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Continuing education in nursing : a lifelong learning perspective 1984

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C o n t i n u i n g Education i n Nursing: A L i f e l o n g L earning P e r s p e c t i v e by Diane E. Reed B.S.N., U n i v e r s i t y of Saskatchewan, 1977 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of A d m i n i s t r a t i v e , Adult and Higher Education) We accept t ^ i i s t h e s i s as conforming to./fhe ):e$^ired standard THE UNIVERSITY OF BRITISH COLUMBIA October 1984 ©Diane E. Reed, 1984 86 In presenting t h i s thesis i n p a r t i a l f u l f i l m e n t of the requirements for an advanced degree at the University of B r i t i s h Columbia, I agree that the Library s h a l l make i t f r e e l y available for reference and study. I further agree that permission for extensive copying of t h i s thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. I t i s understood that copying or publication of t h i s thesis for f i n a n c i a l gain s h a l l not be allowed without my written permission. Department of A d m i n i s t r a t i v e . A d u l t and H i g h e r E d u c a t i o n The University of B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 Date October 10, 198£ DE-6 (3/81) i i CONTINUING EDUCATION IN NURSING: A LIFELONG LEARNING PERSPECTIVE ABSTRACT T h i s study examined the u t i l i t y of l i f e l o n g l e a r n i n g , a notable concept i n a d u l t and higher education, f o r c o n t i n u i n g education i n n u r s i n g . I d e n t i f i a b l e d e f i c i e n c i e s i n CNE l e d to the search f o r a s u i t a b l e framework on which to base a c t i o n . The approach adopted to accomplish t h i s task i n v o l v e d use of a n a l y t i c p h i l o s o p h y . The l i t e r a t u r e r e l a t e d to l i f e l o n g l e a r n i n g was examined and a subset, l i f e l o n g e d u c a t i o n , was i d e n t i f i e d as the prime area of i n t e r e s t . I t was concluded that l i f e l o n g education i s an e d u c a t i o n a l philosophy which answers qu e s t i o n s about e d u c a t i o n a l p r o c e s s e s . P r i n c i p l e s of the philosophy were d i s t i l l e d from the e x i s t i n g l i t e r a t u r e . F o l l o w i n g t h i s e l u c i d a t i o n of the ideas, CNE i n the context of l i f e l o n g education was d e s c r i b e d . I m p l i c a t i o n s f l o w i n g from adopting t h i s philosophy as a framework f o r CNE a c t i v i t i e s were d i s c u s s e d . R e s u l t a n t changes to g o a l s , means, content, a d m i n i s t r a t i o n , and treatment of l e a r n e r s i n CNE were c o n s i d e r e d . I t was concluded that the goals of CNE must i n c l u d e both i n d i v i d u a l nurse development as w e l l as development of the p r o f e s s i o n , these i n t e r a c t i n g to c o n t r i b u t e to improved q u a l i t y of n u r s i n g s e r v i c e . The a d m i n i s t r a t i v e o r g a n i z a t i o n would be b i - l e v e l , r e q u i r i n g s p e c i f i c r o l e s f o r both c e n t r a l and l o c a l s t r u c t u r e s , while a l l o w i n g f l e x i b i l i t y i n p l a n n i n g . Treatment of l e a r n e r s would be such that c h a r a c t e r i s t i c s r e q u i r e d f o r l e a r n i n g throughout l i f e would be f o s t e r e d . The development of g e n e r a l i z a b l e s k i l l s r e l a t e d to a c q u i r i n g knowledge would be emphasized. An emphasis on process and probl e m - s o l v i n g rather than any s p e c i f i c content would be r e q u i r e d . I t was noted that the n u r s i n g p r o f e s s i o n would i t s e l f have to undergo changes i f l i f e l o n g education i s to be s u c c e s s f u l l y implemented as a philosophy f o r CNE.' i v TABLE OF CONTENTS ABSTRACT . i i LIST OF FIGURES v i i ACKNOWLEDGEMENT v i i i CHAPTER ONE: INTRODUCTION 1 The Problem 2 Purpose Of T h i s Study 3 D e s c r i p t i o n Of Approach 4 D e f i n i t i o n Of Terms 8 Lear n i n g And Education 8 Con t i n u i n g Education 10 Research Questions 11 Overview 11 CHAPTER TWO: THE CURRENT STATE OF CONTINUING EDUCATION IN NURSING: A REVIEW OF THE LITERATURE 13 The Context 13 Nursing 14 D e f i n i t i o n 14 A P r o f e s s i o n 15 Ent r y To P r a c t i c e 15 Changing Roles 16 Co n t i n u i n g Education In The H e a l t h P r o f e s s i o n s 17 A H i s t o r y Of Continuing Education In Nursing 18 Present Status 22 Goals 22 V Competence To P r a c t i c e 23 P r o f e s s i o n a l i s m - The Hidden Agenda 25 O r g a n i z a t i o n 26 R e s p o n s i b i l i t i e s 27 The System (or Non-System) 29 The Learners 34 I n t e r n a l M o t i v a t i o n 34 E x t e r n a l M o t i v a t i o n 37 Issues In C o n t i n u i n g Education In Nursing 38 Con c l u s i o n 41 CHAPTER THREE: LIFELONG LEARNING AND LIFELONG EDUCATION ... 43 H i s t o r y 45 A R a t i o n a l i z a t i o n For L i f e l o n g L earning - Change 49 Terminology 52 L i f e l o n g Education - An E d u c a t i o n a l Philosophy 52 Goals 55 Assumptions 59 P r i n c i p l e s 62 Co n c l u s i o n 77 CHAPTER FOUR: APPLICATION OF A PHILOSOPHY OF LIFELONG EDUCATION TO CONTINUING NURSING EDUCATION 79 A Philosophy Of CNE Based On L i f e l o n g Education 80 Goals 80 A d m i n i s t r a t i o n 82 The Learners 87 Content 91 Means 95 v i C o n c l u s i o n 99 CHAPTER FIVE: CONCLUSION 100 T e s t i n g As A Framework 100 F e a s i b i l i t y 101 E v a l u a t i o n 105 Inputs 106 F a c i l i t i e s 106 I n s t r u c t o r s 1 06 I n d i v i d u a l s 106 Costs 106 A c t i v i t i e s . .. 106 People Involvement 106 Reactions 107 Learning Change 107 P r a c t i c e Change .107 End R e s u l t s 107 Co n c l u s i o n 1 08 REFERENCES 111 v i i LIST OF FIGURES Figure 1. Goals Of L i f e l o n g Education 57 F i g u r e 2. Goals And P r i n c i p l e s Of L i f e l o n g Education ...... 64 F i g u r e 3. Philosophy Of L i f e l o n g Education - A p p l i c a t i o n .. 81 v i i i ACKNOWLEDGEMENT I wish to g r a t e f u l l y acknowledge the support and encouragement o f f e r e d at v a r i o u s times and i n sundry ways by my f a t h e r , the P h i l l i p s f a m i l y , Roland, the members of my c e l l group, Dr. R. Boshier, and Dr. T. Sork. A l l of these i n d i v i d u a l s have c o n t r i b u t e d to the completion of t h i s work. 1 CONTINUING EDUCATION IN NURSING: A LIFELONG LEARNING PERSPECTIVE CHAPTER ONE INTRODUCTION The p r o f e s s i o n s have t r a d i t i o n a l l y been i d e n t i f i e d with s p e c i f i c and s p e c i a l i z e d bodies of knowledge. In the past, t h i s " s p e c i a l " knowledge has c r e a t e d a "mystique" around the p r o f e s s i o n a l . Today, the halo around the p r o f e s s i o n s i s r a p i d l y changing i f not f a d i n g a l t o g e t h e r . Two f a c t o r s c o n t r i b u t e to t h i s . F i r s t , consumers of p r o f e s s i o n a l s e r v i c e s are becoming more knowledgeable and v o c a l about what they can reasonably expect from p r o f e s s i o n a l s . I n c r e a s i n g l y , there i s d i s i l l u s i o n m e n t with the p r o f e s s i o n s (Houle, 1980). Secondly, f o r the p r o f e s s i o n a l , the nature of knowledge i s changing. There has been an exp o n e n t i a l i n c r e a s e i n the knowledge base i n v i r t u a l l y a l l areas i n which p r o f e s s i o n a l s might serve. As a consequence, the p r o f e s s i o n s have become i n c r e a s i n g l y aware of, and concerned with the p r o v i s i o n of q u a l i t y s e r v i c e s . The e f f o r t s of the p r o f e s s i o n s i n response to t h i s c h a l l e n g e have r e s u l t e d i n the growth of the c o n t i n u i n g education i n d u s t r y . Of course, other avenues such as s e l f - r e g u l a t i o n of the p r o f e s s i o n s and new laws r e l a t i n g to them have been explored, but c o n t i n u i n g education i s viewed as an important p a r t of the answer to the need f o r a s s u r i n g q u a l i t y . Consequently, 2 t r a d i t i o n a l c o n t i n u i n g education o f f e r i n g s have i n c r e a s e d and i n n o v a t i v e approaches have been developed. Use of new t e c h n o l o g i e s , new approaches to the accumulation of " c r e d i t " f o r c o n t i n u i n g education experiences and a p r o l i f e r a t i o n of e d u c a t i o n a l o p p o r t u n i t i e s r e l a t e d to s p e c i a l i z e d t o p i c s have h i g h l i g h t e d the growth. The n u r s i n g p r o f e s s i o n has shared the concern of other p r o f e s s i o n s i n regard to the p r o v i s i o n of q u a l i t y s e r v i c e s . In n u r s i n g too, there has been an i n c r e a s e d s t r e s s i n recent years on the p r o v i s i o n of c o n t i n u i n g education o p p o r t u n i t i e s . The Problem There are i n d i c a t i o n s t h a t , at l e a s t f o r n u r s i n g , c o n t i n u i n g e d u c a t i o n designed to ensure q u a l i t y care has not proven to be e n t i r e l y s a t i s f a c t o r y . There are i n d i c a t i o n s i n the l i t e r a t u r e t h a t c o n t i n u i n g education i n n u r s i n g i s a "piecemeal" approach to meeting c o n t i n u i n g l e a r n i n g needs. Although o p p o r t u n i t i e s f o r c o n t i n u i n g education i n n u r s i n g are on the i n c r e a s e , there would seem to be no u n i f y i n g concept that g i v e s d i r e c t i o n to t h e i r p r o v i s i o n . Instead, c o n t i n u i n g education a c t i v i t i e s serve l a r g e l y " m i d r o - l e v e l " , "maintenance-type" needs (Pipke, 1981). In a d d i t i o n , i t has yet to be c o n c l u s i v e l y demonstrated that e x i s t i n g c o n t i n u i n g education a c t i v i t i e s promote l e a r n i n g and i n f l u e n c e n u r s i n g p r a c t i c e . T h i s problem, however, i s not unique to n u r s i n g . In f a c t , a l l the p r o f e s s i o n s have questioned 3 the e f f i c a c y of formal c o n t i n u i n g l e a r n i n g a c t i v i t i e s . Given these two n o t i o n s , i t would seem that c o n t i n u i n g n u r s i n g education (CNE) i s , i n a sense, i n a s t a t e of c r i s i s . The s h i p of resources f o r CNE i s proceeding at f u l l speed without a rudder, helmsman, or a p a r t i c u l a r , c o h e r e n t l y i d e n t i f i e d , d e s t i n a t i o n i n mind. Meanwhile, in the world of c h i l d h o o d , a d u l t , and higher e d u c a t i o n , " l i f e l o n g l e a r n i n g " i s g r a d u a l l y coming to the fore as a p l a u s i b l e o r g a n i z i n g p r i n c i p l e f o r the c r e a t i o n of e d u c a t i o n a l o p p o r t u n i t i e s f o r i n d i v i d u a l s of a l l ages. T h i s and r e l a t e d concepts -- l i f e l o n g education and r e c u r r e n t education -- have been o f f e r e d as s o l u t i o n s to the n e c e s s i t y f o r continued l e a r n i n g i n a world of r a p i d t e c h n o l o g i c a l and s o c i e t a l change. Purpose of T h i s Study The purpose of t h i s t h e s i s was to examine the conceptual foundations of l i f e l o n g l e a r n i n g and i t s a p p l i c a b i l i t y to the p r o v i s i o n of c o n t i n u i n g n u r s i n g education o p p o r t u n i t i e s , the u l t i m a t e u s e f u l n e s s of that a p p l i c a t i o n , and the way i t can best be accomplished, i f indeed i t should be. To begin t h i s i n v e s t i g a t i o n , t h e r e f o r e , l i t e r a t u r e r e l a t e d to the two t o p i c s of l i f e l o n g l e a r n i n g and the c u r r e n t p r a c t i c e of c o n t i n u i n g n u r s i n g education was examined. Since t h i s t h e s i s was an attempt to apply a set of ideas ( l i f e l o n g l e a r n i n g ) to a given s i t u a t i o n ( c o n t i n u i n g n u r s i n g e d u c a t i o n ) , i t was necessary to examine that set of ideas c l o s e l y and determine assumptions and goals that 4 stem from i t . It w i l l be argued that l i f e l o n g l e a r n i n g has a subset, l i f e l o n g education. As an e d u c a t i o n a l philosophy, l i f e l o n g e ducation can be a p p l i e d to many s i t u a t i o n s . T h i s i s the case because l i f e l o n g education has the p r o p e r t i e s of a philosophy, and as such f u l f i l l s c e r t a i n f u n c t i o n s r e l a t e d to d e l i n e a t i n g g oals and processes i n e d u c a t i o n a l s i t u a t i o n s . The j u s t i f i c a t i o n f o r t h i s study i s d e r i v e d from the f a c t that the attempt to apply the n o t i o n of l i f e l o n g l e a r n i n g to the p r a c t i c e of CNE i s an example of borrowing and r e f o r m u l a t i n g knowledge from one d i s c i p l i n e and a p p l y i n g i t to another. Jensen (1964) d e s c r i b e d how the unique body of knowledge on which a d u l t education i s based has been formed, at. l e a s t i n p a r t , by "borrowing" from r e l a t e d d i s c i p l i n e s . T h i s t h e s i s took the process one step f u r t h e r by ask i n g how a concept from a d u l t education can be u s e f u l to n u r s i n g , a r e l a t e d d i s c i p l i n e . Asking such q u e s t i o n s can u l t i m a t e l y c o n t r i b u t e to f u r t h e r honing of the body of knowledge of a d u l t and higher education i n that p r o v i d i n g an answer w i l l r e q u i r e more p r e c i s e d e f i n i t i o n s and f u r t h e r e l u c i d a t i o n of concepts. T h e r e f o r e , to begin the study, CNE was d e s c r i b e d . F o l l o w i n g an examination of l i f e l o n g l e a r n i n g an attempt was made to l i n k i t and CNE by u t i l i z i n g key concepts of the former to make recommendations for a l t e r a t i o n s i n the l a t t e r . D e s c r i p t i o n of Approach The methodology u t i l i z e d i n approaching t h i s study was 5 borrowed from a n a l y t i c p h i l o s o p h e r s of education. According to M c C l e l l a n and Komisar (1962), a n a l y s i s i s an important part of the p h i l o s o p h i c a l t r a d i t i o n i n educ a t i o n . P h i l o s o p h e r s of education address q u e s t i o n s c o n c e r n i n g the r a t i o n a l e f o r p r a c t i c e s i n the f i e l d and have r e c e n t l y been concerned with s p e c i f i c and d e t a i l e d a n a l y s i s of concepts (Frankena, 1962). T h i s i s known as a n a l y t i c p h i l o s o p h y . While p h i l o s o p h e r s i n ed u c a t i o n are concerned about normative a s p e c t s of e d u c a t i o n a l thought, a n a l y t i c a l p h i l o s o p h e r s are, i n p a r t , concerned with making e x p l i c i t the meaning of "concepts, arguments, slogans, and statements" (Frankena, 1966, p. 8). While conducting t h i s e l u c i d a t i o n , a n a l y t i c p h i l o s o p h e r s c l a i m to h o l d a " n e u t r a l stance" ( S o l t i s , 1978, p. 83) i g n o r i n g t h e i r own va l u e systems while they "search i n t o the l o g i c a l f e a t u r e s of e d u c a t i o n a l ideas" (p. 83). Some l i t e r a t u r e r e g a r d i n g a n a l y t i c philosophy conveys the impression that i t c o n s i s t s s o l e l y of t h i s a n a l y s i s of language ( E l i a s & Merriam, 1980; H i r s t & P e t e r s , 1970). I t i s true that one t o o l used by a n a l y t i c p h i l o s o p h e r s i s the " e l u c i d a t i o n of concepts", t h i s having been d e s c r i b e d as being "the most c l e a r l y a n a l y t i c endeavor" ( M c C l e l l a n & Komisar, 1962, p. v i i ) i n a n a l y t i c p h i l o s o p h y . I t c o n s i s t s of " a r t i c u l a t i n g whatever c o n v e n t i o n a l r e g u l a r i t i e s ( c r i t e r i a ) are to be found i n the a p p l i c a t i o n of a term i n some range of s i m i l a r c o n t e x t s " ( M c C l e l l a n & Komisar, 1962, p. v i i ) . T h i s search f o r d e f i n i t i o n has been termed conceptual a n a l y s i s . 