IOM Break Report: Lifelong Learning

Author: Heather Stringer 2015 marks a very important halfway point in achieving the ambitious goals set for 2010 in Institute of Medicine report on the longer term of nursing, which included eight recommendations for transforming the nursing occupation. Recommendation 6 calls for the nursing occupation to make sure a commitment to lifelong learning, and a various set of groups—including accrediting bodies, schools of nursing, health care organizations, and continuing competency educators—should work together to attain this goal. “In today’s rapidly evolving health care environment, nurses cannot graduate from nursing school and consider it a day dedicated to education [is concerned]” said Sue Hassmiller, PhD, RN, FAAN, senior nursing advisor on the Robert Wood Johnson Foundation in Princeton, New Jersey “They must continue their education and gain clinical competencies, especially since they need nurses who can practice more than just in the acute care setting, but across the entire continuum of care.” While this advice may not provide specific percentages to measure progress like other recommendations, there are clear signs that the IOM report is motivating organizations to prioritize learning for workers at various stages of care. “Setting ANCC standards,” Hassmiller said. For example, in October 2014, the American Nurses Credentialing Center introduced standards for nurse practitioner residency and fellowship programs. These hospital-based programs move nurses from academic programs to clinical settings or, in some cases, between them in several types of clinical settings. Residency and fellowship participants include recent graduates, nurses changing careers inside practice, and advanced practice nurses. “Historically, the quality of residencies and fellowships has varied significantly,” said Dr. Kathy Chappell, RN, vice chairman of the ANCC Accreditation Program and the Certificate Research Institute. “These programs can last as little as eight weeks or as long as a year. Generally speaking, an extended and concentrated stay or fellowship should last at least six months and sometimes up to a year.” To be accredited for residency or fellowship programs, hospitals currently must meet criteria in areas akin to teacher training, measurable quality outcomes, and qualifications of those that design and teach the programs. So far, 4 residency and fellowship programs have been accredited nationally, and Chappell expects the variety of applications to extend over the following five years. “I suspect many organizations are self-assessing to see if they are meeting standards, and the app can be a template for a gap analysis,” she said. “They will address these gaps before applying.”

Interprofessional education

Recommendation 6 also requires health care organizations to offer resources for interprofessional continuing education, which implies that nurses have the chance to learn in collaboration with other health care professionals. In 2010, the ANCC – in collaboration with accreditor colleagues in medicine and pharmacy – began accrediting organizations providing interprofessional continuing education in nursing, medicine and pharmacy. Chappell has seen a big increase in applications for one of these accreditation because the IOM report was published in 2010. There are 18 accredited organizations and this number is anticipated to double by the top of this 12 months.

Education of leaders

Hassmiller stated that the lifelong learning described in Recommendation 6 applies not only to clinical skills but additionally to leadership skills. To provide nurses with more leadership education, organizations akin to the American Academy of Nursing have launched recent programs, including the Academy’s Nursing Leadership Institute. Launched in the autumn of 2014, this program assists nurses in obtaining gubernatorial and federal nominations and while serving on the boards of national community health and community organizations in order that they will successfully obtain gubernatorial and federal nominations. “These are outstanding nursing leaders, and it’s easy to think they’re already trained as leaders, but they would benefit from more knowledge about political appointments,” said Diana Mason, PhD, RN, FAAN, president of the American Academy of Nursing. Mason became aware of the necessity for one of these training when she recently worked with a nurse who was focused on running for a federal commission. But the nurse was a Republican and lacked the connections in political circles to get a letter of support from a Democrat confirming she was bipartisan and will bring a very important perspective, Mason said. “Governors nominate 200 to 300 people, and we realized that few organizations were focused on preparing nurses for state and federal positions,” Mason said.

Online learning

While employers and nurses will likely face traditional challenges to find money and time for lifelong learning, nurse leaders like Pat Polansky consider that today’s RNs have one significant advantage over their predecessors: technology. “With online learning, access to lifelong learning that is relevant to our lives is greater than ever before,” said Polansky, MS, RN, director of program development and implementation on the Center to Champion Nursing in America. “When I was practicing, I found a babysitter who was taking a continuing education course, taught on weekends or in the evenings in the classroom. Now nurses can watch webinars, live streams and log in anytime from their own homes. Online learning is a game changer when it comes to keeping nurses up to date. The increase in availability and interest in online education in recent years is making a difference in patient care, said Joyce Batcheller, DNP, RN, NEA-BC, FAAN, senior vice president and general manager of Seton Healthcare Network in Austin, Texas. “I saw nurses talking about what they were learning online and coming up with ideas based on what they were taught,” Batcheller said. “I also noticed an impact on the interprofessional environment as there was much more dialogue between nurses and doctors. Everyone brings their professional insights and patients win in the end.” Heather Stringer is a contract author. To comment on email [email protected].