Continuing professional education: The experiences and perceptions of nurses working in perioperative patient care

This thesis presents a holistic description of perioperative nurses' experiences and perceptions of continuing professional education (CPE), from their decisions to study and experiences as students, to the outcomes realised from formal post-registration university courses. Some studies have explored CPE holistically; however these did not include perioperative nurses, whose views may differ from colleagues working in other specialities due to the patriarchal nature of the theatre environment. A descriptive qualitative approach was adopted and 23 unstructured interviews were conducted with 23 perioperative nurses who had recent experience of CPE. Audio-taped interviews were transcribed fully into the Ethnograph, and the data coded and analysed using both Seidel's (1998) and Dey's (1993) models for data analysis. Four themes emerged: 1) 'Background', including managers' attitudes and cultural discourses 2) 'Going In', relating to motivations and deterrents in accessing CPE 3) 'Process', including participants' experiences as students and 4) 'Going Out', describing the personal, professional and practice outcomes which resulted. Findings relating to motivations, barriers and outcomes reflected those of previous studies. Local cultures within theatres appeared to promote practical skills above academic qualifications, with managers controlling access to CPE, and horizontal violence experienced by nurses who traversed dominant cultural discourses. Participants perceived the possession of student cards as symbolic of a raised social status. Formal study did not impact directly on practice, however the development of increased confidence appeared to facilitate participants' collaboration with, and questioning of, medical colleagues and was attributed to indirectly enhancing patient care. The extent to which participants revealed their CPE lay on a continuum from telling all colleagues they were studying (public study) through to telling no one (secret study). Participants indicated the extent to which CPE was revealed, or kept secret, was crucial, based on the prevailing cultural discourse, their own academic confidence, and potential ramifications should they be unsuccessful. This study is the first to attribute significance to the concept of 'secret study'. This work contributes to the knowledge relating to CPE: It confirms the transferability of existing literature relating to motivations, barriers and outcomes of formal study to the perioperative setting, and advances knowledge with regard to participants' perceptions of their student status, and the development of inter-professional relationships following CPE. Further research is required to explore the concept of secret study, and to indicate whether the findings are transferable to areas outside of the perioperative setting. The findings are of significance to nurses working in practice, and educators involved in designing and delivering post-registration formal courses to perioperative nurses