6 However, there i s a second t o o l used i n a n a l y t i c p h i l o s o p h y . I t i s c a l l e d r a t i o n a l r e c o n s t r u c t i o n . M c C l e l l a n and Komisar (1962) s a i d that t h i s i s a more c o n s t r u c t i v e a n a l y t i c a c t i v i t y . A r a t i o n a l r e c o n s t r u c t i o n i s more than an e l u c i d a t i o n of concepts i n that ... i t has to go beyond the l i m i t a t i o n s , a m b i g u i t i e s , and i n c o n s i s t e n c i e s of common usage and has to show how we had b e t t e r construe the meanings of those terms i f we wish to a r r i v e at a c o n s i s t e n t and comprehensive theory ... (p. x ) . The work of r a t i o n a l r e c o n s t r u c t i o n c o n s i s t s of three phases: 1) i d e n t i f i c a t i o n of a b s t r a c t elements 2) establishment of r e l a t i o n s h i p s between the elements 3) a p p l i c a t i o n of the whole "as a b a s i s f o r g u i d i n g and c r i t i c i z i n g the conduct of the o r i g i n a l a c t i v i t y from which the a b s t r a c t i o n began" ( M c C l e l l a n & Komisar, 1962, p. x i ) T h i s i s what was accomplished i n the present study. Beyond the use of conceptual a n a l y s i s to s p e c i f y d e f i n i t i o n s , t h i s second t o o l of a n a l y t i c philosophy was used to assess l i f e l o n g l e a r n i n g and l i f e l o n g education i n a search f o r commonalities that would guide implementation. How these commonalities or " p r i n c i p l e s " r e l a t e to each other i s i l l u s t r a t e d and f i n a l l y the a p p l i c a t i o n to CNE i s made. In going beyond the use of conceptual a n a l y s i s i n t h i s study, i t was recognized that conceptual a n a l y s i s i s an important p a r t of a n a l y t i c p h ilosophy. However as M c C l e l l a n and Komisar (1962) warned, i t may be wise to r e t a i n some of the vagueness i n the language of education because "some newly in t r o d u c e d concepts ... are e x p r e s s i o n s i n search of a 7 d e f i n i t i o n , not terms whose meaning we d i s c o v e r through a n a l y s i s " (p. v i i i ) . The concept of l i f e l o n g l e a r n i n g was t r e a t e d as being i n t h i s category. Consequently, although i t was important to t h i s study to d e f i n e and e l u c i d a t e the concept of l i f e l o n g l e a r n i n g , t h i s was not the u l t i m a t e goal of the t h e s i s . One f u r t h e r c o n s i d e r a t i o n should be taken i n t o account i n regard to methodology. In t h i s study, there was one d e v i a t i o n from the g e n e r a l usage of an a n a l y t i c a l p h i l o s o p h i c a l methodology. Since l i f e l o n g education was i d e n t i f i e d as a subset of l i f e l o n g l e a r n i n g and a philosophy i n i t s own r i g h t , the methods of a n a l y t i c philosophy .were being a p p l i e d to . a philosophy r a t h e r than a concept per se. Frankena (1966) p r o v i d e d a model, based on the ideas of a n a l y t i c p hilosophy, f o r j u s t such a task. Frankena (1966) s t a t e d that the i n q u i r e r looks f o r " d i s p o s i t i o n s " (p. 13) i n the philosophy, the r a t i o n a l e f o r those d i s p o s i t i o n s , and recommendations f o r implementation. T h e r e f o r e , i n the study, p r i n c i p l e s which can form the b a s i s f o r the a p p l i c a t i o n of the philosophy were enunciated. T h i s process i s p a r t of the r a t i o n a l r e c o n s t r u c t i v e phase of a n a l y t i c p h i l o s o p h y . I t i s a l s o the part of a n a l y t i c philosophy where r e c o g n i t i o n of the value assumptions that c h a r a c t e r i z e the philosophy are important. To summarize, t h i s study was an a p p l i c a t i o n of the two p a r t s of a n a l y t i c philosophy — conceptual a n a l y s i s and r a t i o n a l r e c o n s t r u c t i o n - to a concept and a philosophy of e d u c a t i o n . 8 D e f i n i t i o n of Terms Learning and Education The key concepts i n the terms " l i f e l o n g l e a r n i n g " , " l i f e l o n g e d u c a t i o n " , and " c o n t i n u i n g e d u c a t i o n " are "education" and " l e a r n i n g . " I t was necessary to d i s t i n g u i s h between the two and i d e n t i f y the scope of each before proceeding. Gagne (1977) d e f i n e d l e a r n i n g as "a change in human d i s p o s i t i o n or c a p a b i l i t y , which p e r s i s t s over a p e r i o d of time, and which i s not simply a s c r i b a b l e to processes of growth" (p.3). According to Jensen (1964) and L i t t l e (1979), l e a r n i n g may take p l a c e i n any of s e v e r a l s i t u a t i o n s , ranging from spontaneous unplanned l e a r n i n g , to systematic design of s e l f - d i r e c t e d l e a r n i n g , to i n s t i t u t i o n - d e s i g n e d l e a r n i n g . In t h i s approach to the d e f i n i t i o n a l problem, l e a r n i n g i s a broader phenomenon than e d u c a t i o n . Education i s the c r e a t i o n of c o n d i t i o n s designed to f a c i l i t a t e l e a r n i n g . In a sense, education i s an i m p o s i t i o n on the occurrence of the i n t e r n a l process of l e a r n i n g and i s the arrangement of e x t e r n a l c o n d i t i o n s that f o s t e r i t . By d e f i n i t i o n , i t i s the d e l i b e r a t e and systematic arrangement of the c o n d i t i o n s of l e a r n i n g . Education i s one type of s i t u a t i o n in which l e a r n i n g may occur. Cropley (1977) argued f o r an an o p p o s i t e view to the one expressed above. T h i s author c o n c e p t u a l i z e d education as being 9 the more gen e r a l process whereas l e a r n i n g i s d e f i n e d as "the process through which education occurs" (p. 36). In c o n t r a s t to t h i s , the idea that was used f o r t h i s t h e s i s i s that education i s one of the processes through which l e a r n i n g o c c u r s . However, more important f o r present purposes i s that Cropley (1977) admitted that education "does not r e s u l t s o l e l y from contact with s c h o o l s " (p. 38) ( i e . f o r m a l l y planned l e a r n i n g a c t i v i t i e s w i t h i n an i n s t i t u t i o n ) . Education can take p l a c e o u t s i d e of i n s t i t u t i o n s . Dave (1983) equated education with "the whole continuum of s i t u a t i o n s f o r p u r p o s e f u l l e a r n i n g ranging from well-planned and i n s t i t u t i o n a l i z e d l e a r n i n g to n o n - i n s t i t u t i o n a l i z e d and i n c i d e n t a l l e a r n i n g " (p. 4). Dave's (1983) i n c l u s i o n of i n c i d e n t a l l e a r n i n g as . p a r t of l i f e l o n g education i s i n c o n s i s t e n t with the d e f i n i t i o n of education d e s c r i b e d e a r l i e r . The a d d i t i o n of the a d j e c t i v e " l i f e l o n g " to the terms "education" and " l e a r n i n g " stems from the c o n c e p t u a l i z a t i o n of the two processes as extending over the e n t i r e l i f e s p a n of the i n d i v i d u a l . In a d d i t i o n to t h i s obvious i n t e r p r e t a t i o n of the term " l i f e l o n g " , i t can a l s o be i n t e r p r e t e d as " l i f e w i d e " (Cropley, 1980) meaning that l e a r n i n g and e d u c a t i v e processes occur i n a v a r i e t y of s i t u a t i o n s . Thus l i f e l o n g l e a r n i n g and l i f e l o n g e ducation are seen as processes which, i n a v a r i e t y of ways, continue through l i f e . Mocker and Spear (1982) presented a model of l i f e l o n g l e a r n i n g which i l l u m i n a t e d t h i s i d e a . A c c o r d i n g to these 10 authors, l e a r n i n g can take p l a c e i n any of four modes — formal, nonformal, i n f o r m a l and s e l f - d i r e c t e d — d i f f e r e n t i a t e d by whether or not the l e a r n e r or the i n s t i t u t i o n i n v o l v e d c o n t r o l s the ends and means of the p r o c e s s . A l l of these l e a r n i n g modes are planned, thus a l l are e d u c a t i o n a l s i t u a t i o n s . Mocker and Spear l e f t out spontaneous l e a r n i n g where the o b j e c t i v e s and means are unorganized by e i t h e r the l e a r n e r or an i n s t i t u t i o n . Hence, i n t h i s r e s p e c t , t h e i r model was incomplete. However, i t does demonstrate the breadth of " e d u c a t i o n a l " s i t u a t i o n s which should be c o n s i d e r e d . Given the c o n c e p t u a l i z a t i o n of l i f e l o n g education as being l i f e w i d e , i t i s not enough f o r the educator to c o n s i d e r only formal l e a r n i n g s i t u a t i o n s . I t must, of course, be re c o g n i z e d that these d e f i n i t i o n s i d e n t i f y only the meaning of the "words" i n v o l v e d — they do not a l e r t the c a s u a l reader to the complexity of the m i l i e u surrounding the n o t i o n s of l i f e l o n g l e a r n i n g and i t s subset, l i f e l o n g e d u c a t i o n . T h i s m i l i e u i s d i s c u s s e d i n Chapter Three. Continuing Education The term " c o n t i n u i n g e d u c a t i o n " i s a semantic r e l a t i v e of " l i f e l o n g e d u c a t i o n . " I t was used i n t h i s t h e s i s , as i n the l i t e r a t u r e , to r e f e r s p e c i f i c a l l y to the exte n s i o n of e d u c a t i o n a l experiences i n t o the p r o f e s s i o n a l l i f e of an i n d i v i d u a l who has completed formal t r a i n i n g f o r a p r o f e s s i o n . T h e r e f o r e , c o n t i n u i n g education i n n u r s i n g w i l l r e f e r to e d u c a t i o n a l experiences which have a bearing on n u r s i n g p r a c t i c e 11 a f t e r i n i t i a l p r o f e s s i o n a l education or t r a i n i n g . C o n t i n u i n g education w i l l be d e f i n e d simply as the American Nurses' A s s o c i a t i o n (ANA) d e f i n e d i t as c o n s i s t i n g of "planned l e a r n i n g experiences beyond a b a s i c n u r s i n g e d u c a t i o n a l program" ("Standards f o r Continuing ... , 1975, p. 1). Research Questions The key q u e s t i o n of i n t e r e s t i n t h i s study was: How can the n o t i o n of l i f e l o n g l e a r n i n g be of use i n CNE? In order to answer t h i s q u e s t i o n , these q u e s t i o n s must a l s o be asked: What p r i n c i p l e s represent the core ideas of l i f e l o n g l e a r n i n g which would have to be taken i n t o account i n order f o r implementation to occur? Is i t f e a s i b l e to assume that the n o t i o n of l i f e l o n g l e a r n i n g can be of use i n CNE? How can the p r i n c i p l e s of the n o t i o n of l i f e l o n g education be a p p l i e d to CNE? In order to answer these q u e s t i o n s , an understanding of both the c u r r e n t s t a t e of CNE and the concept of l i f e l o n g education must be achieved. In an attempt to answer these q u e s t i o n s , the f o l l o w i n g format i s used. Overview Chapter Two reviews l i t e r a t u r e concerning c o n t i n u i n g education i n n u r s i n g and d e s c r i b e s i t s context and c u r r e n t p r a c t i c e . Of p a r t i c u l a r i n t e r e s t are c o n t i n u i n g education i n 1 2 other p r o f e s s i o n s , the goals and o r g a n i z a t i o n of CNE, the nurse as the l e a r n e r , and the value of f o r m a l i z e d CNE a c t i v i t i e s and i n d i v i d u a l nurse's e d u c a t i o n a l endeavours. Credence given to the n o t i o n s of l i f e l o n g l e a r n i n g and l i f e l o n g education f o r CNE i s acknowledged and present day use of the concept i n n u r s i n g i s d i s c u s s e d . Chapter Three d e s c r i b e s and analyzes l i f e l o n g l e a r n i n g and l i f e l o n g education as concepts c u r r e n t l y used i n the l i t e r a t u r e of a d u l t and higher e d u c a t i o n . The author attempted to o p e r a t i o n a l i z e the n o t i o n of l i f e l o n g e d u c a t i o n . To accomplish t h i s task, i t was necessary to review l i t e r a t u r e concerning the h i s t o r i c a l and conceptual r o o t s of l i f e l o n g l e a r n i n g and l i f e l o n g education and assumptions upon which they are based. In Chapter Three, the emphasis i s on l i f e l o n g e d u c a t i o n , a subset of l i f e l o n g l e a r n i n g . As i n d i c a t e d e a r l i e r , l i f e l o n g e ducation i s t r e a t e d as a philosophy of education and examined in terms of i t s g o a l s , assumptions, and a s s o c i a t e d p r i n c i p l e s of o p e r a t i o n . In Chapter Four, a p r o p o s a l f o r the s y n t h e s i s of l i f e l o n g e d ucation and CNE i s o f f e r e d . Recommendations f o r a l t e r a t i o n s i n t h i s d i r e c t i o n are given. These recommendations r e l a t e s p e c i f i c a l l y to g o a l s , means, content, a d m i n i s t r a t i o n of a c t i v i t i e s and treatment of the l e a r n e r i n CNE a c t i v i t i e s . 13 CHAPTER TWO THE CURRENT STATE OF CONTINUING EDUCATION IN NURSING: A REVIEW OF LITERATURE Con t i n u i n g education i s a growing although r e l a t i v e l y recent aspect of the f i e l d of n u r s i n g . Although p o o r l y documented, i t i s evident that there has been a dramatic i n c r e a s e i n CNE o p p o r t u n i t i e s over the l a s t decade. The l i t e r a t u r e i n d i c a t e s , however, that t h i s growth has not n e c e s s a r i l y been c o o r d i n a t e d i n an e f f i c i e n t manner. Continuing education i n n u r s i n g i s g a n g l i n g i n i t s youth. Numerous authors have made comments r e l a t e d to CNE's unwieldy nature: Nakamoto and Verner (1975) d e s c r i b e d CNE as being "piecemeal" (p.4), G r i f f i n (1978) s a i d that o f f e r i n g s "resemble smorgasbords" (p. 3) and the R e g i s t e r e d Nurses' A s s o c i a t i o n of B r i t i s h Columbia (RNABC) d e s c r i b e d i t as being, f o r B r i t i s h Columbia (B.C.) at l e a s t , "ad hoc" ("Continuing Education f o r 1978, p. 4) and i n need of a c o o r d i n a t i n g mechanism. The Context The p r a c t i c e of c o n t i n u i n g education f o r nurses e x i s t s w i t h i n the framework of the n u r s i n g p r o f e s s i o n and i t c o e x i s t s with the c o n t i n u i n g education p r a c t i c e s of other h e a l t h p r o f e s s i o n s . C o n t i n u i n g education in n u r s i n g a l s o e x i s t s w i t h i n the context of i t s own p a s t . Issues which face the n u r s i n g p r o f e s s i o n as a whole are r e f l e c t e d i n the c u r r e n t p r a c t i c e of c o n t i n u i n g e d u c a t i o n . T h e r e f o r e , before examining contemporary 1 4 CNE, the n u r s i n g p r o f e s s i o n , c o n t i n u i n g education i n the a l l i e d h e a l t h p r o f e s s i o n s as a whole, and the h i s t o r y of c o n t i n u i n g education i n n u r s i n g must be c o n s i d e r e d . Nursing D e f i n i t i o n Nursing i s an a r t and a s c i e n c e . I t i s a s c i e n c e because the p r a c t i c e of n u r s i n g r e q u i r e s a body of knowledge, which can be b u i l t upon, drawn from v a r i o u s d i s c i p l i n e s . Nursing resembles an a r t because i t s p r a c t i c e r e q u i r e s a d a p t a t i o n of knowledge i n s p e c i f i c s i t u a t i o n s . Most important to a d e f i n i t i o n , however, i s that n u r s i n g , as an a r t and s c i e n c e , p r o v i d e s "a s e r v i c e " ( P i e r c e , 1972, p.4). The c e n t r a l focus i s the "care of people who need h e l p i n coping with problems along the continuum of h e a l t h - i l l n e s s " . ( P i e r c e , 1972, p.4). T h i s i s not to say that the nurse i s always d i r e c t l y i n v o l v e d i n g i v i n g care but the nurse i s c e r t a i n l y the f a c i l i t a t o r of the care r e q u i r e d (Orem, 1971). The p o s i t i o n of "nurse" i s not new but n u r s i n g i s s t r u g g l i n g with the need to develop a unique i d e n t i t y . Perhaps the most prominent i s s u e that n u r s i n g must d e a l with i s i t s establishment as a p r o f e s s i o n . Related i s s u e s are the changing r o l e s of nurses and the education r e q u i r e d f o r entry to p r a c t i c e . 