Rural nurses’ continuing education needs: A U.S. multi-site survey reveals challenges and opportunities

Abstract

Background: Provision of relevant, evidence-based continuing education (CE) is an integral part of maintaining a highly competent rural nursing workforce. Numerous tangible and intangible barriers exist to nurses' participation in CE in rural settings. Major barriers to accessibility and participation in CE for rural nurses include: 1) Geographic isolation, 2) lack of perceived administrative, financial, and/or technological resources and support, 3) lack of time due to workload, inadequate staffing, and/or travel distance, 4) lack of relevance of continuing education topics, and 5) lack of a dedicated on-site nurse educator. Proactive development of academic-practice partnerships is important to support rural care providers regarding CE delivery. The purpose of this study was to assess perceptions of CE needs of nursing unit staff working in a group of health care facilities in a rural region of midwestern U.S. Methods: A cross-sectional CE needs assessment survey was conducted in winter of 2010 with rural health care providers (N=302/1107; response rate 27%) working in rural healthcare facilities (N=40), including rural hospitals (n=10) and long-term care (LTC) facilities (n=30). A well-validated 72-item Likert-type survey was distributed via a secure online university survey platform, and included assessment of 59 CE need areas. Internal consistency reliability was 0.87. Data were analyzed using SPSS software, version 16.0. Results: Descriptive statistics revealed a greater number of licensed practical nurses and nursing assistants working in rural LTC's (27.2% and 62.5%, respectively) compared to rural hospital setting (14% and 15%, respectively). There are a large number of associate degree-prepared nurses (63%) working in the participating rural hospitals compared to LTC setting (8.4%). Respondents' priority learning needs included: 1) Review aspects of medication administration/drug interactions; 2) improve skills in patient assessment (physical/mental); 3) increase knowledge of management of patients with comorbidities; 4) promotion of patient safety; 5) enhance communication skills/teamwork; 6) increase lifelong learning. Student's t tests revealed LTC nursing unit staff reported significantly higher priority learning needs in "manage aggressive behavior (verbal/physical)" (t = 2.044, df = 300, α = .003), "family participation in care" (t= 2.470, df= 300, α= www.sciedu.ca/jnep

Burns education for non-burn specialist clinicians in Western Australia

“…Rural/remote clinicians practice in geographic isolation, express unique learning needs, have less access to professional development and function in clinical environments different to clinicians practicing in metropolitan hospitals and tertiary burn units [7,8]. For many rural/remote clinicians, attendance at specialised courses can be challenging due to the barrier of distance, especially in a state as large as WA.…”

Communication tools and sources of education and information: a national survey of rural and remote nurses

“…Urban-based learning opportunities pose geographical barriers for rural nurses that require organizational support and resources to be overcome, such as paid time, funding, relief staff, and formal requirements or incentives for continuing education [24, 27–30]. Although distance-based learning with synchronous and asynchronous webinars and virtual classrooms reduces the expense and time of travel [25, 31], organizations must still provide support (e.g., paid time or position coverage and back-up).…”

“…[35], and Koessel et al [36]). When studies included LPNs with other types of nurses in rural practice, most examined nurses as a single group rather than examining LPNs separately, and all of the studies considered questions such as needs or barriers to use rather than rural nurses’ use of education or information for practice (e.g., Fairchild et al [30], Carter-Templeton and Wu [37], Hodge et al [38]). Given that the nursing responsibilities and education requirements for LPNs and RNs differ and that LPNs account for over one-quarter of the regulated nursing profession in Canada [1], separate examinations of RN and LPN education and information use are warranted.…”

“…[35], Carter-Templeton and Wu [37], Hodge et al [38], Mills et al [39], and Ortiz and Bushy [40]) or have included multiple settings but have not analyzed outcomes by setting (e.g., Winters et al [24], Olade [29], O’Lynn et al [34], Koschel et al [41]). When studies have compared outcomes across rural practice settings, the outcomes have included learning needs or attitudes to evidence-based practice rather than nurses’ use of education or information (e.g., Fairchild et al [30] and Koessel et al [36]).…”

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