Importance of Lifelong Learning and Evidence-Based Practice in Nursing

With reference to current relevant literature, discuss the importance of both lifelong learning and the ability to use evidence/research-based practice in your professional development as a nurse.

Professional nurses obtain their qualification and their registration as evidence of competence, knowledge, skills and ability to render safe and effective nursing or health care thus certified fit to practice. However, there are many challenges due to advancing technology, economics situations and multifaceted nature of the health care system which require competent, dedicated and motivated workers. Nurses must therefore avail themselves to the learning opportunities to meet up with the current standards through lifelong learning (McMaster et al, 2018). In fact, nursing is part of the professions changing rapidly in complexity and technology (HealthStream, 2017) a habit of lifelong learning for nurses is therefore necessary (IOM, 2011). An experienced nurse must be ready to move her traditional practice to one that is steeped in current evidenced based practice. Evidence based practice involves steps which are easy to learn and teach but could be challenging (McFadden, 2009). Nursing is a profession that entails great skills and close contact with the patients in a rapid changing technology. In view of the delicate position occupied by the nurse one cannot afford dealing without knowing and updating himself with the rapid transformation and renovation that go on every time. Therefore, a nurse must endeavour to keep abreast of these development by regularly updating himself to be current and relevant in the profession. Therefore, the aim of this essay is to discuss the importance of lifelong learning and the ability to use evidence-based practice in my professional development as a nurse. Likewise, to be discussed is my preferred learning style according to Peter Honey and Alan Mumford (1968), by assessing my strengths and weaknesses. Patients management has gone beyond the routine administration of tradition techniques and general practice to individualization of treatment based on evidence-based practice. Issues in patient’s management can be resolved by inquiry through information technology. Development and acquisition of new skills and knowledge is possible through lifelong learning of evidence-based practices. Yet, because of the flexibility of human nature, what may have worked for patient A may not be applicable to patient B occasionally which may be due to patient’s desire or the expertise of the nurse. This brings about some limitation in application of some evidence-based practice in all cases as many factors may have to be considered. One must be aware what evidence-based practice is not as he goes on in the profession and the ethical issues in its application. Yet, there are many benefits of lifelong learning and evidence-based practices achieving better outcome in patient’s management when combined with the nurse’s experience and the patients desire. Nurses must continually get involved in continuing education which can be in various forms either as in-service learning, self-directed learning, attending professional courses and conferences despite the tight schedule of the profession. These again are affected or influenced by the individual skills and some factors like ambition and career goals.

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According to Salcido (2013), lifelong learning has been described as continuous, voluntary, and motivated by personal desire for knowledge for professional or personal reasons, mainly for personal and professional development, but also competitiveness and employability. Lifelong learning is defined by the three key components which are an understanding of evidence-based health care and critical appraisal, good knowledge of informatics and literature search and retrieval strategies, practice-based learning and improvement methods, self-evaluation which are knowledge driven (Macy Foundation, 2010). The main goal of lifelong learning is to enable health professionals to be up to date with the rapid development of evidence-based information. Lifelong learning is an essential part of professionalism for health care professionals (Novak et al., 2014). Lifelong learning entails the ability to deal with issues through inquiry, seeking resources, and independent/continual assessment of one’s own learning needs. Lifelong learning is significant to acquiring and building up knowledge and skills in nursing. Continuous learning is essential in nursing to remain current on trends, practices, and the newest treatments. There must be an environment to support and promote the educational growth for advancement in the nursing profession. Nursing expertise is basically rooted on evidence-based practice. In clinical practice of nursing, success in research and experience depend on evidence-based practice and lifelong learning both of which are essential tools in health care service delivery (Eason T, 2010).