1 5 A P r o f e s s i o n ? Nursing has been s t r u g g l i n g f o r years to o b t a i n r e c o g n i t i o n , both from w i t h i n and without, as a p r o f e s s i o n . I t s s t a t u s i n t h i s regard has been dubious. Whether nursing t r u l y possesses some of the c h a r a c t e r i s t i c s of a p r o f e s s i o n , such as a d i s t i n c t and unique body of knowledge, and c l e a r l y d e f i n e d c a r e e r paths, i s a source of debate. S t y l e s (1975) argued that n u r s i n g l a c k s "coherence; i e . that q u a l i t y of being l o g i c a l l y i n t e g r a t e d , c o n s i s t e n t , and i n t e l l i g i b l e " (p. 7) i n almost every f a c e t — ranging from the o r g a n i z a t i o n of i t s p r a c t i t i o n e r s to the education of r e c r u i t s to the f i e l d . Somers (1971) noted that " t h i s important p r o f e s s i o n f i n d s i t s e l f today i n a s o r t of p r o f e s s i o n a l and o r g a n i z a t i o n a l limbo" (p.94). The reasons f o r these problems are not e n t i r e l y c l e a r . However, the n u r s i n g community must deal with them i f i t i s to achieve a d e f i n i t e i d e n t i t y . Entry to P r a c t i c e Part of the i d e n t i t y problem stems from the f a c t that there are d i f f e r e n t methods of e n t e r i n g the f i e l d . These are c h a r a c t e r i z e d by the " p r o f e s s i o n a l " approach, u s u a l l y i n v o l v i n g u n i v e r s i t y study, and the " t e c h n i c a l " approach ("Standards f o r c o n t i n u i n g ... , 1975). There i s l i t t l e a r t i c u l a t i o n between the two and c r i t i c i s m s of both e x i s t . Graduates of the " p r o f e s s i o n a l " approach are seen as being inadequate i n " p r a c t i c a l " n ursing and " t e c h n i c a l " graduates are seen as not 16 c o n t r i b u t i n g to the p r o f e s s i o n . T h i s i s one of the problems r e l a t e d to what Nakamoto and Verner (1972) term the "ambiguity surrounding n u r s i n g " (p.66). The " d i f f e r e n t i a l p r e p a r a t i o n " (Lysaught, 1974, p. 295) of nurses has caused d i f f i c u l t i e s f o r the n u r s i n g p r o f e s s i o n as a whole and has r a m i f i c a t i o n s f o r the p r a c t i c e of c o n t i n u i n g e d u c a t i o n . Part of the c o n f u s i o n i n p r e p a r i n g nurses may stem from the a p p a r e n t l y d i f f e r i n g g o als of n u r s i n g s e r v i c e and n u r s i n g education (Huckaby, 1979). Nursing s e r v i c e takes a pragmatic, p r e s e n t - o r i e n t e d view of n u r s i n g s i t u a t i o n s , based on the d e s i r e to ensure that s e r v i c e r e s p o n s i b i l i t i e s are c a r r i e d out. Nursing education, and i n p a r t i c u l a r , that type which prepares " p r o f e s s i o n a l s " r a t h e r than " t e c h n i c i a n s " , i s more concerned with what, i d e a l l y , the nurse "should be" i f the p r o f e s s i o n i s to progress ( F e l t o n , 1980). The l a c k of agreement on the goals of b a s i c nursing e d u c a t i o n and more g e n e r a l l y , the f u t u r e d i r e c t i o n of the n u r s i n g p r o f e s s i o n i t s e l f , has meant that the i s s u e of p r o f e s s i o n a l i s m i s l a r g e l y u n r e s o l v e d . In the recent past, there has been a move, at l e a s t i n Canada, to assure a u n i v e r s i t y - t y p e " p r o f e s s i o n a l " education f o r a l l i n d i v i d u a l s e n t e r i n g the f i e l d . Changing Roles To add to the dilemma, t e c h n o l o g i c a l changes i n medical s c i e n c e have impinged on the n u r s i n g p r o f e s s i o n . Nursing has responded to the i n c r e a s i n g complexity by f u r t h e r s p e c i a l i z a t i o n 17 among i t s ranks (Cooper & Hornback, 1973; Lysaught, 1974). The " b a s i c " education experience of the i n d i v i d u a l nurse does not, i n most cases, prepare that person f o r these s p e c i a l i z e d and o f t e n h i g h l y t e c h n i c a l r o l e s . Further to t h i s , there i s a movement toward primary n u r s i n g (Cooper & Byrns, 1973), a type of p r a c t i c e i n which the nurse has an expanded r o l e and takes i n c r e a s e d r e s p o n s i b i l i t y f o r the welfare of the i n d i v i d u a l p a t i e n t . The c r e a t i o n of c o n t i n u i n g education o p p o r t u n i t i e s f o r nurses i s a f f e c t e d by the present s t a t e of the nursing p r o f e s s i o n i n terms of i t s own s t a b i l i t y and coherence. At present, the n u r s i n g p r o f e s s i o n i s not strong on e i t h e r of these p o i n t s . C o n t i n u i n g Education i n the H e a l t h P r o f e s s i o n s Continuing education i n n u r s i n g e x i s t s c o n c u r r e n t l y with that o f f e r e d i n other h e a l t h p r o f e s s i o n s . I t i s l o g i c a l to assume that i t i s i n f l u e n c e d by c o n t i n u i n g education p r a c t i c e s i n these a l l i e d p r o f e s s i o n s . Houle (1970) noted, i n f a c t , that " a l l p r o f e s s i o n s have marked s i m i l a r i t i e s of approach when they undertake c o n t i n u i n g e d u c a t i o n a l programs" (p.6). The f a c t t h a t c o n t i n u i n g nursing education resembles the more e s t a b l i s h e d p r o f e s s i o n s may not n e c e s s a r i l y bode w e l l f o r CNE. Houle (1970) s t a t e d that "at present, the most s t a r t l i n g and i r o n i c c h a r a c t e r i s t i c of c o n t i n u i n g education i s i t s d i s c o n t i n u i t y i n the experience of the p r o f e s s i o n a l h i m s e l f " 18 (p.8). Hutchinson (1973) s a i d that " c o n t i n u i n g education f o r h e a l t h manpower i s marked by i t s d i s c o n t i n u i t y . The s e a r c h l i g h t of a p p r a i s a l f i n d s the 'system' of c o n t i n u i n g education a non- system. I t tends to be s p o r a d i c , fragmented, and n o n s e q u e n t i a l " (p.133). Despite the problems, c o n t i n u i n g education i n the h e a l t h p r o f e s s i o n s i s assuming g r e a t e r importance both i n the l i f e of the i n d i v i d u a l p r o f e s s i o n a l and as p a r t of the p r o f e s s i o n as a whole. Consumer demand and the d e s i r e of p r o f e s s i o n a l s to b e t t e r themselves f o r t h e i r p o s i t i o n s are a s s u r i n g a p l a c e f o r c o n t i n u i n g e d u c a t i o n . As much as c o n t i n u i n g education i n i n d i v i d u a l p r o f e s s i o n s i s blossoming, a l b e i t i n an uncoordinated manner, there i s l i t t l e i n t e r - p r o f e s s i o n a l e d u c a t i o n . The p r o f e s s i o n s are c h a r a c t e r i z e d by " i s o l a t i o n i s m " (Hutchinson, 1973) i n regard to what they deem to be t h e i r unique f u n c t i o n s and need for knowledge. I t i s only r e c e n t l y that i n t e r d i s c i p l i n a r y e f f o r t s i n the p r o v i s i o n of c o n t i n u i n g education o p p o r t u n i t i e s have been attempted. Cooper (1972a) i n d i c a t e d that one problem with i n t e r d i s c i p l i n a r y c o n t i n u i n g education i s that i t i s o f t e n seen as one d i s c i p l i n e p r o v i d i n g education f o r another with l i t t l e r e a l c o l l a b o r a t i o n . A Hi s t o r y of Continuing Education i n Nursing F l o r e n c e N i g h t i n g a l e i s r e p o r t e d to have s a i d , "Let us never c o n s i d e r o u r s e l v e s as f i n i s h e d nurses ... We must be 19 l e a r n i n g a l l of our l i v e s " (Goldberg, 1975, p. 1). During the l a s t century, p r o v i s i o n of f o r m a l l y organized o p p o r t u n i t i e s i n c o n t i n u i n g education f o r nurses has i n c r e a s e d . A b r i e f examination of the progress of CNE demonstrates that some of the problems faced were s i m i l a r to and grew out of those faced by the p r o f e s s i o n as a whole. In the e a r l i e s t part of the present century, nurses worked p r i m a r i l y i n h o s p i t a l s and p r i v a t e duty. The p o s i t i o n of nurse was not h i g h l y lauded -- i t was a woman's job (Cooper, 1978). The nurse was seen as. a handmaiden (Schweer, 1978), and the p o s i t i o n was not h i g h l y p a i d . Basic n u r s i n g education c o n s i s t e d of " t r a i n i n g " , r a t h e r than a well-rounded academic and p r a c t i c a l course of s t u d i e s . Although i t was r e c o g n i z e d that nurses needed to l e a r n , there was l i t t l e time and few o p p o r t u n i t i e s f o r them to p a r t i c i p a t e i n e d u c a t i o n a l programs d i r e c t e d toward improving t h e i r p r a c t i c e . According to s e v e r a l w r i t e r s , post-graduate courses, a type of i n s e r v i c e education o f f e r e d by h o s p i t a l s , were the f i r s t formal e f f o r t s aimed at b e t t e r i n g the p r a c t i c e of n u r s i n g through c o n t i n u i n g education (Cooper & Hornback, 1973; L u s s i e r , 1980; Nakamoto, 1972). Begun i n the f i r s t decade of the 1900's, these courses were u s u a l l y r e l a t e d to c l i n i c a l s p e c i a l t i e s . There i s reason to b e l i e v e that the courses d i d not represent the most e d u c a t i o n a l l y sound endeavours and that t h e i r q u a l i t y v a r i e d g r e a t l y . The primary m o t i v a t i o n of h o s p i t a l s i n p r o v i d i n g these courses seems to have been to i n c r e a s e t h e i r work f o r c e . 20 In the beginning of t h i s century, the general e d u c a t i o n a l system made l i t t l e p r o v i s i o n f o r c o n t i n u i n g education i n n u r s i n g . Cooper and Hornback (1973) and L u s s i e r (1980) i n d i c a t e d that i n the year 1899, courses were o f f e r e d by Columbia U n i v e r s i t y f o r r e g i s t e r e d nurses. G r a d u a l l y , the connection between n u r s i n g and higher education strengthened. By the 1940's, nurses were seeking c o l l e g e c r e d i t f o r t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education and the post-graduate courses of e a r l i e r times were l e s s a p p r e c i a t e d . In that decade, the U n i v e r s i t y of P i t t s b u r g h o f f e r e d u n i v e r s i t y c o n t i n u i n g education courses (Schweer, 1978). The 1920's saw a s l i g h t l y d i f f e r e n t form of c o n t i n u i n g education become a v a i l a b l e to nurses. Workshops, short courses, and i n s t i t u t e s were sponsored by i n s t i t u t i o n s such as the American Nurses' A s s o c i a t i o n and the N a t i o n a l League f o r Nursing (NLN) (Cooper, 1982). U n i v e r s i t y s c hools of n u r s i n g began at t h i s time and there was some u n i v e r s i t y involvement i n c o n t i n u i n g education (Cooper & Hornback, 1973; Goldberg, 1975). A f t e r World War I, n u r s i n g changed somewhat as nurse veterans sought p o s i t i o n s other than p r i v a t e duty (Cooper, 1978). World War II provided the impetus f o r the development of r e f r e s h e r courses f o r nurses. H o s p i t a l s found that they needed s t a f f and i n a c t i v e nurses wished to r e t u r n to p r a c t i c e to support the war e f f o r t . Consequently, h o s p i t a l s developed r e f r e s h e r programs (Cooper & Hornback, 1973; Schweer, 1978). In those e a r l y times, u n i v e r s i t i e s were not p a r t i c u l a r l y 21 i n v o l v e d i n c o n t i n u i n g e d u c a t i o n . By 1959, i n the U n i t e d S t a t e s , f e d e r a l funds became a v a i l a b l e f o r the p r o v i s i o n of short courses i n n u r s i n g (Cooper, 1978; Cooper & Hornback, 1973). At about the same time, three regions developed i n t e r s t a t e higher education consortiums. Two important consortiums were WICHE, the Western I n t e r s t a t e C o u n c i l on Higher Education, and WCHEN, the Western C o u n c i l on Higher E d u c a t i o n . These groupings have had strong n u r s i n g r e p r e s e n t a t i o n and C o u n c i l s on Nursing Education have been e s t a b l i s h e d as sub-bodies. These groups c o n t r i b u t e d to r e g i o n a l p l a n n i n g f o r c o n t i n u i n g education f o r nurses by i n s t i t u t i o n s of higher education (Nakamoto, 1972; Schweer, 1978). In 1968, the p r o f e s s i o n ' s concern with c o n t i n u i n g education was demonstrated i n a n a t i o n a l conference h e l d at the U n i v e r s i t y of Wisconsin. T h i s was f o l l o w e d up i n 1969 by the F i r s t N a t i o n a l Conference on C o n t i n u i n g Education i n Nursing h e l d at W i l l i a m s b u r g , V i r g i n i a . T h i s meeting was concerned with the r o l e of i n s t i t u t i o n s of higher education i n the p r o v i s i o n of c o n t i n u i n g education f o r nurses (Nakamoto, 1972). A Second N a t i o n a l Conference was h e l d at Syracuse U n i v e r s i t y i n 1970. T h i s meeting recommended working with the ANA i n the p r o v i s i o n of c o n t i n u i n g n u r s i n g education ( L u s s i e r , 1980 ; Goldberg, 1975). Consequently, i n 1973, the ANA C o u n c i l on Continuing Education was e s t a b l i s h e d . The h i s t o r y of CNE i n Canada has p a r a l l e l e d that i n the United S t a t e s . Canadian nurses, too, have demonstrated concern 22 for c o n t i n u i n g education i n t h e i r p r o f e s s i o n . At the I n t e r n a t i o n a l Congress of Nurses (ICN) meeting h e l d i n Montreal in 1969, an a d d i t i o n a l s e s s i o n .was devoted to c o n t i n u i n g e d u c a t i o n . Canadian nurses h e l d t h e i r own f i r s t n a t i o n a l conference on c o n t i n u i n g education i n 1979 (L u s s i e r , 1 9 8 0 ) . Recent trends i n CNE i n the U n i t e d S t a t e s have been r e l a t e d to the concern f o r q u a l i t y . As e a r l y as 1970, a mechanism f o r the approval of programs, the C o n t i n u i n g Education R e c o g n i t i o n Program (CERP), was embraced by s t a t e nurses' a s s o c i a t i o n s who urged t h e i r members to p a r t i c i p a t e to maintain competence (Cooper, 1982; L u s s i e r , 1980). L a t e r in the 1970's, the ANA urged p a r t i c i p a t i o n by s t a t e a s s o c i a t i o n s i n a nationwide Continuing Education Approval and R e c o g n i t i o n Program (CEARP). In 1975, a system f o r n a t i o n a l a c c r e d i t a t i o n of c o n t i n u i n g education o f f e r i n g s was c r e a t e d by the American Nurses' A s s o c i a t i o n (Cooper, 1982, p. 106). Much of t h i s a c t i v i t y was r e l a t e d to trends toward mandatory c o n t i n u i n g education requirements. As of 1979, ten s t a t e s had mandatory c o n t i n u i n g education laws f o r nurse r e l i c e n s u r e ( L u s s