios.
The scope of adult learning in nursing practice is very significant and nurses are committed for
lifelong learning to themselves and it needs to be continued throughout the professional life. If the
nurse lacks motivation in learning new concepts, she will continue practicing the old trends in nursing
practice which are supposed to change with time and social trends.

9
CHARACTERISTICS OF ADULT LEARNING
Malcolm knowles identifies following characters:
• Adults are autonomous and self- directed: They need to be free to direct themselves, their
teacher must actively involve adult participants in learning process and serve as facilitators for them.
• Adult are goal oriented: As the adult want to attain, sense of apprentice adult learning.
• Adult have accumulated a foundation of life experiences and knowledge that may include
work related activities family responsibility and previous education
• Adult are relevancy orientated: so, they must see a reason for learning something, every
individual has their own personal and professional objectives by directing them towards these
objectives.
• Adults are practical; focusing on the aspects of a lesson must useful to them in their work.
They may not be interested in knowledge for its own sake. Instructions must tell participants
explicitly how the lesson will be useful to them on job.
• Adults need to be shown respect: Adults are people with years of experience and wealth, have
established values, believes and opinion. Hence, they need to be respected.
• Adults tend to have a problem centered orientation to learning: Emphasize how learning can
be applied in a practical setting. Use case studies, problem, solving groups and participatory activities
to enhance learning.
• Individual difference among people increase with age.
• Self- direction: Adult have a deep need to be self- directed and motivated to have effective
learning.
PRINCIPLES OF ADULT LEARNING
• Needs assessment.
• Safety in environment and process.
• Sound relationship between teacher and learner and among learners.
• Sequence of content and reinforcement.
• Praxis, which mean action with reflection or learning by doing.
• Respect for learner as decision- maker.
• Involve cognitive, affective and psychomotor aspects of learning.
• Immediacy of learning.
• Clear roles and role development.
• Teamwork and use of small groups.
• Engagement of learner in what they are learning.
• Accountability how they know.
IMPORTANCE OF ADULT LEARNING
• Too many people think that because they have attained a certain age, they are too old to be
educated. This is not true; as long as you are alive, there is still a lot that you can achieve. Studying
might be tough, but many adult education programs take that into consideration.
• Getting a higher education is never a bad idea. The latter years still count for something.
• By the content or complexity of an adult education program, you can tell if it is something
you can do or not. However, if you are the type who really wanted to do that course, you would not let
it make any difference to you if it were complex or not.
• Sometimes you lack a diploma can hold you back professionally, at the time adult learning is
very importance.
• Adult learning helps in updating the knowledge.
• It helps in improving professional growth and also in productivity.
• It helps in maintaining the interest during the work period.

10
FACTORS/ELEMENTS THAT INFLUENCE THE ADULT LEARNING

• Preparing the learners: If the learners are well prepared for the adult learning then it will be
easy in conducting the adult learning.
• Climate setting: The environment and the physical set-up should be appropriate so that it can
be done effectively.
• Mutual setting: Sometimes for particular learning topics help of another department Is also
needed. So, in that case it should be managed properly. For example, if the learning program is
decided to teach on projector and by use of other machines, instruments then there should be in the
Collaboration of the technicians.
• Identification of learning needs: As the aim of adult learning is to improve the knowledge in
that field in which learner is no efficient but need to be efficient, and learning is no use in one's
profession. Then that learning is not fulfilling the objectives of adult learning.
• Formation of learning objectives: Before the adult learning there should be setting of the
objectives so that effectiveness can be maintained.
• Learning plan design: Learning plan of teaching makes the teaching program fruitful and
decrease Tue chance of time wastage.
• Learning plan execution: For every making learning plan execution is must, because it shows
that learning plan is appropriate or not. so that after implementing the plan there should be no
hindrance in learning and teaching process.
• Evaluation: Evaluation is done for checking the effectiveness of the teaching- learning
program. So if it is not performed properly, then it is difficult to assess the extent of learning by
learners.
RESEARCH IN CONTINUING EDUCATION
• Research is searching for the facts or truth. Research in continuing education (CNE) is
broader in scope which gives insight to the subject matter. Research in this area is often ignored and
does not seek must importance. The emergency of new knowledge and changes in all the fields
demands one to update him on her in order to be an effective nurse.

IMPORTANCE OF RESEARCH IN CONTINUING EDUCATION

• Professionalism: As by the researches, we get recognize the need to extend the base of
nursing knowledge as part of professionalism responsibility and endorse scientific investigations as a
way to achieve this objective. And by providing that knowledge in the continuing education one can
improve the professionalism.
• Accountability: Research improves the scientifically body of knowledge and critical thinking,
and so by continuing education the accountability can be improved and mentioned.
• Decision- making practice: New standard are established by the researches only. And
exploring the new researches in continuing education helps in the establishing the decision- making
practice.
- The ultimate goal of research in continuing education is to improve practice of by
practitioners so that services provided will be maximally effective. A profession seeking to enhance
its professional stature strives for the continuing development of a scientific body of knowledge
fundamental to its practice.
• Evidence based practice: It help in encouraging for the evidence-based practice.
• Updating with current issues: By exploring the research studies during continuing education
the learner become updated with current practices and issues.

11
THE ROLE OF DIRECTOR OF CONTINUING NURSING EDUCATION

The main challenge confronting the director of continuing education is to develop intensive and
pragmatically oriented courses and workshops which will measure up to the university’s standard of
educational excellence.

