Nursing Participation in Continuing Professional Education in Saudi Arabia

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Introduction

Internationally, professionals in different fields have realized the need for continuing professional education (CPE) as a basic procedure to acquire the necessary skills and stay relevant in the job market. Nurses have to participate in CPE practices to boost their skills. Unlike in the past, the demand for an experienced workforce is increasingly rising thus compelling the nurses to engage in CPE practices. The high rate of globalization, consumerism, high technology, and the impact of climate change has compelled the health sector to facilitate practice and services that are modernized to meet the ever-changing needs in the sector. Since nurses form the largest number of health care professionals in Saudi Arabia and other places around the world, nurses are needed to engage in CPE activities to improve their skills and expertise. Nurses are urged to enhance personal development and accountability for continual learning. While considering the fundamental role of CPE to nurses, many countries have set mandatory learning for nurses. Currently, Saudi Arabia has shown significant efforts in promoting CPE among health care professionals. Nonetheless, the participation in CPE by nurses in Saudi Arabia remains to be very low, and no study has been done in Hafr Al-Batin to explore factors that influence nurse involvement in CPE.

To fill this void in research, this survey aims at exploring the current practice and the perceived needs for CPE among nurses in Hafr Albatin city in Saudi Arabia. This quantitative cross-sectional survey incorporates 200 registered nurses serving in governmental hospitals and health centers in Hafr Albatin. This survey intends to bring congruent knowledge for consumption by CPE providers to understand factors influencing CPE participation of nurses in Hafr Albatin. The findings will be necessary to increase the participation of the nurses in CPE hence promoting the nursing competence and health care dispensation quality. The survey also investigated if caregivers felt that engaging in CPE missions meets their current requirements and the upcoming expectations in the health care sector. This topic matters now because not much information is available for CPE providers to apply in engaging nurses in CPE practices despite the escalating challenges demanding more competencies in this field.

Literature Review

Search Strategy

This study uses EBSCO databases since it offers highly accessible resources for any kind of research at any given time. Current nursing theories, research findings, and trends in the nursing field were extensively explored to access credible studies addressing the perceived need for CPE in Saudi Arabia. EBSCO is a complimentary research database that offers online interactive retrieval services for peer-reviewed journal articles, books, and magazines among other research materials (Fowler & Davis 2013). Thirty research articles were accessed from this database with particular interest to articles not older than 10 years. The search strategy targeted peer-reviewed articles to ensure credibility. Therefore, the accessed articles were then analyzed and discussed under various topics related to the CPE needs for nurses in Hafr Albatin. Research materials that examined gender, age and motivating factors such as promotion were utilized in this study.

Background to the study

Most of the materials examined in the literature tried to examine the barriers as well as motivations that affected nurses’ participation in CPE practices. Several studies indicated that the reasons that account for the increasing necessity of continuing professional education include consumerism, competitiveness, the need for quality services, and competence (Pickard 2007). The findings in the articles reviewed will be applied to disclose the main issues that impend or motivate nurses to participate in CPE. However, most studies indicated that nurse involvement in CPE was minimal at Hafr Albatin. Alhaider, Alshehri, and Almedhesh (2015) carried out a qualitative analysis aimed at identifying the correlation between nursing competencies and nurse involvement in CPE. Haider and colleagues noted that people are the greatest asset for any entity, thus their wellbeing, and performance are very crucial. To assess nurses learning needs another qualitative study by Murphy, Cross, and McGuire (2006) analyzed to answer various questions regarding nursing involvement in CPE practices.

According to Kataoka-Yahiro, Richardson, and Mobley (2010), the rise of consumerism has resulted in the emergence of a more influential consumer society. Consumerism has also led to a more enlightened and sophisticated public. Consequently, the public has generated more expectations on the quality of services provided by their health professionals. The conventional knowledge and skills acquired during the usual training in higher education may not be sufficient to equip nurses to meet the growing expectations (Cowen & Moorhead 2011). The purpose of continuous learning is to enable nurses to gain current skills and knowledge to stay relevant in the industry as well as maximize safety for the community (Pickard 2007).