i e r , 1980). The Continuing Education U n i t was e s t a b l i s h e d as a means of s t a n d a r d i z a t i o n of p a r t i c i p a t i o n i n c o n t i n u i n g education. Present S t a t u s Goals Today, CNE has two b a s i c purposes. The primary goal i s 23 r e l a t e d to competence. A secondary goal i s r e l a t e d to development of the emergent p r o f e s s i o n of n u r s i n g . Subtle v a r i a t i o n s on each of these themes e x i s t . Competence to p r a c t i c e The c e n t r a l purpose of CNE i s to f o s t e r competence to p r a c t i c e i n the f i e l d . The b a s i c stimulant to the p r o v i s i o n of c o n t i n u i n g education i s the maintenance (or development) of minimal c l i n i c a l competence by p r a c t i t i o n e r s (Levine, 1978). A. n a t i o n a l survey d e s c r i b e d by McNally (1972) found that i n the U n i t e d S t a t e s the primary reason fo r the e x i s t e n c e of CNE was the updating of knowledge and s k i l l s . The I n t e r n a t i o n a l C o u n c i l of Nurses (ICN) statement ("Continuing Education f o r 1980) on CNE i n d i c a t e d that one of the purposes of c o n t i n u i n g education i s that i t should serve the p r a c t i t i o n e r ' s needs for updated knowledge. The American Nurses' A s s o c i a t i o n p o s i t i o n paper on standards fo r n u r s i n g education ("Standards f o r nursing ...", 1978) i n d i c a t e d that c o n t i n u i n g education i s c e n t r a l to m a i n t a i n i n g competence. Nakamoto's (1972) review of the North American l i t e r a t u r e concluded that the primary purpose of CNE was "the achievement of the l e a r n i n g needed to improve p a t i e n t c a r e " (p. 75). A somewhat higher l e v e l purpose that has been s t a t e d i s to improve the q u a l i t y of c l i n i c a l n u r s i n g p r a c t i c e (Loucks, 1973) r a t h e r than simply m a i n t a i n i n g present l e v e l s . The R e g i s t e r e d Nurses' A s s o c i a t i o n of B r i t i s h Columbia (RNABC) s t a t e d that the 24 purpose of c o n t i n u i n g education i s to c o n t r i b u t e to the improvement of nur s i n g care (Continuing Education Approval 1983; Co n t i n u i n g Education f o r R e g i s t e r e d ... , 1978). Schweer (1978) i n d i c a t e d that c o n t i n u i n g education o p p o r t u n i t i e s should b u i l d on pr e v i o u s competence, u t i l i z i n g present knowledge and s k i l l s . Such goals are a step beyond that of mai n t a i n i n g the s t a t u s quo. Some authors have adopted a more g l o b a l p e r s p e c t i v e on CNE. Tobin (1976a) r e l a t e d i t s p r o v i s i o n to the q u a l i t y of h e a l t h care i n g e n e r a l . Schechter (1974) and Knox (1973) i n d i c a t e d that c o n t i n u i n g education f o r h e a l t h p r o f e s s i o n a l s should improve the he a l t h . c a r e system. The primary goals of c o n t i n u i n g education are r e l a t e d c l o s e l y to p r a c t i t i o n e r s ' needs to maintain and improve performance. The a l t r u i s t i c m o t i v a t i o n f o r the nurse i n seeking e d u c a t i o n a l o p p o r t u n i t i e s and f o r agencies i n p r o v i d i n g them i s that i t enables the i n d i v i d u a l "to do the best of which he i s capable when c a r i n g f o r p a t i e n t s " (Hayter, 1972, p. 32) and to c o n t r i b u t e , along with other p r o f e s s i o n a l s , to the p r o v i s i o n of the best h e a l t h care p o s s i b l e . Such goals are probably the most common purposes of c o n t i n u i n g education o p p o r t u n i t i e s f o r nurses. However, there are i n d i c a t i o n s that n u r s i n g l e a d e r s are aware of other p o s s i b l e purposes. Cooper and Hornback (1973) i n d i c a t e d t h at the aims of c o n t i n u i n g education are broader than that of the maintenance of competence i n the d i r e c t p r o v i s i o n of h e a l t h c a r e . These authors 25 i n d i c a t e d that c o n t i n u i n g education must h e l p the i n d i v i d u a l nurse recognize "the importance of h i s c o n t r i b u t i o n to the s o c i e t y of which he i s a part and the s i g n i f i c a n c e of h i s work to the common good" (Cooper & Hornback, 1973, p. 53). S i m i l a r to t h i s , the R e g i s t e r e d Nurses' A s s o c i a t i o n of O n t a r i o (RNAO) ( P o s i t i o n Paper ... , 1980) s a i d CNE should serve s e v e r a l purposes i n c l u d i n g : the enhancement of p r a c t i c e , and the promotion of p e r s o n a l and p r o f e s s i o n a l growth. T h i s p o s i t i o n i n d i c a t e s that c o n t i n u i n g education should f a c i l i t a t e the development of the n u r s i n g p r o f e s s i o n i t s e l f . Statements such as t h i s c l e a r l y go beyond the purpose of c o n t i n u i n g education f o r nurses as being d i r e c t l y r e l a t e d to the p r o v i s i o n of p a t i e n t c a r e . P r o f e s s i o n a l i s m - the Hidden Agenda One argument f o r c o n t i n u i n g education i s that nurses are p r o f e s s i o n a l , and, as such, must continue t h e i r l e a r n i n g (Bevis, 1975; Hayter,1972). Cooper (1972b) and Norman (1983) suggested that one of the c h a r a c t e r i s t i c s of p r o f e s s i o n a l s i s a commitment to i n c r e a s i n g t h e i r knowledge and a b i l i t i e s r e l a t e d to p r a c t i c e . Statements s i m i l a r to these ideas, i n d i c a t e a b e l i e f , at l e a s t by authors i n the l i t e r a t u r e , i n a r e l a t i o n s h i p between c o n t i n u i n g e d u c a t i o n and p r o f e s s i o n a l i s m . I t would seem that f o r the nurse, as a p r o f e s s i o n a l , c o n t i n u i n g education i s an o b l i g a t i o n . C e r t a i n l y , c o n t i n u i n g education i s , as the ANA has i n d i c a t e d (Standards fo r n u r s i n g ... , 1978), to s t i m u l a t e p e r s o n a l growth and p r o f e s s i o n a l m a t u r i t y . 26 The r e c o g n i t i o n of the r e l a t i o n s h i p of c o n t i n u i n g education to p r o f e s s i o n a l growth on an i n d i v i d u a l b a s i s i s a microcosm of what some authors i n d i c a t e that c o n t i n u i n g education should be accomplishing i n r e l a t i o n to the p r o f e s s i o n as a whole. S t y l e s (1975) maintained that c o n t i n u i n g education i s at "the c u t t i n g edge of the p r o f e s s i o n " (p.8). T h i s author viewed c o n t i n u i n g education f o r nurses as being "the v e h i c l e f o r p r o f e s s i o n a l coherence" ( S t y l e s , 1975, p.8). The goals of c o n t i n u i n g education are thus l i n k e d with those of the p r o f e s s i o n as a whole. The C o u n c i l on Continuing Education of the 53rd ANA Convention i n 1982 r e l a t e d c o n t i n u i n g education to "the emerging autonomy of the nursing p r o f e s s i o n " (The Impact of Continuing Education ... , 1982, p. 7). Such goals may be more i d e a l i s t i c than r e a l i s t i c . I t i s d i f f i c u l t to know a c c u r a t e l y s i n c e surveys and s t u d i e s of the u s e f u l n e s s of c o n t i n u i n g education to the developing p r o f e s s i o n are n o n - e x i s t e n t . Perhaps t h i s i s an area which the n u r s i n g p r o f e s s i o n must f u r t h e r c o n s i d e r . O r g a n i z a t i o n Today, there are an i n c r e a s i n g number of o p p o r t u n i t i e s f o r nurses to be i n v o l v e d i n c o n t i n u i n g education a c t i v i t i e s . These o p p o r t u n i t i e s are provided by s e v e r a l persons/groups which have i d e n t i f i e d what they see as being t h e i r r o l e . 27 R e s p o n s i b i l i t i e s The l i t e r a t u r e on c o n t i n u i n g education i n nur s i n g i d e n t i f i e s s e v e r a l prime r e s p o n s i b i l i t y - b e a r e r s . The American Nurses' A s s o c i a t i o n , f o r example, d e s c r i b e d the unique r e s p o n s i b i l i t i e s of f i v e s p e c i f i c persons/groups ("Continuing Education i n Nursing: An Overview", 1976). I t i d e n t i f i e d the r e s p o n s i b i l i t i e s of the i n d i v i d u a l , the employer, the sponsor ( i e . an e d u c a t i o n a l i n s t i t u t i o n ) , the s t a t e nurses' a s s o c i a t i o n , and the American Nurses' A s s o c i a t i o n i t s e l f . S i m i l a r l y , i n Canada, the RNABC suggested that r e s p o n s i b i l i t y f o r c o n t i n u i n g education should be shared by the i n d i v i d u a l nurse, p r o f e s s i o n a l n u r s i n g o r g a n i z a t i o n s , h e a l t h care agencies where nurses are employed, and e d u c a t i o n a l i n s t i t u t i o n s . The RNAO i d e n t i f i e d the same bodies as the RNABC with the a d d i t i o n of governmental h e a l t h and e d u c a t i o n . The r a t i o n a l e f o r the involvement of each of these persons/groups i s understandable. The i n d i v i d u a l i s the prime p a r t i c i p a n t i n c o n t i n u i n g education a c t i v i t i e s and the key f a c t o r i n outcomes as a r e s u l t of c o n t i n u i n g e d u c a t i o n . The employer or h e a l t h care agency has a r e s p o n s i b i l i t y to ensure a standard of c a r e administered by i t s nursing personnel and an o b l i g a t i o n t o ensure that t h i s i s adequate. E d u c a t i o n a l i n s t i t u t i o n s have an o b l i g a t i o n , by v i r t u e of t h e i r e x i s t e n c e , to provide a c c e s s to l e a r n i n g o p p o r t u n i t i e s f o r the many segments of the pop u l a t i o n s which they serve. Members of the nur s i n g p r o f e s s i o n comprise one of these segments. Regional and 28 n a t i o n a l n u r s i n g a s s o c i a t i o n s have a s e l f - a p p o i n t e d mandate to uphold the n u r s i n g p r o f e s s i o n and are t h e r e f o r e r e q u i r e d to c o n t r i b u t e to the c o n t i n u i n g education of t h e i r members. F i n a l l y , government can be seen as having a r e s p o n s i b i l i t y f o r c o n t i n u i n g education f o r nurses in that i t i s a major source of funding f o r h e a l t h care and education and i s concerned with the c o s t s and b e n e f i t s of i t s investment. The r e s p o n s i b i l i t y of c o l l e g e s and s c h o o l s of n u r s i n g w i t h i n i n s t i t u t i o n s of higher education have been d i s c u s s e d more f r e q u e n t l y ( C u r t i s , Darragh, Fancher, Ingmire, Lesnan, Orwig, P o p e i l , and Shores, 1969). As p r o f e s s i o n a l s c h o o l s recognize that t h e i r f u n c t i o n does not end with the e j e c t i o n of the "complete" product, t h i s t r e n d w i l l be i n evidence. Each group i d e n t i f i e d has a vested i n t e r e s t i n the d i r e c t i o n CNE should take. Nursing o r g a n i z a t i o n s would be most i n t e r e s t e d , f o r example, in the promotion of the p r o f e s s i o n . On the other hand, h e a l t h care i n s t i t u t i o n s have tended to j u s t i f y education which c o n t r i b u t e s to the q u a l i t y of p a t i e n t care (Hamil, 1974). I t may be that as a r e s u l t of these d i f f e r i n g r e s p o n s i b i l i t i e s , c o n f l i c t i n g d i r e c t i o n s are s e l e c t e d . T h i s seems to c h a r a c t e r i z e the c u r r e n t s t a t e of c o n t i n u i n g education in n u r s i n g . Despite the involvement of d i f f e r e n t o r g a n i z a t i o n s , primary r e s p o n s i b i l i t y f o r continued l e a r n i n g seems to- r e s t with the i n d i v i d u a l . The ANA and the RNAO, are examples of n u r s i n g o r g a n i z a t i o n s which have i n d i c a t e d that the primary 29 r e s p o n s i b i l i t y f o r the type of personal and p r o f e s s i o n a l growth that can be achieved through c o n t i n u i n g education belongs to the i n d i v i d u a l . The System (or Non-System) Continuing education f o r nurses occurs i n many s e t t i n g s . There are many l e a r n i n g o p p o r t u n i t i e s a v a i l a b l e . These range from f o r m a l l y planned classroom l e c t u r e s to i n f o r m a l conferences. McNally's (1972) n a t i o n a l survey of c o n t i n u i n g education programs f o r r e g i s t e r e d nurses i n the United S t a t e s found that the p r i n c i p a l conductors of c o n t i n u i n g education were schools of nur s i n g (27.3%) and h o s p i t a l s (26.8%). In B r i t i s h Columbia, c o n t i n u i n g education f o r nurses i s provided by u n i v e r s i t y h e a l t h s c i e n c e d i v i s i o n s , community c o l l e g e s , the p r o v i n c i a l n u r s i n g a s s o c i a t i o n , and e d u c a t i o n a l o r g a n i z a t i o n s as w e l l as i n d i v i d u a l h e a l t h care agencies. The formal o r g a n i z a t i o n of c o n t i n u i n g education o p p o r t u n i t i e s f o r nurses i s probably more well-developed i n the Un i t e d S t a t e s than i n Canada. T h i s i s l i k e l y a r e s u l t of the requirement f o r mandatory c o n t i n u i n g education f o r r e l i c e n s u r e i n some s t a t e s . The ANA House of Delegates has made a motion i n d i c a t i n g that the ANA should do whatever i t can to support those i n d i v i d u a l s t a t e s that wish to e s t a b l i s h c o n t i n u i n g education f o r r e l i c e n s u r e . The American Nurses' A s s o c i a t i o n p r o v i d e s strong l e a d e r s h i p i n the area of c o n t i n u i n g e d u c a t i o n . It has i d e n t i f i e d i t s best c a p a b i l i t y i n c o n t r i b u t i n g to 30 c o n t i n u i n g education as being that of the assessment of common ed u c a t i o n a l needs and the d i s s e m i n a t i o n of standards for n u r s i n g p r a c t i c e ( " S e l f - D i r e c t e d C o n t i n u i n g ... , 1978). The Continuing Education C o u n c i l of the American Nurses' A s s o c i a t i o n has d r a f t e d standards to be used by s t a t e n u r s i n g a s s o c i a t i o n C o n t i n u i n g Education Approval and Recognition Programs ( P o p e i l , 1976). The CEARP f a c i l i t a t e s record-keeping and t r a n s f e r of records on c o n t i n u i n g education a c t i v i t i e s when nurses move from one s t a t e to another. T h i s f u n c t i o n i s r e l a t e d to the need to demonstrate p a r t i c i p a t i o n i n s t a t e s r e q u i r i n g mandatory c o n t i n u i n g education f o r r e l i c e n s u r e . At the s t a t e l e v e l , the s t a t e a s s o c i a t i o n s ass.ume l e a d e r s h i p f o r CNE. D i f f e r e n t stages of c o o r d i n a t i o n e x i s t i n d i f f e r e n t s t a t e s . There are examples of i n n o v a t i v e approaches to c o o r d i n a t i o n of c o n t i n u i n g education a c t i v i t i e s . C a r l l e y (1974) d e s c r i b e d the Indiana experience, where f o r a number of y e a r s , CNE c o n s i s t e d of a "myriad of uncoordinated a c t i v i t i e s " (p.13) which were not a l l that s a t i s f a c t o r y . A p r o j e c t to develop a statewide system of CNE was i n t r o d u c e d . T h i s statewide system was s t r u c t u r e d on a " b i l e v e l b a s i s " ( C a r l l e y , 1974, p. 14) with an o v e r a l l s t a t e o r g a n i z a t i o n and l o c a l s t r u c t u r e s . T h i s allowed o v e r a l l c o o r d i n a t i o n , and yet was f l e x i b l e enough to meet the needs of the l e a r n e r p o p u l a t i o n s i n the d i f f e r e n t r e g i o n s of the s t a t e . T h i s system was deemed to be s u c c e s s f u l . Another i n n o v a t i v e approach to c o o r d i n a t i o