The ten specific roles of the director of continuing education:

• Adventurer: The director must give free reign of her imagination. She/he should search
targets and track down the non-obvious.
• Mover: The director should be ambitious. Should be open minded, concerning new ideas.
• Actor: The director's real concern that what she/he is doing benefits everyone involved can
spell out the difference between rejection and ace in behaviour on the part of the learner.
• Prophet: the director must have ability to gauge the winds in change, set his/her activity
accordingly and assess participant needs and restless to learn.
• Student: the director involved in continuing education for nursing should acquire knowledge
of social psychology and learning theory with special reference to adult learning and develop skill in
leadership and decision making, i.e. the director should continue own education through courses,
workshop, reading and on the job training.
• Specialist regarding the customer: The nurse participants hold the destiny of a continuing
education service can try to please her public is in to climb into their skins and their situations and
attempt to view the programs from their points of view.
• Facilitator: The most important task of the teacher in continuing education is to facilitate self-
directed or mutual learning. In- depth knowledge of specific subject is not nearly as important to a
director of continuing educational as to a teacher in undergraduate or graduate program in nursing.
• Delegator: The director of continuing education cannot be all things to all people, nor can she
have all of the knowledge and skills necessary for successful implementation of continuing education
programs.
• Compassionate peer: The director must be surrounding board for staff and participant
problems and become a leader in the most comprehensive meaning of the word.
• Evaluator: The director must take leadership in promoting staff evaluation, Participant
evaluation and program evaluation.
BENEFITS OF CNE
• Professional: Change is knowledge skill and attitude.
• Personal: Increased job satisfaction and better patient care
• Organizational: Better performance and quality patient care.

SUMMARY
Continuing nursing education is a means of broadening the scope of knowledge of the individual;
thereby improving the educational background and giving self – satisfaction or enhancing the earning
potential. It helps in keeping pace with the changing patterns in health education by adding new
information. Continuing education is being practiced in several nursing institutions in the country,
some of them having a separate department for continuing nursing education which helps the nurses
to keep them update of the recent advancement in health science.
CONCLUSION

CNE bridges the gap between knowledge and demand of service, research and practice, educational
ideals and reality of clinical setting, employees’ capabilities and job demands.

12
RESEARCH FINDINGS
Challenges in nursing continuing education: A qualitative study
BACKGROUND
Nursing continuing education with development of knowledge, skill, and attitude results in
improvement of nursing activity, and thus improves the health care in the society. If the education is
not planned and implement properly, it affects the patient care. This study was designed to explore the
challenges of nursing continuing education in Isfahan University of Medical Sciences hospitals.
MATERIALS AND METHODS: The research was conducted from April 2012 to February 2013 in
Isfahan, Iran. The sampling was begun with purposeful method and continued with snowball method.
Thirty-nine participants were selected among the nurses of Alzahra, Kashani, and Noor hospitals,
nursing and midwifery faculty, continuing education center, and the vice-chancellery for treatment.
The participants were both learners and planners of continuing education program. In this descriptive
explorative qualitative research, we interviewed 39 participants in five focus group and five individual
interviews, until data saturation was achieved. We used semi-structured interviews and field notes for
data gathering, and members checking, triangulation (data and method), peer debriefing, and peer
review to increase the strength of data. Data were analysed with thematic analysis method that was
proposed by Broun and Clarke in 2006.RESULT: Data analysis produced 175 initial codes, 8
subthemes, and 5 main themes. The main themes included: Learners related factors, teachers related
factors, educational process related factors, inadequate facilities, and defective evaluation.
CONCLUSION: According to the results, we need to revise the educational process in nursing
continuing education. To achieve this goal, we need a team for needs assessment, planning, and
evaluation. In addition, we must pay attention to educators’ and learners’ issues.

Evaluating transfer of continuing education to nursing practice

ABSTRACT
BACKGROUND:
The nursing profession needs solid evidence of the important contributions that continuing education
(CE) makes to nursing practice change. We analyzed nurses' intent to change practice, actual practice
change, and examples of practice change after completing CE courses of differing types, topics, and
geographic locations.METHOD:A retrospective, mixed-methods study design was used to assess
quantitative and qualitative survey data gathered upon completion and within 1 year following
completion of 16 different CE courses.RESULTS:A large majority of nurses reported positive intent
to change practice (88.6%) and actual practice change (89.1%) following participation in the CE
courses. Qualitative analysis revealed four themes related to types of practice change, including
Becoming Certified, Improved Leadership, Enhanced Role Performance, and Educating or Mentoring
Others.CONCLUSION:CE can positively influence nursing practice change and lead to broader
organizational improvements. 

BIBLIOGRAPHY
1. Sudha R. Nursing education: Principles and concepts. 1st edition. New delhi; Jaypee brothers’
medical publishers (p) ltd: 2013. P. 217-223.
2. Jaspreet K. S. Comprehensive Textbook of Nursing Education. New delhi; Jaypee brothers’
medical publishers (p) ltd: p. 316-328.
3. Neeraja K.P. Textbook of Nursing Education. New delhi; Jaypee brother’s medical publishers
(p) ltd: 2013. P. 387-394.
4. Bastable SB. Nurses as Educator, Principles of Teaching and learning for Nursing Practice.
Second Edition, Published by Jones and Bartlett publisher,

13
14