Learning is behavioural change that occurs through action or experience according to behavioural theory. It is also a series of activities in which one relates new thought or idea to his previous experiences to have insight as defined by the cognitive theory (Tummons,2014). According to Laal, there are various forms of learning which include formal learning occurring in an organized structure that may be formally recognized. Non-formal learning occurring mostly in workplaces acquired as skills but not actually designated as learning. Then, the informal learning occurring from daily activities gained as experiences. To be a good learner you must be dynamic in research, knowledge seeking and communication. (Laal, 2011). Learning has two main conceptions. The first projects learning as an essential continuous process that may not have an objective, but it is useful. The second projects learning as functional for specific purpose in a disciplined structured pattern (UNESCO, 2016). This was re-emphasized by Alsop that learning occurs in two forms; incidental learning experience and the learner having a structured educational experience which can be by formal or informal approach (Alsop, 2013). One of the driving forces in lifelong learning is to appreciate learning and achieve one’s desired goals. The desired result is to improve oneself and gain the trust of the society. However, the process is hindered by inadequate time, stress and fatigue and routine activities (Qalehsari, 2017). They also noted that some notions which influence lifelong learning include the person’s intelligence, spirituality, the physical and mental capability. Essential attributes that a learner must have include an inquisitive mind, taking new initiatives, good interpersonal and group relationship and skills (Candy, 2000 in Alsop, 2013).

There are different and sometimes unique way by which students learn and these affect their performances. These are what the different learning theories try to explain. The behavioural theory promoted by Pavlov and Watson (1927). They emphasized classical conditioning in which the person reacts to the environment as demonstrated by his dog experiment. Skimmer on the other hand emphasized operant conditioning. Learning through this theory is brought about by reinforcement or repeated action (Gould, 2009). Motivators that improve behaviourism could be extrinsic like promotion, salary increase or social like wide acceptance or approval by colleagues and admiration. The fear of punishment is another factor. The changes that come about in behaviour due to the extrinsic motivator may be temporary or short lived once the reward has been obtained. This may not be too good in a nursing in a nursing profession as the experienced gained must not be forgotten in one’s lifestyle. Yet a nurse learns by repeated actions reinforced by one’s experience over time.

The cognitive theory on the other hand uses head reasoning. Learning is achieved by processing information through organization and assessing relationship between different pieces of information. For an action to be carried out, the information must be interpreted and processed. Therefore, previous experience must call to play. Learning from the cognitive approach is a change in the way events are perceived, organised from experiences to have an understanding. Learning is achieved through insight. Kochler emphasized this through his “Sultan the chimpanzee” experiment on retrieving banana outside its cage with a stick. He demonstrated that the material to solve the problem has always been present but not recognised until the relationship was established. Motivation is derived intrinsically through self-satisfaction. Bruner and Ausubel (1963) built on the work of Piaget that new learning develops on previous learning with understanding and meaning. Knowledge therefore must be structured and organised. This kind of knowledge can easily be retained and applied as personal efforts have been put into it. Ausubel emphasised meaningful reception learning which means one acquires new knowledge which is linked to existing knowledge that can easily be retained and applied. Bruner on the other hand emphasised on discovery learning in which the learner discovers information and its relationship himself. This allows him to remember the information for a longer period and better heart application of the new knowledge. He also explain sequence in learning from enactive in which learning is based around object or actions iconic in which learning is based around images too symbolic in which learning is based around abstract object.

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Evidence based practice is defined by Sackett 2000 (Lipscomb, 2015) as unifying best research evidence with clinical experience and patients desire to make clinical decision. By this, the effective patient’s care is given. Research which is one form of and the strongest of the evidence-based practice can mislead if taken out of context. Nursing research is a scientific way of validating and upgrading previous knowledge to generate new knowledge that influences clinical practice either directly or indirectly (Grove, 2014). Evidence based practice allows the nurse to be well informed as her patient for a good clinical decision. Embracing this practice results in cost-effective practice, improved clinical outcome and better job satisfaction. The cost effectiveness affects the patient, family members, the health care provider and the entire system. A nurse practitioner who wants to be relevant seeks up to date and best evidence associated with a case, reflects on her experiences and expertise and in combination with the patient’s preference makes decisions about care. A nurse can make positive impact by her potential to make change from best evidence. Barriers to implementing evidence-based practice are inadequate knowledge in identifying and critic research outcomes, misconception and wrong approach to research and evidence-based care, large number of patients and lack of adequate time to search for evidence, pressure from colleagues to follow traditional methods and patient’s preference for some types of care (Hopp, 2012). Now in the UK, NMC 2015 makes sure that qualified nurses are responsible and accountable to provide safe, personalised, evidence-based care. Knowing the best outcome research and guidelines without paying attention to the clinical expertise nor the patient desire is not evidence-based practice. It is also not just asking a colleague’s opinions about an appropriate care (McFadden, 2009). It was through evidence-based research that the best route of administration of medications were established. One will as a nurse impact the newest ways of patient’s management when one gives adequate attention to research.