Motivating factors

Cowen and Moorhead (2011) indicated that most nurses recognized the need to engage in CPE practices to increase their competencies and match the practice demands of the new technology. Sarantinos (2009) revealed that some of the nurses believe that they have gained enough experience and might not need to advance their knowledge. Sarantinos (2009) suggested that such perception was due to a lack of motivation by nurse leaders and a poor understanding of nurses’ needs. Therefore, in this study motivating factors will be addressed to provide knowledge to CPE providers. Nonetheless, few studies presented contrasting opinions regarding the prevalence and essence of CPE activities in Saudi Arabia. For instance, Penz et al. (2007) argued that nurse participation in CPE activities was adequate and thus not related to poor nursing performance.

Continuing professional learning is extremely necessary for the nursing field due to the highly evolving nature of medical science and technology. Practicing nurses must maintain competency and ensure their skills are up to date. Nurses need current scientific knowledge to support their decision-making concerning how to implement issues that affect the patients (Pickard 2007). However, practicing nurses need a lot of support from their employers and colleagues to motivate them to pursue continuing professional learning. With the increased reluctance by nurses in Hafr Albatin to engage in continuous learning, it is indicative of this lack of motivation. In most cases, nurses who embark on education programs end up losing their decision-making responsibilities among other leadership roles they had before starting professional education (Penz et al. 2007). This situation creates a conflict since there is no support for the nurses to complete their education. It is against this background that this study aims to obtain answers to the various problems mentioned below.

Relationship between gender and participation in CPE

Studies offered adequate evidence that gender is an influencing factor for participation in CPE activities in Hafr Albatin. In most cases, men are more involved in activities that result in personal development when compared to women (Pickard 2007). According to Sarantinos (2009), due to the dominance of men in leadership positions, women feel discouraged to engage in professional learning yet they do not benefit directly. On the other hand, men are motivated to take any training opportunity in a bid to increase competency as well as go up the hierarchical system. Contrary to this belief, Penz et al. (2007) declare the perception that men benefit more by participating in CPE practice is wrong since the system provides everyone with equal opportunity to develop.

To maintain a competitive edge in the nursing industry, it is critical to ensure continuous investment in developing nurses’ skills. In Saudi Arabia, the competition is growing steadily, and thus it is necessary to encourage professional nurses practicing in Harf Albatin to participate in CPE. Quality assurance has been a growing concern among key role players and the patient fraternity in the health care sector. The need for increased standards has illuminated the relevance of continuing professional education. Regarding competence, Jeffries (2015) suggests that the skills and knowledge acquired in higher education have an average impact on the practice that lasts for about five years. Moreover, with the changing technology, new measures for service dispensation are emerging every day. These conclusions highlight the growing need to ensure nurses keep learning new models as they evolve with the changing technology. However, this qualitative cross-sectional study will try to examine whether the aforementioned correlation between continuing learning and improved nursing practices is the case in the Hafr Albatin.

The outcome of the review

The impact of the CPE

For professional nurses in Hafer Albatin, CPE activities are essential for safe and effective nursing care. According to Griscti and Jacono (2006), knowledge needed to take care of complex situations in medical practice cannot be attained only via experience. Nurses who are involved in CPE activities manifest a better understanding of the patient care system concerning the change in technological advancement in the medical sector (Jeffries 2015). Additionally, CPE practices help nurses gain a clear understanding of their hospital’s procedures as well as promote communication that is an integral part of effective performance.

Factors influencing nurses’ participation in CPE

Job security is one of the primary aspects that motivate nurses to embark on CPE activities. Following the current competition in the labor market, nurses have found it essential to increase their skills to ensure that their skills weigh up with the current demands of the informed patient population. Moreover, nurses are bound by the code of professional ethics to offer professional services. Therefore, flexible, diverse, and skill-oriented CPE practices allow the nurses to cope better with the dynamics that emanate from a fast-evolving healthcare system (Cowen & Moorhead 2011). Nurses expect CPE studies to last for short periods and target improving their competencies.

Nurses’ attitudes towards CPE

According to Soffer (2014), most nurses indicate a positive response towards CPE practices and willingness to commit to various obligations such as time and cost. However, the need for motivation is essential to assist nurses to update their skills, and increasing their scholarship. Nurses respond positively when they are encouraged and they can see the benefits of their training (Soffer 2014). Most nurses in Hafer Albatin understand and acknowledge the value of CPE practices, but the interest to participate is low due to poor planning and exclusion in decision-making.

Therefore, this study will try to answer the following RESEARCH QUESTIONS

What are the factors that influence Continuing Nursing Education participation of nurses in Hafr Albatin?
How do nurses in Hafr Albatin perceive continuing professional education and the existing barriers?
What are the areas that require improvement to motivate nurses to engage in CPE practices?
Is there a relationship between gender and age in participating in professional development through continuous learning?

