Nurse practitioner continuing education: exploring influences.

PURPOSE: This article introduces the interrelated concepts of nurse practitioner (NP) continuing education (CE) funding patterns, regulatory guidance surrounding NP CE, and its effect on patient outcomes in the United States. DATA SOURCES: A literature review was done by searching online databases: MEDLINE and CINAHL. Searches included review of NP certifying body websites, Institute of Medicine, Josiah Macy Foundation, and the National Council of State Boards of Nursing websites. CONCLUSIONS: The nursing literature supports no connection between required CE and improvement in provision of care to patients, nor does it support improvement in individual provider competence. The funding patterns for nursing and medicine indicate a bias toward biomedical and pharmacological interventions. This type of funding stream may contribute to practice gaps rather than improve them. IMPLICATIONS FOR PRACTICE: Understanding factors that influence CE program availability, plus the choices NPs make regarding mandatory CE, can provide planning guidance. This guidance can help reach the goal of improved patient outcomes and decreased healthcare disparities as a result of CE interventions. NP-specific findings may potentially influence regulatory reform relevant to mandatory CE and maintenance of certification. It is important that NPs recognize existing conflicts of interest in order to make informed program choices.

Effect of a primary care continuing education program on clinical practice of chronic obstructive pulmonary disease: translating theory into practice.

OBJECTIVES: To describe the development and implementation process and assess the effect on self-reported clinical practice changes of a multidisciplinary, collaborative, interactive continuing medical education (CME)/continuing education (CE) program on chronic obstructive pulmonary disease (COPD). METHODS: Multidisciplinary subject matter experts and education specialists used a systematic instructional design approach and collaborated with the American College of Chest Physicians and American Academy of Nurse Practitioners to develop, deliver, and reproduce a 1-day interactive COPD CME/CE program for 351 primary care clinicians in 20 US cities from September 23, 2009, through November 13, 2010. RESULTS: We recorded responses to demographic, self-confidence, and knowledge/comprehension questions by using an audience response system. Before the program, 173 of 320 participants (54.1%) had never used the Global Initiative for Chronic Obstructive Lung Disease recommendations for COPD. After the program, clinician self-confidence improved in all areas measured. In addition, participant knowledge and comprehension significantly improved (mean score, 77.1%-94.7%; P<.001). We implemented the commitment-to-change strategy in courses 6 through 20. A total of 271 of 313 participants (86.6%) completed 971 commitment-to-change statements, and 132 of 271 (48.7%) completed the follow-up survey. Of the follow-up survey respondents, 92 of 132 (69.7%) reported completely implementing at least one clinical practice change, and only 8 of 132 (6.1%) reported inability to make any clinical practice change after the program. CONCLUSION: A carefully designed, interactive, flexible, dynamic, and reproducible COPD CME/CE program tailored to clinicians' needs that involves diverse instructional strategies and media can have short-term and long-term improvements in clinician self-confidence, knowledge/comprehension, and clinical practice.