In conclusion, because of the nursing profession which is more dynamic and practical in its approach, a nurse must regularly develop herself through lifelong learning and apply evidence-based practise to be relevant in the profession. Though there may be many challenges because of the nature of the work, determination with availability of resources will make good success of one’s career as a nurse.  

References:

• Chiang. V. C. L. et al (2013). Building lifelong learning capacity in undergraduate nursing freshmen within an integrative and small group learning context. Nurse Education Today, 33(10), 1184-1191. doi: 10 1016/j.nedt 2012.05.009
• Josiah Macy Foundation, American Association of College of Nursing (AACN) and the Association of American Medical Colleges (AAMC), ‘Lifelong Learning in Medicine and Nursing Final Conference Report.’2010
• John, J. M., & Lisa, J. T. (2009). Evidence-Based practice for long-life learning, Journal of Infection control – evidence based 77(6), 423-426
• Salcido, R. (2013). Lifelong learning. Advances in skin and wound care, 26(10), 440-440.doi: 10.1097/01.ASW,0000434952.89478.e0.
• Tummons, J., & Powell, S. (2014). A-Z of lifelong learning. Maidenhead: MC Graw- Hill Education.
• Rose McMaster, Violeta Lopez, Michelle Cleary. Lifelong learning and Professional Practice. Nurse Health Sci. 2018; 20:1-3
• Barbara L. Nichols et al. The Future of Nursing: Leading Change, Advancing Health. Institute of Medicine.National Academies Press (US); 2011.
• John McFadden, Lisa Thiemann. Evidence-based Practice for Lifelong Learning. AANA Journal 2009;77(6):423-426
• Marjan Laal. Lifelong learning: What does it mean? Procedia – Social and Behavioral Sciences. 2011; 28:470-474
• Mojtaba Qanbari Qalehsari, Morteza Khaghanizadeh, Abbas Ebadi. Lifelong learning strategies in nursing: A systematic review. Electronic Physician (2017) 9:10;5541-5550
• Novak, Malorie Kosht, PT, PhD, DPT, et al., “Measuring Health Professions Students’ Orientation Toward Lifelong Learning,” Journal of Allied Health, 2014; 43(3): 446-449.
• UNESCO Institute for Lifelong Learning 2016. Conceptions and realities of lifelong learning. https://unesdoc.unesco.org/ark:/48223/pf0000245626
• Gould, J. (2010;2009;). Learning theory and classroom practice in the lifelong learning sector. Exeter: Learning Matters.
• Easton T. Lifelong Learning: Fostering a Culture of Curiosity. Creative Nursing. 2010; 16(4):
• Lifelong Learning is a Vital Effort for Nurses. https://www.healthstream.com/resources/blog/blog/2017/05/23
• Alsop, A. (2013). Continuing professional development in health and social care : strategies for lifelong learning. Retrieved from https://ebookcentral.proquest.com
• Lipscomb, M. (2016;2015;). Exploring evidence-based practice: Debates and challenges in nursing. London: Routledge. doi:10.4324/9781315764559
• Hopp, L., & Rittenmeyer, L. (2012). Introduction to evidence-based practice: A practical guide for nursing. Philadelphia: F. A. Davis Company.
• Grove, S. K., Gray, J. R., & Burns, N. (2014;2015;). Understanding nursing research: Building an evidence-based practice (6th; Sixth; ed.). Saint Louis: Elsevier Health Sciences.