Continuing professional education: participation and motivational orientations of greek health care professionals

Introduction: Continuing Professional Education (CPΔ) for doctors and nurses became extremely essential to the assurance and improvement of quality patient care as an element.Purpose: The main purpose of the study was to investigate the participation and the motivational reasons which influence Greek doctors and nurses to participate in CPE programs. Furthermore, the study aimed to confirm the validity and reliability of the instrument involved and to determine the factors that deter their participation, as well as, the perceived benefits, resulting participation in CPE. Further, to explore the effects of personal and professional characteristics on the aforementioned issues.Methods and material: The study entailed a descriptive, comparative, correlational design. The sample size consisted of 971 health professionals (n=971), 531 military doctors and 440 military nurses, of a total population of 2025, working in the Hellenic Army health services, throughout the Greek territory (response rate 47,2%). A self completed questionnaire was used for the data collection (Mar 2010-Sep 2010). The questionnaire included three Likert type scales: the revised Participation Reasons Scale (PRS), the revised Deterrents Participation Scale (DPS) and the Participation Benefits Scale (PBS). In order to establish the scales’ construct validity, responses to the PRS and DPS were factor analysed. Following the factor analysis, emerged 4 PRS factors and 6 DPS factors. The factors of the revised PRS were: improvement of professional competence and patient service, professional commitment, collegial learning and interaction, personal benefits and job security, for doctors (α=0.92) and nurses (α=0.93), as well. The factors of the revised DPS were: disengagement, lack of time, lack of quality, family commitments, work commitments and cost, for doctors (α=0.92) and nurses (α=0.93), as well. Statistical analysis was performed with SPSS version 17.0 using descriptive and inferential statistics. The level of significance was set at p=0.05.Results: The vast majority of doctors (98.3%) and nurses (86.2%) were informed for the scientific developments, demonstrating interest in on-line CPE (90.6% and 74.6%, respectively), reading articles (71.5% and 58.3%, respectively), attending conferences (75.8% and 51.7%, respectively). Doctors referred that spent 12.2 days in CPE activities (SD ±17,5), with median 10 days, and nurses 7.3 days (±26.2), with median 3 days, during the previous year. A percentage of 74.8% of doctors and 67.1% of nurses, reported that updating their knowledge and skills through CPE was very important. Moreover, important percentages of doctors (55.3%) and nurses (51.8%), believed that participation in CPE should be mandatory. In relation to motivational orientations, the factor of improvement of professional competence and patient service received the highest recognition amongst doctors and nurses [5.5 (±1.1) and 5.4 (±1.2), respectively] and the factor of personal benefits and job security the least [4.5 (±1.2) and 4.6 (±1.2), respectively]. The top ranked reason for non participation for doctors was cost [3.06 (±1.24)], following by work commitments [3.01 (±1.04)], while the area of least importance was disengagement [1.81 (±0.78)]. More significant deterrent factor for nurses, in relation to doctors, was work commitments [3.44 (±1.04), p˂0,001] and the least important was disengagement [2.11 (±0.87), p˂0.001]. The main single barrier for doctors was lack of administrative support and enhancement and for nurses lack of communication of educational opportunities. Doctors’ and nurses’ most important perceived benefits related to the factor of improvement of professional competence and patient service [5.0 (±1.3) and 4.7 (±1.4), respectively] and the least important, related to the area of personal benefits and job security [4.0 (±1.3) and 3.7 (±1.3), respectively]. Statistical significant correlations were found between all motivational PRS factors and benefit PBS factors. The higher the doctors’ and nurses’ motivation to participate in CPE was, the more the perceived benefits (p˂0.001). More CPE days, in the previous year, reported the doctors and nurses who were older (p˂0.001 and p=0=0.001, respectively), more experienced (p˂0.001 and p=0.011, respectively), with a master’s degree (p˂0.001 and p=0.002, respectively) and IT skills (p=0.001 and p=0.003, respectively).Conclusions: Military doctors and nurses demonstrated a positive attitude towards CPE. More of them had high percentages of participation in CPE activities. However, doctors had greater participation than nurses. The participants’ majority preferred compulsory CPE. Their most important reason to participate was their need for professional development and improvement for the benefit of patient care and the least important their personal benefit. For doctors, the most important deterrent factor was cost, while for nurses, was a series of work constraints. The higher the degree of motivation they referred, the higher the benefit they anticipated. The study’s findings could facilitate the CPE providers to realise the factors that influence doctors’ and nurses’ participation in CPE, in order to update their policies for the benefit of the health professionals, the service, the patients and the society as a whole.Key words: continuing professional education, continuing nursing education, continuing medical education, educational programs, nurse, doctor, physician, motivation, motivational orientations, Participation Reasons Scale, deterrents, barriers, Deterrents Participation Scale, benefits