n was sponsored 31 by WICHE i n Idaho, Montana, and Wyoming. An attempt was made to overcome g e o g r a p h i c a l b a r r i e r s and to ensure that nurses i n r u r a l areas of these s t a t e s had access to c o n t i n u i n g e d u c a t i o n . T h i s p r o j e c t experimented with v a r i o u s d e l i v e r y systems and was s u c c e s s f u l i n p r o v i d i n g access to c o n t i n u i n g education o p p o r t u n i t i e s . The major problem was the e f f o r t r e q u i r e d to maintain c o o r d i n a t i o n . T h i s p r o j e c t concluded that the framework of higher education i s the most l o g i c a l p o s i t i o n to pl a c e a c u r r i c u l u m f o r c o n t i n u i n g education i n n u r s i n g . The American system of formal o p p o r t u n i t i e s f o r c o n t i n u i n g education i s i n a developmental stage. There are many examples of experimental approaches to c o o r d i n a t i o n of c o n t i n u i n g education a c t i v i t i e s which would i n d i c a t e that the nu r s i n g p r o f e s s i o n i n the United S t a t e s i s s t r u g g l i n g to f i n d a more u s e f u l and e f f i c i e n t way to provide c o n t i n u i n g education o p p o r t u n i t i e s . While the American s i t u a t i o n i s not f a r advanced, the Canadian s i t u a t i o n l a g s behind even t h a t . In Canada, the parent o r g a n i z a t i o n , the Canadian Nurses' A s s o c i a t i o n , p r o v i d e s minimal l e a d e r s h i p i n the area of c o n t i n u i n g e d u c a t i o n . Probably the most t a n g i b l e evidence of i t s involvement i s the p u b l i c a t i o n of t o p i c a l b i b l i o g r a p h i e s and the spora d i c advertisement of c o n t i n u i n g education o p p o r t u n i t i e s i n i t s j o u r n a l , the Canadian Nurse. By and l a r g e , the p r o v i n c i a l n u r s i n g a s s o c i a t i o n s are l e f t to t h e i r own de v i c e s i n d e c i d i n g upon the extent of t h e i r involvement i n c o n t i n u i n g e d u c a t i o n . G e n e r a l l y , while p r o v i n c i a l 32 nurs i n g a s s o c i a t i o n s have is s u e d statements on c o n t i n u i n g education, i n d i c a t i n g t h e i r a f f i r m a t i o n of i t s importance, they have pr o v i d e d l i t t l e i n the way of c o o r d i n a t i o n of c o n t i n u i n g education a c t i v i t i e s i n i n d i v i d u a l p r o v i n c e s . Across Canada, there have been examples of inno v a t i o n s i n c o n t i n u i n g education f o r nurses i n attempts to meet the p a r t i c u l a r needs of v a r i o u s n u r s i n g p o p u l a t i o n s . The use of d i s t a n c e education has assumed i n c r e a s i n g importance i n CNE as e f f o r t s are made to overcome g e o g r a p h i c a l b a r r i e r s . Correspondence-type p o s t - b a s i c courses such as the Nursing Unit A d m i n i s t r a t i o n course have been developed to a s s i s t nurses i n d i f f e r e n t r o l e s . T e l e c o n f e r e n c i n g , the use of s a t e l l i t e t e l e v i s i o n c ourses, and independent l e a r n i n g packages are being u t i l i z e d with some success. Most of the a c t i v i t i e s and i n n o v a t i o n s , however, have been examples of r e l a t i v e l y i s o l a t e d attempts at p r o v i s i o n with no c e n t r a l a d m i n i s t r a t i o n or even wide-spread d i s s e m i n a t i o n of inf o r m a t i o n about what i s a v a i l a b l e . T h e i r e x i s t e n c e seems to c h a r a c t e r i z e c o n t i n u i n g education f o r n u r s i n g i n Canada. Kotaska (1981) d e s c r i b e d the s i t u a t i o n i n B r i t i s h Columbia: Although there has been much a c t i v i t y i n p r o v i s i o n of o p p o r t u n i t i e s , "there i s no c o o r d i n a t e d way f o r CNE i n B r i t i s h Columbia to determine nurses' l e a r n i n g needs a c c u r a t e l y , to share r e s o u r c e s , and to a v o i d gaps or unnecessary d u p l i c a t i o n of programs" (p. 13). 33 I r o n i c a l l y while the u l t i m a t e r e s p o n s i b i l i t y f o r c o n t i n u i n g education has been given to the i n d i v i d u a l , i n the o r g a n i z a t i o n a l framework of the c u r r e n t p r o v i s i o n of CNE, the i n d i v i d u a l has an i n s i g n i f i c a n t p l a c e . The nurse seeking to i d e n t i f y p e r s o n a l e d u c a t i o n a l needs and f i n d i n f o r m a t i o n about c o n t i n u i n g education o p p o r t u n i t i e s i s given l i t t l e d i r e c t i o n e i t h e r i n i d e n t i f y i n g d e f i c i t s , p l a n n i n g g o a l s , or determining means to achieve those g o a l s . The r o l e and a s p i r a t i o n s of the i n d i v i d u a l nurse are ap p a r e n t l y of l i t t l e consequence to the o v e r a l l o r g a n i z a t i o n a l scheme. A l s o , the p o s s i b i l i t i e s of s e l f - d i r e c t e d , continued l e a r n i n g , apart from i n s t i t u t i o n a l l y planned a c t i v i t i e s , are not in c o r p o r a t e d i n t o an o v e r a l l o r g a n i z a t i o n a l p l a n . Canadian s t u d i e s have, however, i n d i c a t e d that nurses are s i g n i f i c a n t l y i n v o l v e d i n s e l f - d i r e c t e d continued l e a r n i n g a c t i v i t i e s . A survey of h o s p i t a l nurses by B e l l and Rix (1979) found that "nurses are spending over twice as much time each month i n s e l f - d i r e c t e d a c t i v i t i e s as i n o t h e r - d i r e c t e d a c t i v i t i e s " (p. 17). Cl a r k and Di c k i n s o n ' s (1976) study demonstrated s i m i l a r r e s u l t s . These f i n d i n g s are in c o n t r a d i c t i o n to Tobin's (1976b) statement t h a t , "nurses i n general are not s e l f - d i r e c t i v e i n t h e i r own l e a r n i n g " (p. 33). C l e a r l y , nurses are capable of pl a n n i n g and c a r r y i n g out t h e i r own c o n t i n u i n g education a c t i v i t i e s . Under the c u r r e n t system, there are many o p p o r t u n i t i e s f o r nurses to p a r t i c i p a t e i n formal c o n t i n u i n g education. There i s , however, l i t t l e sequencing of e d u c a t i o n a l o p p o r t u n i t i e s (Levine, 34 1978) and l i t t l e obvious c o n t i n u i t y i n the experience of the i n d i v i d u a l . What i s needed i s "planned growth" (Cooper, 1972, p. 583) f o r the i n d i v i d u a l and the p r o f e s s i o n . The a l t e r n a t i v e i s that " c o n t i n u i n g education i n n u r s i n g w i l l continue to be uncoordinated, fragmented, and with d u p l i c a t i o n of e f f o r t s and unmet needs" (Cooper, 1972, p. 583). The Learners A dichotomy e x i s t s i n the p a r t i c i p a t i o n p r a c t i c e s of nurses with regard to c o n t i n u i n g e d u c a t i o n . While most nurses p a r t i c i p a t e i n some form of c o n t i n u i n g education, one study (Dolphin, 1983) found that a small percentage of nurses w i l l not p a r t i c i p a t e unless f o r c e d . Hayter (1972) c i t e d evidence, p r i m a r i l y r e l a t e d to formal e d u c a t i o n a l o p p o r t u n i t i e s , of i n d i v i d u a l nurses' f a i l u r e to take r e s p o n s i b i l i t y f o r t h e i r own l e a r n i n g . Hayter (1972) attempted to i d e n t i f y reasons f o r t h i s behavior and concluded that inconvenient and i n a p p r o p r i a t e o p p o r t u n i t i e s and deemphasis on l e a r n i n g may be the cause. The f a c t that nurses may be i n v o l v e d i n i n f o r m a l education of t h e i r own design was appa r e n t l y not taken i n t o account. I n t e r n a l M o t i v a t i o n G e n e r a l l y , however, i t would seem that nurses a t t i t u d e s toward c o n t i n u i n g education are f a v o r a b l e . C l a r k and D i c k i n s o n (1976) concluded that most nurses' a t t i t u d e s were p o s i t i v e . On the other hand, Bevis (1975) c i t e d s t u d i e s which i n d i c a t e d t h a t 35 most nurses d i d not h i g h l y value l e a r n i n g . Cooper's (1972) statements, although based on experience r a t h e r than o b j e c t i v e data, i n d i c a t e d that a lack of respect f o r l e a r n i n g e x i s t s among some nurses. C o n t r i b u t i n g to t h i s a t t i t u d e i n some cases, may be the f a c t that t r a d i t i o n a l e d u c a t i o n a l p r a c t i c e s i n nu r s i n g have not been congruent with the n o t i o n of l i f e l o n g l e a r n i n g (Puetz & R y t t i n g , 1979). However, b a s i c n u r s i n g education has been a l t e r e d somewhat in recent years and attempts have been made to i n s t i l l the idea of continued l e a r n i n g i n graduates. Attempts to study reasons that nurses p a r t i c i p a t e in c o n t i n u i n g education i n d i c a t e that there are a v a r i e t y of p o s s i b l e m o t i v a t i o n s , although a given i n d i v i d u a l may be i n f l u e n c e d by more than one f a c t o r at a time. Dolphin (1983) concluded that the most important m o t i v a t i n g f a c t o r was r e l a t e d to job competence. S i m i l a r l y , O'Connor's (1980) survey of nurses in c o n t i n u i n g education courses and O'Connor's (1982) study of s e l f - s t u d y p r a c t i c e s among nurses found that p a r t i c i p a t i o n was p r i m a r i l y r e l a t e d to a d e s i r e to a c q u i r e p r o f e s s i o n a l knowledge although, agai n , there were found to be many reasons f o r p a r t i c i p a t i o n . Bevis (1975) found that p a r t i c i p a t i o n was r e l a t e d to r o l e p e r c e p t i o n . A s e r v i c e r o l e o r i e n t a t i o n was found to be the primary i n f l u e n c e on p a r t i c i p a t i o n i n c o n t i n u i n g education, although s e r v i c e and p r o f e s s i o n a l r o l e o r i e n t a t i o n s e x h i b i t e d complementary i n f l u e n c e s i n favor of p a r t i c i p a t i o n . For 36 i n d i v i d u a l s p o s s e s s i n g a p r o f e s s i o n a l r o l e o r i e n t a t i o n , involvement i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s would be " i n t r i n s i c a l l y rewarding" (p. 171). There are a l s o socioeconomic f a c t o r s r e l a t e d to nurses' m o t i v a t i o n toward p a r t i c i p a t i o n . Schoen (1981) found that p a r t i c i p a t i o n i n formal c o n t i n u i n g education o p p o r t u n i t i e s was c l o s e l y r e l a t e d to employment s t a t u s . The i n d i v i d u a l who worked f u l l time i n nu r s i n g was more l i k e l y to p a r t i c i p a t e than one who d i d not. T h i s seems l o g i c a l s i n c e a prominent reason f o r attendance was r e l a t e d to job competence. T h i s a l s o i s congruent with t h e o r i e s of l e a r n i n g which suggest that a d u l t s are most i n t e r e s t e d i n l e a r n i n g what has immediate a p p l i c a t i o n f o r them. C l a r k and D i c k i n s o n (1976) a l s o found that a " s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n e x i s t e d between o c c u p a t i o n a l o r i e n t a t i o n and s e l f - d i r e c t e d p a r t i c i p a t i o n ... i n d i c a t i n g that nurses more motivated to i n c r e a s e t h e i r o c c u p a t i o n a l s t a t u s and p r e s t i g e are i n c l i n e d to engage i n more s e l f - d i r e c t e d l e a r n i n g a c t i v i t i e s " (p. 21). Some r e s e a r c h e r s have i d e n t i f i e d a r e l a t i o n s h i p between e d u c a t i o n a l p r e p a r a t i o n and p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . C l a r k and D i c k i n s o n (1976) found that nurses whose bas i c p r e p a r a t i o n was i n a u n i v e r s i t y s e t t i n g or who had some u n i v e r s i t y experience were more l i k e l y to p a r t i c i p a t e i n s e l f - d i r e c t e d c o n t i n u i n g e d u c a t i o n . Dolphin (1983) concluded that nurses with at l e a s t some u n i v e r s i t y p r e p a r a t i o n possessed more i n t e r n a l m o t i v a t i o n toward involvement i n c o n t i n u i n g education. 37 T h i s was a t t r i b u t e d to the e x i s t e n c e of a " d i p l o m a - l e v e l m e n t a l i t y " (Dolphin, 1983, p. 14) that a l l o w s some nurses "to b e l i e v e that t h e i r b a s i c education prepares them f o r a l i f e t i m e of p r a c t i c e " (p. 14). " I n t e r n a l " m o t i v a t i o n seems to stem from d e s i r e s s t i m u l a t e d by the o c c u p a t i o n a l s i t u a t i o n of the nurse as w e l l as an u n d e r l y i n g b e l i e f i n the value of l e a r n i n g . E x t e r n a l M o t i v a t i o n I t appears that few e x t e r n a l motivators f o r p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s e x i s t . Reward and r e c o g n i t i o n systems for honoring the p a r t i c i p a n t f o r e f f o r t s made in t h i s d i r e c t i o n are few and f a r between. Kotaska (1981), d e s c r i b i n g the s i t u a t i o n i n B r i t i s h Columbia, noted that there are few i n c e n t i v e s , e i t h e r monetary or i n terms of e d u c a t i o n a l c r e d i t , f o r p a r t i c i p a t i o n i n p o s t - b a s i c courses. There e x i s t " d i s i n c e n t i v e s " to involvement i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . Hayter (1972) noted that there i s l i m i t e d o p p o r t u n i t y to use what i s l e a r n e d and that the "work s i t u a t i o n i s not conducive to implementing improvements. Change may a c t u a l l y be r e s i s t e d " (p. 35). Cooper (1972) r e f e r r e d to a t t i t u d e s among nurses which degrade the c o n t r i b u t i o n nurses can make to each other's l e a r n i n g . T h i s , combined with a l a c k of value p l a c e d on continued l e a r n i n g , has a n e g a t i v e i n f l u e n c e on a t t i t u d e s toward c o n t i n u i n g e d u c a t i o n . 