Method and Material

The Study Aims

This research proposal aims to:

To examine the current CPE participation of Harf Albatin nurses. This study will also explore opinions from the participating nurses to establish their needs and involvement in these activities
This survey will be in a better position to establish the current and future CPE needs of nurses across Hafr Albatin.

Study Design

In this research, a quantitative model has been chosen as the suitable research method. A correlation study will be used to establish to what extent are the variables related. Identifying the optimal sample size for this survey requires a power calculation to determine statistical significance (Pawliszyn et al. 2012). It is a fundamental step to avoid too big a sample since it is costly. To justify the size of health-related studies, it is essential to undertake a sample size calculation to avoid unnecessary waste of resources for very large samples and inconclusive findings for underpowered studies (Pickard 2007). Since this study assumes a quantitative model, random sampling is an appropriate procedure to determine the number of participants to select from a sample frame (Speziale & Carpenter 2011).

Sample

It is impractical and expensive to gather data from every registered nurse in the city of Hafr Albatin. This research targets about 400-500registered nurses working in the Ministry of Health hospitals as well as community-based clinics in Hafr Albatin. A two-phase, stratified sampling criterion was employed for this study. The first phase was meant to select various clinics from the entire Hafr Albatin city in a random manner. The second phase entailed selecting at least two representative hospitals from primary, secondary, and tertiary level hospitals. The main purpose of this sampling procedure is to build a random sample of 150-200 registered nurses for this survey. The sample population targeted to involve both men and women of ages 25-45. The motive for selecting these certain age limits is because the group is young and is more likely to participate in continuous learning. Nurses of an age past 45 years may find it less beneficial to engage in CPE activities.

Inclusion criteria entail features that research subjects must possess to qualify to participate in the study (Walker 2005).

Registered nurses with a minimum working experience of two years.
Have been working in Hafr Albatin for at least two years

The exclusion criteria entail aspects that research subjects lack to take part in the study Walker (2005).

Nurses who had just reported from leave, those on maternity leave, or study leave. This group of nurses was excluded on the basis that they were not well informed about the current affairs and needed time to adjust.

Strengths

This survey covers a relatively large number of participants chosen randomly from a large population thus increasing the probability that the results will possess features of the large group. Besides, the larger the size of the sample, the more precise the findings are expected to be (Bryman 2012). The sampling exclusion criterion allows only on-duty nurses to participate indicating that the survey benefits from the most accurate and updated information. Research has identified that respondents are more willing to give information when they feel their autonomy to decide is respected (Nieswiadomy 2012). This study utilizes the random sampling technique thus giving each nurse within the sample frame an equal chance to be picked for the study. The sample will be adequately reached because sending questionnaires through the web is less tasking as opposed to face-to-face interviews.

Weaknesses

Selecting part of a total of a large population makes it difficult to avoid bias, and it is hard to ensure accuracy and consistency (Nassaji 2015). Since this study involves large samples, data collection and analysis will be costly as well as take a long time. The study regarding nursing CPE practices in the selected region is a matter that calls for urgency and accuracy. Therefore, this research needs to be speedy but accurate. Due to the large samples, such requirements may be hard to meet even though efforts will be made to ensure such drawbacks are eliminated (Bryman & Cramer 2011).

Setting and Recruitment Strategy

The setting of this study will be at Hafr Albatin in Saudi Arabia. The study is intended to look back at events that have influenced the low involvement of nurses in CPE activities across Hafr Albatin. A quantitative cross-sectional assessment will be employed to acquire facts from the health care people concerning CPE missions. The purpose of this survey will be to scrutinize the present CPE practices of Hafr Albatin’s caregivers, as well as find out the instant and potential CPE requirements for the health officials. The quantitative cross-sectional model will be used because it allows the researcher to examine the interaction between variables in a broad manner (Omer 2012).

Instruments

The nurses as the target population of this study will be involved through the completion of an online close-ended questionnaire. The questionnaires will be e-mailed to participants chosen voluntarily upon signing informed consent. In the implementation of this research, nurses will be expected to share their concerns and the impact of the CPE practices (Pickard 2007). The descriptive research will be applied to probe information regarding the traits of a phenomenon of interest. The aim will be to generate a sketch of the situation. This study in Hafr Albatin seeks to picture nurses’ perceptions concerning formal education. The study will also explore barriers and motivators to CPE practices from nurses’ perspectives.

