What are the continuing education needs of nurse practitioners in northern and rural Ontario?

"Health Canada recently announced that the Council of Ontario University Programs in Nursing (COUPN) will administer a $1.5 million fund to support continuing education programs for nurse practitioners (NPs) who work in rural and remote areas in Ontario. COUPN commissioned the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University to conduct an NP continuing education needs assessment study.

"The primary objective of this needs assessment was to determine the perceived continuing education needs of NPs in primary care settings in rural, northern, and remote communities in Ontario. This objective was met in part through a survey of NPs practising in northern and rural southern Ontario;

"Results from the survey suggested that NPs saw continuing education as important in order to maintain their competency. However, accessing continuing education was difficult due to a variety of barriers such as travel, cost, work, and family obligations.

"The three most frequently reported health problems in their geographic areas of practice were: (1) diabetes and related sequelae/complications; (2) cardiovascular diseases; and (3) psycho-social problems. The three client-focused content areas ranked as most important were (1) advanced counseling skills, (2) assessment, diagnosis, and differential diagnosis, (3) drug prescriptions and interactions. As well, the three profession-focused content areas ranked as most important were (1) program planning, (2) community development and mobilization, (3) evidence-based practice. The linkage between client-focused and profession-focused content areas reflects a broad nature of NP practice, namely health promotion, disease prevention, illness treatment, and health maintenance.

"Concerning the best way to deliver continuing education programs or courses, the respondents generally preferred face-to-face modalities. But, those living in remote areas of northern Ontario recognized the benefits of information and communications technologies such as CD-ROM and videoconferencing.

"On the basis of the results of this needs assessment and a review of the literature, a number of recommendations were offered for consideration by COUPN. Three of these recommendations were:

1) Attend to the paradox of an expressed interest in more face-to-face learning opportunities and the financial and geographic barriers to accessing these opportunities. Most NPs prefer face-to-face learning opportunities. At the same time, most of them have access to computers and other communications technologies and often have trouble leaving their jobs because of heavy workload. These problems may best be addressed by using multiple delivery approaches.

2) Consider developing continuing education activities that correspond to the nature of current NP practice - health maintenance, prevention, promotion, and treatment. In particular they need to address the social determinants of health, and the three additional controlled acts designated to RN (EC)s.

3) Consider re-defining the meaning of “course.” This needs assessment and the existing literature suggest that NPs are interested in shorter and more focused, practically-oriented continuing education activities. They report a need for both a) general updates and b) specific clinical- and professional-focused content areas.

From: Suzanne Caty, Kate Tilleczek, Raymond Pong, Isabelle Michel and Sandy Lemieux (2002). Assessing Continuing Education Needs of Nurse Practitioners in Northern and Rural Southern Ontario. Sudbury, Ontario: Centre for Rural and Northern Health Research, Laurentian University.