38 Issues in Continuing Education in Nursing C o n t i n u i n g education i n n u r s i n g i s s t r u g g l i n g with i s s u e s which w i l l have to be r e s o l v e d i f i t i s to be of great use to i n d i v i d u a l p r a c t i t i o n e r s and the nu r s i n g p r o f e s s i o n as a whole. Some i s s u e s are r e l a t e d to the n u r s i n g p r o f e s s i o n as a whole, others are s p e c i f i c to c o n t i n u i n g education i n n u r s i n g . One i s s u e that c o n t i n u i n g education i n n u r s i n g faces i n co n s o r t with other aspects of the nu r s i n g p r o f e s s i o n i s the e d u c a t i o n / s e r v i c e dilemma. As i n d i c a t e d p r e v i o u s l y , there i s a c o n f l i c t between the goals of education and s e r v i c e . Ehrat (1979) i n d i c a t e d that while s e r v i c e i d e n t i f i e s the goal of education as being the p r a c t i t i o n e r "who has the a b i l i t y to render care and s o l v e problems at a s o p h i s t i c a t e d l e v e l " (p. 1), academia's goal f o r education i s the c r e a t i o n of a person with a broad knowledge base who can l e a r n to f u n c t i o n i n v i r t u a l l y any s e t t i n g . T h i s dilemma pervades a l l l e v e l s of n u r s i n g e d u c a t i o n . However, i t i s probably f a i r to s t a t e that c o n t i n u i n g e d u c a t i o n , more than a l l other l e v e l s of n u r s i n g education, has "sought to be the bri d g e between education and p r a c t i c e , to serve as the c o l l a b o r a t i v e l i n k between nurse educators and n u r s i n g s e r v i c e p e r s o n n e l " ("The impact of c o n t i n u i n g education ... , 1982, p. 9). Whether i t has a c t u a l l y accomplished t h i s task i s another q u e s t i o n . The f a c t that s e r v i c e o r g a n i z a t i o n s are o f t e n the p r o v i d e r s i s a c o m p l i c a t i n g f a c t o r i n t h i s . Another i s s u e i s the s t a t u s of c o n t i n u i n g education i n r e l a t i o n to the n u r s i n g p r o f e s s i o n . U n t i l r e c e n t l y , c o n t i n u i n g 39 education has been accorded l i t t l e equality with other areas of nursing education. Linked with t h i s , and related to the problems of coordination and organization which were discussed e a r l i e r , i s the fact that continuing education in nursing also struggles with i t s a b i l i t y to provide access for a l l nurses (Tobin, 1976b). Because of i t s r e l a t i v e l y low position in the educational system, support for continuing education in nursing i s often not afforded as much of a p r i o r i t y as other aspects of nursing education. An RNABC report ("Continuing education for registered ... , 1978) c i t e d evidence of some problems in thi s regard in B r i t i s h Columbia. A v a i l a b i l i t y i s also a concern in l i g h t of the requirements for mandatory continuing education for nurses that are a r i s i n g in some states. If the requirement to pa r t i c i p a t e in mandatory continuing education i s to be present, then opportunities must be available. Another question concerns whether continuing education should be a requirement for relicensure in nursing. Arguments against mandatory continuing education for nurses have included that i t w i l l promote a "stay-in-place" (Levine, 1978, p. 138) education and that i t w i l l lead to a "l e v e l of mediocrity" (Kelly, 1977, p. 19). Huber (1972) . postulated that with a requirement for mandatory continuing education, the reasons nurses seek continuing education may change. A c r u c i a l question is w i l l the nursing profession trust i t s members to maintain 40 t h e i r competence or w i l l i t f o r c e them i n t o c o n t i n u i n g education a c t i v i t i e s ? . Mandatory c o n t i n u i n g education i s f u r t h e r complicated by doubt concerning the impact of c o n t i n u i n g education on p r a c t i c e . T h i s q u e s t i o n i s unanswered ( F o r n i & Overman, 1974; Lysaught, 1981). P h i l l i p s (1979) i n d i c a t e d that the idea that p a r t i c i p a t i o n i s e q u i v a l e n t to competence i s an "unproven assumption" (p. 238). The e v a l u a t i o n of the e f f e c t of c o n t i n u i n g education on p r a c t i c e has been a problem. I t i s d i f f i c u l t and expensive to a c q u i r e the kind of i n f o r m a t i o n r e q u i r e d by t h i s type of e v a l u a t i o n . There i s c o n f l i c t i n g evidence as to whether p a r t i c i p a t i o n i n c o n t i n u i n g education i n f l u e n c e s behavior. Puetz and R y t t i n g (1979), although not u t i l i z i n g r i g o r o u s r e s e a r c h techniques, found that nurses i n v o l v e d i n c o n t i n u i n g education were able to use what they l e a r n e d . Del Bueno (1977), in a study of s p e c i f i c behavior, found that p a r t i c i p a t i o n d i d not have a s i g n i f i c a n t impact. F o r n i and Overman (1974) c o u l d not answer c o n c l u s i v e l y , on the b a s i s of t h e i r survey, whether or not there was a s i g n i f i c a n t impact on behavior as a r e s u l t of c o n t i n u i n g e d u c a t i o n . Although i t i s c l e a r that c o n t i n u i n g education r e s u l t s i n the a c q u i s i t i o n of knowledge and s k i l l s , s e v e r a l authors i n d i c a t e d that there may be other f a c t o r s to c o n s i d e r i n determining whether or not c o n t i n u i n g education has an impact on p r a c t i c e . Del Bueno (1977) concluded that "few performance 41 f a i l u r e s are r e l a t e d to lack of knowledge or s k i l l " (p. 34) but may be r e l a t e d more to o r g a n i z a t i o n a l problems in the workplace. Along the same l i n e of thought, Huber (1972) noted that " p u t t i n g new knowledge i n t o p r a c t i c e i n v o l v e s f a r more than j u s t r e q u i r i n g a person to be exposed to a l e a r n i n g s i t u a t i o n " (p. 29). In order to make c o n t i n u i n g education u s e f u l , CNE o f f e r i n g s must provide o p p o r t u n i t y to develop c l i n i c a l s k i l l s . There must a l s o be support f o r a p p l i c a t i o n of new l e a r n i n g i n the workplace. Co n c l u s i o n The recent h i s t o r y and present s t a t u s of c o n t i n u i n g education i n n u r s i n g a t t e s t s to the burgeoning expenditure of energy and r e s u l t a n t a c t i v i t y i n the development of formal c o n t i n u i n g e d u c a t i o n o p p o r t u n i t i e s f o r nurses. In a d d i t i o n , there i s some evidence that i n d i v i d u a l nurses are i n v o l v e d i n p l a n n i n g t h e i r own s e l f - d i r e c t e d e d u c a t i o n a l a c t i v i t i e s r e l a t e d to n u r s i n g . There i s , however, no o v e r a l l c o o r d i n a t i n g mechanism f o r CNE. At p r e s e n t , there are m u l t i p l e p r o v i d e r s i n m u l t i p l e s e t t i n g s - each with t h e i r own vested i n t e r e s t s . Thetfe i s no coherent approach to c o n t i n u i n g education p r e s e n t a t i o n . Hence, there i s l i t t l e c o n t i n u i t y , f o r the i n d i v i d u a l nurse or f o r a h o l i s t i c scheme on a broader l e v e l . Because of t h i s , c o n t i n u i n g education i n n u r s i n g d e a l s with the " p r e s s i n g needs of the moment" (Nakamoto and Verner, 1972, p. 69), responds to c r i s i s 42 s i t u a t i o n s , and p r e s e n t s i t s e l f i n "time-bound segments" ( G r i f f i n , 1978, p. 5). C o n t i n u i n g education r e q u i r e s a framework which can serve to guide i t s a c t i o n s . At present, the n u r s i n g p r o f e s s i o n i s not able to provide such a framework s i n c e i t faces i t s own dilemmas. A s o l u t i o n to t h i s d e f i c i t must be found i f CNE i s to have any s i g n i f i c a n t impact. W r i t e r s i n the area of CNE have i s s u e d "motherhood" statements i n d i c a t i n g t h at l i f e l o n g l e a r n i n g should be adopted as a s o l u t i o n to the dilemma i n which CNE f i n d s i t s e l f . There i s l i t t l e evidence that t h i s has o c c u r r e d . Perhaps t h i s i s because l i f e l o n g l e a r n i n g and l i f e l o n g education have not been w e l l understood. Schechter (1974) p o i n t e d out, i n r e l a t i o n to the h e a l t h p r o f e s s i o n s as a whole, that " f o r too long there has been l i p s e r v i c e to a f u z z i l y d e f i n e d concept of the need f o r ' l i f e - long l e a r n i n g ' " (p. 95). The remaining chapters represent an attempt to apply the ideas and p r i n c i p l e s of l i f e l o n g education to c o n t i n u i n g education i n n u r s i n g . The next chapter d e s c r i b e s a method f o r examining the concept of l i f e l o n g l e a r n i n g i n an e f f o r t to i d e n t i f y ideas which can c o n t r i b u t e to the c r e a t i o n of a u s e f u l framework on which to base a c t i o n i n CNE. Only by the a n a l y s i s d e s c r i b e d i n Chapter Three and a p p l i e d i n Chapter Four can n u r s i n g b e n e f i t from and make r a t i o n a l use of the n o t i o n of l i f e l o n g l e a r n i n g . 43 CHAPTER THREE LIFELONG LEARNING AND LIFELONG EDUCATION L i f e l o n g l e a r n i n g and l i f e l o n g education have been d e s c r i b e d as no t i o n s of importance to today's and tomorrow's world. L i f e l o n g education has been t r e a t e d more e x t e n s i v e l y i n the l i t e r a t u r e with more c a s u a l and l e s s d e f i n i t e r e f e r e n c e s made to l i f e l o n g l e a r n i n g . Given the d e f i n i t i o n of l e a r n i n g p r o v i d e d i n Chapter One, i t i s understandable that l i f e l o n g e ducation should be t r e a t e d more e x t e n s i v e l y s i n c e the "education" aspect of a l l l e a r n i n g s i t u a t i o n s i s the area that i s most sub j e c t to e x t e r n a l i n f l u e n c e by educators. The problem in the l i t e r a t u r e i s that the terms " l i f e l o n g l e a r n i n g " and " l i f e l o n g e d u c a t i o n " are used interchangeably although there are d i f f e r e n c e s between the two. Lawson (1982) ca u t i o n e d a g a i n s t t h i s , saying that the use of " l i f e l o n g l e a r n i n g " as a synonym fo r " l i f e l o n g e d u c a t i o n " "might be seen as a negation or at l e a s t a weakening of the concept of 'education'" (p.100). An example of t h i s mixing of ideas i s found i n Peterson, Cross, H a r t l e , H i r a b a y a s h i , Kutner, Powell, and V a l l e y ' s (1979) d e f i n i t i o n of l i f e l o n g l e a r n i n g . These authors d e s c r i b e d i t as "a conceptual framework f o r c o n c e i v i n g , p l a n n i n g , ' implementing, and c o o r d i n a t i n g a c t i v i t i e s designed to f a c i l i t a t e l e a r n i n g by a l l Americans throughout t h e i r l i f e t i m e s " (Peterson et a l , 1979, p.5). Since t h i s d e f i n i t i o n embodies the idea of a d e l i b e r a t e p l a n n i n g of a c t i v i t i e s r e l a t e d to improving l e a r n i n g , i t i s probably more c o n s i s t e n t with a d e f i n i t i o n of l i f e l o n g 44 education. O v e r l y , McQuigg, S i l v e r n a i l , and Coppedge's (1980) d e f i n i t i o n of l i f e l o n g l e a r n i n g as "any p u r p o s e f u l l e a r n i n g that an i n d i v i d u a l ( a c t o r ) engages i n throughout the l i f e span" (p.5) s u f f e r s from the same f a u l t . In a d d i t i o n , t h i s d e f i n i t i o n l a c k s c l a r i t y because i t i n c l u d e s the term being d e f i n e d . Cropley's (1980) d e f i n i t i o n of l i f e l o n g education takes i n t o c o n s i d e r a t i o n the r e l a t i o n s h i p between education and l e a r n i n g d e s c r i b e d e a r l i e r . The author s t a t e d that " l i f e l o n g education r e q u i r e s c o n s i d e r a t i o n of the changes i n education which would be necessary f o r promoting, s u p p o r t i n g , even improving l i f e l o n g l e a r n i n g " (Cropley, 1980, p.3). Dave's (1976) d e f i n i t i o n i s probably most c o n s i s t e n t with d i s t i n c t i o n s between l e a r n i n g and e d u c a t i o n : L i f e l o n g education i s a process of accomplishing p e r s o n a l , s o c i a l and p r o f e s s i o n a l development throughout the l i f e - s p a n of i n d i v i d u a l s i n order to enhance the q u a l i t y of l i f e of both i n d i v i d u a l s and t h e i r c o l l e c t i v e s . I t i s a comprehensive and u n i f y i n g idea which i n c l u d e s formal, non-formal and i n f o r m a l l e a r n i n g f o r a c q u i r i n g and enhancing enlightenment so as to a t t a i n the f u l l e s t p o s s i b l e development in d i f f e r e n t stages and domains of l i f e . (p. 34) While the emphasis in t h i s chapter i s on l i f e l o n g e ducation, the" c o n c e p t u a l i z a t i o n of i t as a subset of l i f e l o n g l e a r n i n g as i n d i c a t e d i n Chapter One should be kept i n mind. Educators can c r e a t e optimal e x t e r n a l c o n d i t i o n s f o r l e a r n i n g but cannot i n f l u e n c e the i n d i v i d u a l ' s i n t e r n a l l e a r n i n g process. 45 H i s t o r y Although i t i s only r e c e n t l y that l i f e l o n g l e a r n i n g and l i f e l o n g education have been embraced wholeheartedly by the world of educators, they are, i n f a c t , not new i d e a s . People have always been able to l e a r n throughout t h e i r l i v e s r e g a r d l e s s of the r e c o g n i t i o n of that f a c t by the formal e d u c a t i o n a l establishment. According to Faure, H e r r a r a , Kaddoura, Lopes, Petrovsky, Rahnan and Ward (1972) education i n p r i m i t i v e s o c i e t y was a c o n t i n u a l a f f a i r . There were no f o r m a l l y o r g a n i z e d s t r u c t u r e s for the purpose of f o s t e r i n g e d u c a t i o n . Instead, i n d i v i d u a l s learned "by l i v i n g and d o i n g " (Faure et a l , 1972, p. 5), by i n t e r a c t i n g with each other and the environment. Examples c i t e d were from a n c i e n t A f r i c a n c i v i l i z a t i o n s where l e a r n i n g was a c o n t i n u a l p r o c e s s . These peoples probably had very p r a c t i c a l reasons f o r involvement i n continuous l e a r n i n g . Other e a r l y c i v i l i z a t i o n s a l s o recognized the need fo r c o n t i n u a l l e a r n i n g . T h e i r g o a l s were, however, more r e l a t e d to enlightenment than s u r v i v a l . Shukla (1971) d e s c r i b e d a n c i e n t Indian times and noted how i t was that the Satapada Brahmanu admonished people to "study every day" (p.15). The Greeks conceived of the idea of a l e a r n i n g s o c i e t y i n which the c u l t u r e provided the environment f o r i n d i v i d u a l l e a r n i n g (Lewis, 1981; McCannon, 1979). For example, i n Athens there were no f o r m a l i z e d schools except f o r a chosen few because the c i t y i t s e l f was to be the t e a c her. Under t h i s system, l e a r n i n g would continue 46 throughout l i f e . When democracy was adopted i n Athens, the So p h i s t s took on the job of educating those of the middle c l a s s e s who so wished. The goal of education was to enhance the r o l e of the c i t i z e n as a p a r t i c i p a n t i n government. A r i s t o t l e and P l a t o emphasized education i n the p u r s u i t of an i d e a l (Lewis, 1981). P l a t o p o s t u l a t e d an i d e a l s o c i e t y -- the Re p u b l i c . To these t h i n k e r s , the purpose of education was to mold a good c i t i z e n but "education was not only f o r the purposes of the s t a t e , ... i t had an end i n i t s e l f " (Lewis, 1981, p. 18). P l a t o and A r i s t o t l e developed metaphysical arguments l i n k i n g a l i f e t i m e of l e a r n i n g with happiness. More r e c e n t l y , The 1919 Report of the Adult Education Committee of the B r i t i s h M i n i s t r y of R e c o n s t r u c t i o n d e a l i n g with the aftermath of World War I recommended that a d u l t education be " u n i v e r s a l and l i f e l o n g " (p.5) i n order to f o s t e r s o c i a l and economic recovery. For modern times the ideas of l i f e l o n g e ducation s t a r t e d i n the arena of a d u l t e d u c a t i o n . A c c o r d i n g to Alanen (1982) the idea of l i f e l o n g education as we know i t today was developed i n the e a r l y 1960's by the United Nations E d u c a t i o n a l , S c i e n t i f i c , and C u l t u r a l O r g a n i z a t i o n (UNESCO). The Second UNESCO World Conference on Adult Education i n Montreal (Lowe, 1975) i n 1960 recommended "to a l l governments the i n c l u d i n g of a d u l t education i n the normal system of education as an e s s e n t i a l and i n t e g r a l p a r t (Alanen, 1982, p.4) T h i s was a formal step to e n l a r g i n g the domain of education beyond c h i l d h o o d . 