Research design

Successful research relies on careful planning as well as implementation. The focus of a research design is the product and the feasibility of the research. Before embarking on a research project, it is recommendable to prepare the research design (Walker 2005). A descriptive research design will be used to make inquiries to gather data via the use of a web-based survey. The research questions will act as a framework for developing the instrument for the research. The instrument or rather a questionnaire for this research will be built using short, well-structured research questions that will be evaluated quantitatively. The questionnaires will pass quality scrutiny by competent research consultants to enhance content validity. The critiquing professionals should be having experience in developing instruments as well as be familiar with procedures used in the entire development of the electronic procedures (Alhaider et al., 2015).

Data Collection

According to Thomas (2008), data collection is a planned compilation of information needed for particular research goals. Data collection will be achieved through an online close-ended questionnaire to be emailed to all participants. Five hundred (500) questionnaires will be sent to registered nurses from eight hospitals and four community health centers from all regions of Hafr Al-Batin. The quantitative study aims at measuring relationships between variables (Thomas 2008). In the planned study to establish CPE practices in Hafr Albatin, the variables include age, gender, time, and region. This relationship is measured using the SPPS to determine effects such as deviation, frequencies, and correlations. After the date is set, the targeted respondents will be e-mailed the research instrument.

Surveys targeting to quantify variables take two forms descriptive and experimental. A descriptive study of this nature is intended to offer the relationship between continuous learning and increased competence among nurses in Hafr Albatin (Thompson 2009). Unlike in descriptive study, in experimental study researchers take measurements, devise means of intervention, and eventually repeat the process to analyze the results (Chong et al. 2014).

Strengths

For accurate conclusions of the interdependence within variables, a descriptive study utilizes a large sample of respondents such as the one targeted in this study (Murphy, Cross, & McGuire 2006). The quantitative model is a desirable procedure when a researcher wants to establish a state of something or a result of a particular pattern. Second, the quantitative method is well suited when it comes to testing hypotheses.

Weaknesses

While quantitative procedures are good for tackling various questions, there are cases when this method will fail to offer elaborate solutions (Greasley 2008). First, quantitative research is appropriate when exploring a situation in breadth, from a wide scope of analysis. On the other hand, when researchers want to explore a condition in-depth, quantitative research can be unreliable. To obtain an in-depth analysis, the research has to employ other models such as qualitative methods (Walker 2005).

Data Analysis

The primary aim of data analysis in this study will be to break down the data so that it offers solutions to the research questions. Since this is the most fundamental stage of the study, a considerable amount of time will be taken to ensure that ensure critical aspects of the data are covered to provide the most accurate conclusions (Cucu-Oancea 2012). The data analysis procedure will adapt the statistical package for social sciences (SPSS) version 16. Data will be transferred into SPPS format with the help of the systems personnel. A special SPSS file for developing frequencies, mean, and deviation will be designed to receive data and automatically rely on the quantitative responses. Statistical methods to be applied include percentage, mean, frequency, and standard deviation. Statistical analysis assists researchers to shed light on quantitative information (McLeod-Sordjan 2013).

Measures to increase reliability and validity

This research aims at generating findings that reflect the reality in Hafr Albatin. The research will only contribute to knowledge to utilize in informing nurse education if the findings are free of bias, consistent, and represent the experiences of the target population (Mohite, Naregal, & Kadam 2015). The instrument proposed for this research is an online-based questionnaire. Before the questionnaire is released, it has to be tested for reliability and validity. Reliability entails the accuracy and consistency of data collected in a study (McLeod-Sordjan 2013). The methods used to measure research variables should be examined to ensure consistency and results should reflect the elements of the entire sample frame rather than just the research respondents. On the other hand, validity entails the degree to which a questionnaire succeeds in measuring what it is designed to measure (McLeod-Sordjan 2013). To ensure validity, the questionnaire will be pre-tested by a research consultant.

