Diffusing nursing theory through nursing continuing education: knowledge, beliefs, and practices of nursing continuing education providers

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Virginia Polytechnic Institute and State University


Continuing education (CE) is that arm of the nursing educational system charged with the responsibility to disseminate nursing theory to those nurses whose formal education did not include nursing theory. This study examined the extent to which nursing theory was disseminated through CE programs in nursing. Subjects were continuing education providers (CEPs) employed by schools and hospitals who offered state or nationally approved CE programs during the 1987 calendar year. The results of the study were based on responses from 187 CEPs of which 91 respondents (49%) were from schools and 96 respondents (51%) were from hospitals.

Data for the descriptive survey were collected by an investigator developed self-administered questionnaire. The major findings from data analyses follow. CEPs gained knowledge about nursing theory at all levels of formal education with the majority having nursing theory in the masters program. The usual pattern was to have multiple theories as part of several courses in one formal education program. The respondents were most knowledgeable about nursing theories enunciated by Orem, Roy, Peplau, and Rogers. The respondents perceived that nursing theory was essential for selected nursing functions, nursing practices, and for establishing nursing as a profession. Of all CE programs offered during the 1987 calendar year, the total number of programs without nursing theory slightly exceeded the number of programs that included nursing theory. In those programs, nursing theory was presented most frequently as part of a program for a particular nursing intervention, or as a major objective of a clinical course. Level of knowledge was associated with the number of formal education programs, education, and type of employing agency. Beliefs ascribed to nursing practice were related to formal education and were significantly different when categorized by the number of theory courses and by the number of theories presented. Characteristics of a theory that influenced a decision regarding nursing theory were significantly different when classified by the number of formal education programs in which one had nursing theory. Significant differences existed in the CEPs' level and sources of knowledge, beliefs, education, and years as a registered professional nurse when categorized according to program type.

Recommendations in the following areas were made for further research and the diffusion of nursing theory: (a) social systems and adoption, (b) program outcomes, (c) expectations for continuing education providers, (d) reevaluation of nursing theory courses, (e) teaching strategies, (f) instrument validation, and (g) responsibilities of the American Nurses’ Association and the National League for Nursing.