47 A key f a c t o r i n the development of the idea of l i f e l o n g education was a paper by Lengrand (1975). In 1965 The UNESCO I n t e r n a t i o n a l Committee f o r the Advancement of Adult Education, a f t e r reviewing t h i s paper, recommended that UNESCO adopt the p r i n c i p l e of l i f e l o n g e d u c a t i o n . Thus, the o f f i c i a l endorsement of the concept of l i f e l o n g education by the e d u c a t i o n a l community came from the a d u l t education s e c t o r . In 1970, l i f e l o n g education became one of the major themes of the I n t e r n a t i o n a l Education Year (Alanen, 1982; Parkyn, 1973). The work of the I n t e r n a t i o n a l Commission on the Development of Education, set up i n 1971, culminated i n the p u b l i c a t i o n of Learning to Be (Faure et a l , 1972). T h i s i n f l u e n t i a l r e p o r t presented the background and philosophy of l i f e l o n g e d ucation. I t d e s c r i b e d the need for l i f e l o n g education and made recommendations about the development of a l e a r n i n g s o c i e t y . Faure et a l (1972) proposed " l i f e l o n g education as the master concept for e d u c a t i o n a l p o l i c i e s i n the years to come" (p. 182). Throughout the 1970's, p a r a l l e l developments of a s l i g h t l y d i f f e r e n t form were t a k i n g p l a c e i n The O r g a n i z a t i o n f o r Economic Cooperation and Development (OECD) and the C o u n c i l of Europe. OECD developed i t s idea of r e c u r r e n t education or "the d i s t r i b u t i o n of education over the l i f e s p a n of the i n d i v i d u a l i n a (formal) r e c u r r i n g way" (Centre f o r E d u c a t i o n a l Research and Innovation, 1973, p. 7). (Here again, the d e f i n i t i o n u t i l i z e s the word being defined.) The C o u n c i l of Europe c o n c e p t u a l i z e d "education permanente" as a means of p r e s e r v i n g the European 48 c u l t u r a l h e r i t a g e . In the ensuing years, v a r i o u s developing and developed c o u n t r i e s demonstrated i n t e r e s t i n the concept of l i f e l o n g l e a r n i n g . The Scandinavian c o u n t r i e s , i n p a r t i c u l a r , have implemented i n n o v a t i v e approaches to l i f e l o n g l e a r n i n g . The development of i n t e r e s t i n the U n i t e d S t a t e s and Canada has been slower. Most r e c e n t l y , educators i n t e r e s t e d i n promoting higher education have endorsed the concept. Some authors have questioned the m o t i v a t i o n behind t h i s endorsement. Higher education i n s t i t u t i o n s are e x p e r i e n c i n g decreased enrollment and i t i s only n a t u r a l that they should want to expand t h e i r c l i e n t e l e by i n c l u d i n g the " l i f e l o n g l e a r n e r " as w e l l as the t r a d i t i o n a l student (Cross, 1979; Gross, 1977; Lawson, 1982; Mondale, 1976). However, the American 1973 L i f e l o n g L earning Act gave f e d e r a l l e g i s l a t i v e support and r e c o g n i t i o n to the concept of l i f e l o n g l e a r n i n g ( C h r i s t o f f e l , 1977; MacLean, 1981). U n f o r t u n a t e l y , the e d u c a t i o n a l community in the U.S. has not given whole-hearted support to the implementation a p p a r e n t l y because they fear that funds f o r programs p r e s e n t l y i n o p e r a t i o n w i l l be decreased. Consequently, implementation has lagged somewhat. I t i s evident that the ideas of l i f e l o n g l e a r n i n g have e x i s t e d i n v a r i o u s forms f o r c e n t u r i e s . However, i t i s only w i t h i n the l a s t 20 years that they have been s e r i o u s l y c o n s i d e r e d and e v a l u a t e d i n terms of p o l i c y making f o r e d u c a t i o n a l p r a c t i c e . 49 Today, the concepts of l i f e l o n g l e a r n i n g and l i f e l o n g e ducation remain nebulous. More work needs to be done to d e f i n e them and t h e i r i m p l i c a t i o n s . L i f e l o n g education i s , i n many r e s p e c t s , s t i l l at the conceptual stage. K a l l e n (1979) observed that UNESCO i t s e l f "has not made a c o n s i s t e n t f u r t h e r e l a b o r a t i o n of the o r i g i n a l concept" (p. 54). However, s e r i o u s e f f o r t s are being made more r e c e n t l y to e l u c i d a t e the ide a s . Future developments r e l a t e d to l i f e l o n g l e a r n i n g and education w i l l depend on the q u a l i t y of that work. C e r t a i n l y , there i s evidence that the academic community i s g r a p p l i n g with the ide a . (Dave, 1983). The appearance i n 1975 of an E d u c a t i o n a l Resources Information Center (ERIC) d e s c r i p t o r c a l l e d l i f e l o n g l e a r n i n g and the i n c r e a s i n g number of p u b l i c a t i o n s and amount of f u g i t i v e l i t e r a t u r e r e l a t e d to i t gi v e evidence of t h i s . However, no matter what stage of development the concept of l i f e l o n g l e a r n i n g and i t s subset l i f e l o n g education are c u r r e n t l y i n , the need f o r some new c o n c e p t u a l i z a t i o n of education i s apparent. A j u s t i f i c a t i o n f o r the concept of l i f e l o n g l e a r n i n g i s provided i n the r e a l i t y of modern-day change. A R a t i o n a l i z a t i o n f o r L i f e l o n g Learning - Change We l i v e i n a world of change u n p a r a l l e l l e d i n previous times. T h i s f a c t has been thoroughly documented. Dubin (1974). and Dutton (1979) p o i n t e d to the tremendous e x p o n e n t i a l i n c r e a s e i n knowledge i n recent y e a r s . Wroczynski (1972) noted changes as 50 a r e s u l t of the s c i e n t i f i c and t e c h n o l o g i c a l r e v o l u t i o n and i t s i m p l i c a t i o n s f o r d a i l y l i f e . Faure et a l (1972) d e s c r i b e d the outcomes of these changes in terms of " l e a p s " and "gaps" and c i t e d such examples as the decreased l a g time between s c i e n t i f i c d i s c o v e r y and implementation in s o c i e t y , demographic s h i f t s , and unemployment r e s u l t i n g from changes in working l i f e as outcomes of change. A l l t h i s ferment in the world has s u b j e c t e d the e d u c a t i o n a l system to c o n s i d e r a b l e p r e s s u r e . There are i n d i c a t i o n s that i t , i n t u r n , must change. C e r t a i n l y , i t i s the brunt of c r i t i c i s m (Parkyn, 1973; Leagans, 1978). One source of c r i t i c i s m stems from the f a c t that education has t r a d i t i o n a l l y r e s t e d on the assumption that formal l e a r n i n g can be t e r m i n a l and s u f f i c i e n t f o r a l l of l i f e . Leagans (1978)' noted two assumptions of t r a d i t i o n a l education which no longer are t r u e : 1) "the assumption that the need f o r organised e d u c a t i o n a l o p p o r t u n i t i e s can be met d u r i n g the f i r s t o ne-fourth of the l i f e span" (p. 12). 2) "the converse assumption that the need f o r education d u r i n g the remaining t h r e e - f o u r t h s of a l i f e t i m e can be adequately met by i n c i d e n t a l l e a r n i n g " (p.12). According to the Carnegie Commission on Higher Education (1973), education can no longer be thought of as " p r e p a r a t i o n fo r l i f e " (p. 24). In today's world, people "need not only s o l i d e d u c a t i o n a l foundations, but a l s o l i f e l o n g o p p o r t u n i t i e s to adapt, to renew themselves, and to a c q u i r e new knowledge" ("Carnegie ... , 1973, p.24). 51 L i f e l o n g education has been touted as a s t r a t e g y f o r coping with change (Overly et a l , 1980). S e v e r a l authors (eg. Boshier,1980) have d e s c r i b e d a l e a r n i n g s o c i e t y i n which l e a r n i n g i s a way of l i f e . T h i s idea i s presented as a n e c e s s i t y r a t h e r than an o p t i o n given the world that people must deal with. L i f e l o n g education would be one f a c e t of the l e a r n i n g s o c i e t y . In making c l a i m s f o r l i f e l o n g e d u c a t i o n , one must be c a r e f u l to acknowledge which occurred f i r s t , the changes i n the world, or the appearance of l i f e l o n g education on the scene. L i f e l o n g education has, i n some i n s t a n c e s , been presented as -a new theory of e d u c a t i o n a l p r a c t i c e , but as Cropley (1980) p o i n t e d out, i t i s more l i k e l y that the concept of l i f e l o n g education as i t e x i s t s today i s a " r a t i o n a l i z a t i o n of a number of e x i s t i n g ( s o c i e t a l ) t r e n d s " (p.7). And as Mondale (1976) po i n t e d out i n d e s c r i b i n g change i n American s o c i e t y these " s o c i a l trends p r o p e l us toward a n a t i o n a l p o l i c y of l i f e l o n g l e a r n i n g " (p.44). C l e a r l y , given present r e a l i t i e s , the e d u c a t i o n a l system must commit i t s e l f to developing "people capable of adapting to change" (Peterson et a l , 1979, p.2). The f a c t o r s moving l i f e l o n g e ducation to the f o r e f r o n t of thought have been summarized by the Japanese N a t i o n a l I n s t i t u t e f o r E d u c a t i o n a l Research ("The I d e a l s and the Tasks", 1982) as being: 1) the need to adapt to the r a p i d changes i n soc i e t y . . . 2) the general i n c r e a s e of e d u c a t i o n a l and c u l t u r a l 52 a s p i r a t i o n s among people 3) the i n c r e a s e i n people's l e i s u r e time and economic c a p a c i t y . . . 4) the need to r e - d i r e c t e d u c a t i o n a l f u n c t i o n s towards b u i l d i n g a f r e e r and more e n e r g e t i c s o c i e t y , (p.3) The need f o r l i f e l o n g l e a r n i n g i s apparent. The techniques f o r o p e r a t i o n a l i z a t i o n and implementation of t h i s n o t i o n are l e s s obvious. Terminology D e s p i t e the apparent a b i l i t y to d e f i n e the words, the terms " l i f e l o n g l e a r n i n g " and " l i f e l o n g e d ucation", as used today, are surrounded by much c o n f u s i o n . L i f e l o n g education alone had been v a r i o u s l y r e f e r r e d to as a "concept" and "more than an e d u c a t i o n a l theory" ( G e l p i , 1979, p.5), a " u n i f y i n g p r i n c i p l e " (Cropley,1980, p.8), a " d i s t a n t hope" (UNESCO,1978, p.9), a "theory" of education (Cropley, 1979, p.3), a "philosophy" (Mocker and Spear, 1982, p. 1), a " p o l i c y " (Lawson, 1982, p. 97) and a "slogan" (Moon, 1979, p. 219; Richardson, 1979, p. 46). I t i s important, i n attempting to d e r i v e an understanding of l i f e l o n g l e a r n i n g and l i f e l o n g education to i d e n t i f y which of the nouns i s a p p l i c a b l e . L i f e l o n g Education - An E d u c a t i o n a l Philosophy The author of t h i s t h e s i s contends that l i f e l o n g i s an e d u c a t i o n a l p h i l o s o p h y . A philosophy has been education d e f i n e d as 53 "a search f o r a general understanding of values and r e a l i t y by c h i e f l y s p e c u l a t i v e rather than o b s e r v a t i o n a l means: an a n a l y s i s of the grounds of and concepts e x p r e s s i n g fundamental b e l i e f s " (Webster, 1981, p. 854). Merriam (1977) d e f i n e d a philosophy as "a systematic conceptual framework embodying c e r t a i n v a l u e s " (p. 196). E l i a s and Merriam (1980) i d e n t i f i e d s i x p h i l o s o p h i c a l c a t e g o r i e s r e l a t e d to education. L i f e l o n g education would seem to be a p h i l o s o p h i c a l s y n t h e s i s of s e v e r a l d i s t i n c t viewpoints - a s y n t h e s i s made necessary by modern times. There are advantages to the educator i f l i f e l o n g education i s d e f i n e d as an e d u c a t i o n a l philosophy s i n c e such a philosophy f u l f i l l s c e r t a i n funct i o n s . Apps (1973) t r i e d to h e l p a d u l t educators develop a working philosophy of t h e i r own. That author i n d i c a t e d that a w e l l - developed philosophy should h e l p answer q u e s t i o n s about the e d u c a t i o n a l p r o c e s s . Questions r e l a t e d to the f o l l o w i n g areas should be d e a l t with by a p h i l o s o p h y : - what should be - the r e l a t i o n s h i p of e d u c a t i o n a l problems with each other - the r e l a t i o n s h i p of education to s o c i e t y - the purpose of education - the l e a r n e r - content or subject matter - t h e - l e a r n i n g process If l i f e l o n g education i s a philosophy then i t should be p o s s i b l e to u t i l i z e or adapt the framework i m p l i e d by the areas above to analyze the l i t e r a t u r e and answer fundamental q u e s t i o n s about the b a s i c ideas which form i t . An examination of the l i t e r a t u r e r e v e a l s that t h i s i s the case. Although the answers 54 are not o f t e n e x p l i c i t l y s t a t e d , i t i s evident that proponents of l i f e l o n g l e a r n i n g have given thought to these and other q u e s t i o n s . Dave (1983) i d e n t i f i e d the c h a r a c t e r i s t i c s of l i f e l o n g e ducation and t r i e d "to v i s u a l i z e p r a c t i c a l i m p l i c a t i o n s of the c o n c e p t - c h a r a c t e r i s t i c s f o r d i f f e r e n t stages and aspects of e d u c a t i o n " (p.2). That author s a i d that "at the o p e r a t i o n a l l e v e l l i f e l o n g education p r o v i d e s a t o t a l system of a l l l e a r n i n g " (Dave, 1983, p.11) and saw i t as a system of education from which a t h e o r e t i c a l framework and g u i d e l i n e s f o r p r a c t i c e c o u l d be drawn. By l o o k i n g at the l i t e r a t u r e with a view to l e a r n i n g more about the areas i n d i c a t e d above, i t w i l l be p o s s i b l e to b e t t e r understand the concept. What seems l o g i c a l , i f l i f e l o n g education i s being examined with the view that i t i s a philosophy, i s to examine the goals and assumptions that c h a r a c t e r i z e the p h i l o s o p h y , as presented i n the l i t e r a t u r e . From that base, i t i s p o s s i b l e to move i n t o a c o n s i d e r a t i o n of the p r i n c i p l e s of o p e r a t i o n that govern p r a c t i c e . From these p r i n c i p l e s can be d e r i v e d , p r o v i d i n g there i s i n t e r n a l c o n s i s t e n c y , the outcomes, in terms of methods and techniques, which u l t i m a t e l y c h a r a c t e r i z e the p h i l o s o p h y . In addressing these.aspects of l i f e l o n g e ducation, answers to the questions i n d i c a t e d above w i l l become e v i d e n t . If l i f e l o n g education i s a p h i l o s o p h y , ' then general p r i n c i p l e s , and the methods and techniques stemming from them, 55 should have u n i v e r s a l a p p l i c a b i l i t y i n a v a r i e t y of e d u c a t i o n a l s i t u a t i o n s . Once the o v e r a l l framework of the concept has been i d e n t i f i e d , i t should be p o s s i b l e to examine i t s u s e f u l n e s s to c o n t i n u i n g education i n n u r s i n g . Goals In the l i t e r a t u r e two major themes r e l a t e d to the goals of l i f e l o n g education are e v i d e n t . They are l i f e l o n g education f o r p e r s o n a l and f o r s o c i e t a l development. The f i r s t of these goals seems to have r e c e i v e d the g r e a t e s t emphasis. C o n s i d e r i n g the e a r l y h i s t o r i c a l r o o t s of l i f e l o n g l e a r n i n g t h i s i s not s u r p r i s i n g . However, when the modern-day j u s t i f i c a t i o n f o r a concept of l i f e l o n g l e a r n i n g i s i n s e r t e d , i t seems that the second goal should predominate. However, i t i s probable that the two goals are c l o s e l y l i n k e d ( i e . personal development and f u l f i l l m e n t c o n t r i b u t e to s o c i e t a l w e l l - b e i n g ) . Cropley was a major proponent of the individual.development approach as being the goal of l i f e l o n g e d ucation. In h i s view, l i f e l o n g education should "have as i t s u l t i m a t e goal promotion of the s e l f f u l f i l m e n t ( s i c ) of each i n d i v i d u a l " (Cropley 1979, p.3). Dave (1983) seemed to concur with t h i s view: "Above a l l , ( l i f e l o n g education) i s viewed as a means of a t t a i n i n g the h i g h e s t form of s e l f - r e a l i s a t i o n " (p.2). On the other hand there i s the n o t i o n that l i f e l o n g e d u c a t i o n i s to develop s o c i e t y . A paper presented by the N a t i o n a l I n s t i t u t e f o r E d u c a t i o n a l Research i n Japan i n d i c a t e d 56 that f o r that country l i f e l o n g education i s "necessary i n order to keep and enhance the dynamism of s o c i e t y " ("The Id e a l s 1982, p.1). The i d e a l expressed here i s that of developing soc i e t y . S o c i e t a l development i n c l u d e s economic and c u l t u r a l a s p e c t s . Scandinavian and European c o u n t r i e s emphasized the c u l t u r a l r e t u r n s of l i f e l o n g education (Overly et a l , 1980). Other c o u n t r i e s have p l a c e d emphasis elsewhere. Each of the views c o u l d be what Jessup (1969) termed "narrowly u t i l i t a r i a n " (p.21). For example, i t i s wrong to p l a c e too much emphasis on education towards the economic development of s o c i e t y . While i t i s t r u e that s o c i e t i e s r e q u i r e education to maintain economic p r o s p e r i t y , to see t h i s as being the s o l e reason f o r l i f e l o n g education i s misguided. I t would seem t h a t , i n a sense, a dichotomy e x i s t s i n some of the l i t e r a t u r e r e l a t e d to l i f e l o n g education as to what the goals of education should be. T h i s can be r e s o l v e d when i n d i v i d u a l development i s seen as c o n t r i b u t i n g to s o c i e t a l development and v i c e v e r s a . The q u a l i t y of one i n f l u e n c e s the q u a l i t y of the other and together both c o n t r i b u t e to a q u a l i t y of l i f e . T h i s r e l a t i o n s h i p i s i l l u s t r a t e d i n F i g u r e 1. 