Expected limitations

The first challenge is expected to be time and money constraints. This kind of research is expected to be large enough to take several months and huge sums of money. Studies conducted concerning academic purposes have a limited period for their completion. Moreover, for a study to be considered applicable, it has to meet set deadlines (Griscti & Jacono 2006). To make consistent and unbiased conclusions, the study should cover the entire city of Haft Albatin. Even though there will be not much movement involved since the questions will be availed via the internet, the cost input is expected to be relatively high (Bordens & Abbott 2011). The response rate of participants is expected to vary widely meaning that the data collection process will take a long period. Since the data gathering process is intended to be confidential and anonymous, it is expected to be challenging to identify who has not handed the questionnaire. This move is expected to prolong the data collection process as well as increase the expenditure by double figures. While administering this research, it is highly expected that the respondents have competing and urgent tasks to undertake, and thus low priority is granted to the completion of this survey (Soffer 2014).

Possible solutions to the limitations

To overcome the drawbacks of this study, the quantitative method will be applied to eliminate the concerns of the large nursing population in Hafr Albatin. Thus, to eliminate the problems of cost, this research intends to rely on a pilot study to convince the funding bodies to support this project since it is feasible (Yoder-Wise 2007). While addressing the issue of time, this study seeks to structure the questionnaires in an easily understandable manner. This will improve clarity thus increasing the possibility of completing the questionnaire within the shortest time possible. This study will also utilize competent staff to ensure that all deadlines are met as well as quality data is obtained.

Ethical Issues

Application of ethical approval to undertake this survey in Hafr Albatin will be submitted to the College Research Ethics Panel for approval. Participating nurses should be informed of the duration of the research since it might take much of their time and interrupt their schedules. This research intends to prioritize the interests of the participants ahead of those of the study. This study is a low-risk study thus it is expected that the potential benefits of the research will exceed the risks. When respondents are assured of security and confidentiality of information, they become more open-minded (Griscti & Jacono 2006).

To address the ethical issues before the study, this research intends to distribute a cover letter to all the participants. A written cover letter will include details such as the contact name and address of the researcher, reasons as to why the participant was chosen, what the study seeks to achieve, any possible benefits or risks that may arise from the research, and how the information collected will be treated (Greasley 2008). The covering letter should ensure that the person to participate meets the specifications of informed consent (Sperry & Pies 2010). The cover letter should also motivate the respondent to participate by indicating how the research is intended to influence the issue in the study. However, the covering letter should insist that the participation is voluntary, and the information to be gathered will be handled with the optimum regard for privacy and anonymity.

Conclusion

The primary goal of this study will be to obtain outcomes and information that assist CPE providers with the exact needs of nursing training and facilitate relevant training based on nurses’ needs. Given the facts and opinions discussed in this paper, it seems desirable to argue that the use of quantitative methods can be of great value to the generation of new knowledge and form grounds for further research. However, CPE programs may not be of positive impact on the immediate and future needs of the health sector unless the programs meet the needs and requirements of the nurses. Therefore, collaboration and extensive consulting are fundamental to nursing leadership at every level if nurses are expected to benefit from the CPE initiatives. This study will encourage the process of including CPE practices for practicing nurses. If the study works, CPE providers will have enough information on what areas need adjustments to increase the efficacy of CPE practices.

The researcher is likely to conclude that most of the barriers to professional learning are structural and attitudinal. The structural barriers likely to be mentioned by the nurses include lack of role models, insufficient funds, job expectations, lack of nurse involvement in decisions that affect their growth, and poor planning. The attitudinal barriers are expected to include a lack of motivators and the belief that nurses have gained adequate experience in the many years of service. If the study is successful, adequate solutions will be provided to show how CPE providers can engage nurses in Hafr Albatin and get them involved in continuous learning. If the study works, it will show that nursing participation in CPE is not convincing in Hafr Albatin despite nurses showing interest to engage in education. However, it is most likely most nurses will participate in professional learning if offered suitable conditions by their organizations.

Study Timetable

A study timetable is essential to facilitate the planning and articulation of each phase of the study process. A one-year period is selected for this study. The table below presents the estimated period for each phase.

Table 1. Study Timetable.

Activity

Month

Application for ethics approval

Writing literature review

Preparing questionnaire and sampling and the pilot study

Data collection

Data analysis

Writing of report and preparation for publishing

Resources

To optimize resources, the estimated expenditure is planned to add up to $ 1000. This amount is planned to cater for communication, transport, internet and miscellaneous. To reduce the costs, the researcher intends to use personal materials such as phone, laptop, and printers.

Dissemination

After completion of the study, the researcher will present a formal report to college dean indicating the results of the study and its influence to CPE practices in Hafr Albatin. The researcher will find platforms to present the findings of the study to various CPE providers and nursing institutions. Besides, publishing the results in journal articles will boost the spread of this information.

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