57 F i g u r e J_: Goals of L i f e l o n g Education p e r s o n a l development- d u a l i t y of l i f e s o c i e t a l development Thus, the u l t i m a t e goal of l i f e l o n g e d u c a t i o n , as i n d i c a t e d by Dave (1983) and Overly (1980) becomes "to maintain and improve the q u a l i t y of l i f e " (Dave, 1983,p.9). In order to achieve t h i s " q u a l i t y " the s i t u a t i o n c r e a t e d must possess c e r t a i n c h a r a c t e r i s t i c s . According to proponents of l i f e l o n g e d u c a t i o n , the s o c i e t y c r e a t e d w i l l be an "educative" (Cropley, 1979, p.42), l e a r n i n g - o r i e n t e d , and democratic (Alanen,1982; Faure, 1972; K a l l e n , l 9 7 9 ) and w i l l manifest e q u a l i t y of access to e d u c a t i o n a l e x p e r i e n c e s . These c h a r a c t e r i s t i c s are sometimes mistakenly i d e n t i f i e d as being the goals of l i f e l o n g e ducation. What they r e a l l y represent are steppingstones on the way to the u l t i m a t e goal of l i f e l o n g e d ucation. For example, what i s important i s not to develop a democracy per se but to develop a s i t u a t i o n i n which people can grow and l i v e m e a n i n g f u l l y (Di Paula, 1981; "The i d e a l s 1982), both p e r s o n a l l y and c o l l e c t i v e l y . I f t h i s r e q u i r e s the development of democratic i d e a l s along the way, then so be i t . Thus, as Skager and Dave (1978) noted, i n d i s c u s s i n g democracy and l i f e l o n g e d u c a t i o n , i t i s both an i d e a l and a p r i n c i p l e . 58 In order to achieve the " q u a l i t y of l i f e " which serves as the goal of l i f e l o n g education, i t must be recognized that the c e n t r a l f u n c t i o n of education " i s that of enhancing the human experience" (Skager and Dave, 1977, p.9). Education w i l l be an experience i n which each c i t i z e n has the r i g h t to personal development and the op p o r t u n i t y " f o r a c q u i r i n g , supplementing, and renewing the necessary knowledge, s k i l l s , and a b i l i t i e s to enable h i s p a r t i c i p a t i o n i n working, s o c i a l , and c u l t u r a l l i f e " ("Planning ... , 1981, p.4). I n d i v i d u a l s must develop the c h a r a c t e r i s t i c s which w i l l allow them to p a r t i c i p a t e f u l l y i n s o c i a l change. Thus, the goal of l i f e l o n g education i s to "enable people to maximally develop themselves v i s - a - v i s t h e i r s o c i e t y " (Overly, 1979, p.55). Faure et a l (1972) i d e n t i f i e d t h i s goal as being the development of the person who i s ready to make a s o c i a l commitment. I n d i v i d u a l s d e veloping i n a l i f e l o n g education environment w i l l possess c h a r a c t e r i s t i c s such that they are adaptable to the changing c o n d i t i o n s of s o c i e t y (Faure et a l , 1972; Parkyn,1973), are t r a i n e d to p a r t i c i p a t e i n democratic s o c i e t y , have le a r n e d how to l e a r n (Faure et a l , 1972), are capable of choosing the d i r e c t i o n of t h e i r development (Parkyn, 1973), and have an "ap t i t u d e f o r continuous enrichment throughout l i f e " (UNESCO, 1978, p.11). They w i l l a l s o understand the world around them and be c h a r a c t e r i z e d p r i m a r i l y by e d u c a b i l i t y (Skager & Dave, 1977). Only t h i s type of person can c o n t r i b u t e to a q u a l i t y of l i f e both f o r the i n d i v i d u a l and f o r the r e s t of the s o c i e t y i n which the i n d i v i d u a l l i v e s . 59 L i f e l o n g education t h e r e f o r e , w i l l c o n s i s t not of a set content and body of knowledge, but of a proc e s s . The s p e c i f i c purposes vary a c c o r d i n g to stages of i n d i v i d u a l and s o c i e t a l development (Overly et a l , 1980). I t ' s goal i s to help people d i s c o v e r themselves (Faure et a l , 1972) so that they can then reach t h e i r own p e r s o n a l maximum p o t e n t i a l and c o n t r i b u t e to s o c i e t y . As the Commission on E d u c a t i o n a l Planning i n A l b e r t a put i t , a philosophy of l i f e l o n g education "seeks to make every i n d i v i d u a l t r u l y a person and a f u l l c i t i z e n of our s o c i e t y " ("A f u t u r e ..." , 1972, p.38). Under the auspices of l i f e l o n g e d u c a t i o n , " i t i s hoped that education w i l l be seen as being r e l e v a n t to the t o t a l i t y of experience" (Lawson, 1982, p.101). Assumptions Such l o f t y g o a ls as are i d e n t i f i e d as being the d e s i r e d outcomes of l i f e l o n g education are, of course, based on c e r t a i n assumptions. The nature of the assumptions upon which l i f e l o n g e ducation seems to be based are r e l a t e d to c o n s i d e r a t i o n s concerning the l e a r n e r , the s o c i e t y i n which the l e a r n e r e x i s t s , and the r e s u l t s of the l e a r n i n g p r o c e s s . One of the key assumptions r e l a t e d to the l e a r n i n g process i s the b e l i e f that the systematic l e a r n i n g p r o v i d e d by l i f e l o n g education can prepare a person to d e a l with the problems to be faced i n the s o c i e t y of which the i n d i v i d u a l i s a p a r t . T h i s b e l i e f p l a c e s q u i t e a burden on the shoulders of the proponents of l i f e l o n g e d u c a t i o n . N e v e r t h e l e s s , i n the f i n a l a n a l y s i s , 60 there may i n a c t u a l i t y be no other way to deal with i n d i v i d u a l or s o c i e t a l problems, other than by " l e a r n i n g " toward the s o l u t i o n s . A r e l a t e d assumption i s that the f u l l y s e l f - a c t u a l i z e d person w i l l make a c o n t r i b u t i o n to the s o c i e t y . The Faure Report (Faure et a l , 1972) i n d i c a t e d that there " i s a c l o s e c o r r e l a t i o n ... between changes in the socio-economic environment and the s t r u c t u r e s and forms of a c t i o n of education" (p. 56). Of course, c o r r e l a t i o n does not n e c e s s a r i l y imply c a u s a t i o n . N e v e r t h e l e s s , i f there i s a c o r r e l a t i o n between education and what goes on i n s o c i e t y , i t may very w e l l be that the mediating i n f l u e n c e i s the i n d i v i d u a l . Thus, perhaps i t i s r e a l i s t i c to assume that a f u l l y developed and s e l f - a c t u a l i z e d person w i l l i n f l u e n c e s o c i e t y . T h i s , of course, presupposes the "goodness" of humankind, a p r e s u p p o s i t i o n upon which the humanistic philosophy i s based. Proponents of l i f e l o n g education a l s o assume that s o c i e t y as a c o l l e c t i v e w i l l demonstrate a p o s i t i v e a t t i t u d e toward the ten e t s of l i f e l o n g e d u c a t i o n . Value w i l l be p l a c e d on the " l e a r n i n g - l i v i n g e x p e r i e n c e s " (MacLean, 1981, p.12) which are so i n t e g r a l a p a r t of a c h i e v i n g the goals of l i f e l o n g e d u c a t i o n . A second assumption r e l a t i n g l i f e l o n g education to s o c i e t y i s t h a t education i s synonymous with democracy, democracy being "the a b o l i t i o n of p r i v i l e g e and the promotion w i t h i n s o c i e t y as a whole of the ideas of autonomy, r e s p o n s i b i l i t y and d i a l o g u e " ("Recommendations on the Development 1976, p.1). T h i s presumes that democratic i d e a l s and processes are the only 61 a p p r o p r i a t e ones. The l e a r n e r i n t h i s s i t u a t i o n i s imbued with a great number of worthy c h a r a c t e r i s t i c s . I t i s assumed that the l e a r n e r w i l l be motivated to l e a r n (McOannon, 1979), s e l f - c o n f i d e n t about and capable of i d e n t i f y i n g p e r s o n a l goals (Overly et a l , 1980) and able to manage l e a r n i n g experiences (Di Paula, 1981). These c h a r a c t e r i s t i c s r e l a t e back to the r a t h e r humanistic b a s i s f o r l i f e l o n g e d u c a t i o n . A f u r t h e r c h a r a c t e r i s t i c of the l e a r n e r which i s r e q u i r e d and assumed f o r l i f e l o n g education i s that the l e a r n e r w i l l not only have the d e s i r e to be i n v o l v e d i n l e a r n i n g but that the l e a r n e r has the c a p a b i l i t i e s r e q u i r e d f o r doing so. T h i s f i n a l assumption i s probably the one which i s most c l o s e l y r e l a t e d to f a c t . Faure et a l (1972) c i t e d r e s e a r c h which i n d i c a t e d that humans have a l a r g e unused i n t e l l e c t u a l p o t e n t i a l . Cropley (1977) d e s c r i b e d r e s e a r c h that promotes the idea that i n d i v i d u a l s , of a l l ages, are capable of continued l e a r n i n g . Cropley (1977) p l a c e d p a r t i c u l a r emphasis on the c a p a c i t i e s and c a p a b i l i t i e s of a d u l t s f o r l e a r n i n g . , T h i s i s an important f e a t u r e when c o n s i d e r i n g c o n t i n u i n g l e a r n i n g i n the p r o f e s s i o n s . C l e a r l y , the idea of l i f e l o n g education i s based on some important and f a r - r e a c h i n g assumptions which presuppose p o s i t i v e a t t i t u d e s and a c t i o n s by the i n d i v i d u a l and s o c i e t y . Perhaps, however, in l i g h t of the present r e a l i t i e s , the world can do l i t t l e e l s e than presume that the assumptions upon which l i f e l o n g education are based are true and work towards the goals 62 i t puts forward. P r i n c i p l e s From any c o n s i d e r a t i o n of the goals and assumptions of l i f e l o n g education stem ideas about p r i n c i p l e s i n v o l v e d i n making the goals a r e a l i t y ( i e . how the goals can be worked out in concrete s i t u a t i o n s ) . Since l i f e l o n g education i s somewhat nebulous and i d e a l i s t i c , i t has been d i f f i c u l t f o r w r i t e r s on the t o p i c to i d e n t i f y d e f i n i t e p r i n c i p l e s on which to base p r a c t i c e . Some authors have made noteworthy attempts. Peterson et a l (1979) i d e n t i f i e d three p r a c t i c a l p r i n c i p l e s which they b e l i e v e d c h a r a c t e r i z e what l i f e l o n g education i s . These p r i n c i p l e s a r e : (1) there should be c o o r d i n a t e d l e a r n i n g o p p o r t u n i t i e s f o r people of a l l ages; (2) a l l manner of o r g a n i z a t i o n s - school and nonschool - concerned with the w e l l - b e i n g of people should take p a r t i n f a c i l i t a t i n g l e a r n i n g ; and (3) the community (or c i t y or m e t r o p o l i t a n region) should be the l o c u s f o r p l a n n i n g and conducting l e a r n i n g a c t i v i t i e s ... (Peterson et a l , 1979, p.5) Although encompassing some of the ideas which are at the core of l i f e l o n g e d u c a t i o n , t h i s l i s t i s by no means complete. Neither i s . i t of a general enough nature that by implementing the three p r i n c i p l e s , one would have implemented the essence of what i s l i f e l o n g e d u c a t i o n . 63 Gropley (1980) l i s t e d the p r i n c i p l e s of l i f e l o n g e ducation. Key f e a t u r e s that he i d e n t i f i e d as c h a r a c t e r i z i n g l i f e l o n g education are: (1) u n i v e r s a l i t y (2) comprehensiveness (3) a r t i c u l a t i o n (4) f l e x i b i l i t y (5) d i v e r s i t y (6) o r i e n t a t i o n towards s e l f - f u l f i l l m e n t Although the f e a t u r e s l i s t e d by Cropley (1980) are more comprehensive, they a l s o i n c l u d e some of the g o als of l i f e l o n g e d u c a t i o n . Dave (1983) has a l s o done e x t e n s i v e work toward i d e n t i f y i n g p r i n c i p l e s of o p e r a t i o n f o r l i f e l o n g e d u c a t i o n . That author l i s t e d 20 " c o n c e p t - c h a r a c t e r i s t i c s " which were p o s i t e d as being the key ideas and p r i n c i p l e s upon which a system of l i f e l o n g education can be based. Although some of the f e a t u r e s Dave (1983) i d e n t i f i e d were c l e a r l y r e l a t e d to o v e r a l l p r i n c i p l e s of p r a c t i c e , many of the statements are what c o u l d be viewed as c a t e g o r i e s w i t h i n o v e r a l l p r i n c i p l e s . A l s o , some of the f e a t u r e s i d e n t i f i e d as being p r i n c i p l e s , are i n a c t u a l i t y , the goals of l i f e l o n g e d u c a t i o n . In order to put l i f e l o n g education i n t o p r a c t i c e , what i s needed are g e n e r a l p r i n c i p l e s which can be a p p l i e d i n any of a v a r i e t y of s i t u a t i o n s . A review of the l i t e r a t u r e r e l a t e d to l i f e l o n g education i n d i c a t e s key f e a t u r e s , as i n d i c a t e d i n F i g u r e 2, which can be put forward as p r i n c i p l e s of o p e r a t i o n which would c h a r a c t e r i z e the implementation of l i f e l o n g 64 education i n any of a v a r i e t y of s i t u a t i o n s . As i s evident i n the f i g u r e and as w i l l be d i s c u s s e d i n the t e x t to f o l l o w , the p r i n c i p l e s of o p e r a t i o n stem d i r e c t l y from the s t a t e d goals of l i f e l o n g e d u c a t i o n . F i g u r e 2: Goals and P r i n c i p l e s of L i f e l o n g Education Goals P r i n c i p l e s Q .^The need i s to pro v i d e systematic l e a r n i n g U ^ throughout l i f e ( v e r t i c a l i n t e g r a t i o n ) A s o c i e t a l L d e v elopment^—Education i s l i n k e d with l i f e I ( H o r i z o n t a l i n t e g r a t i o n ) ^ L e a r n i n g and education are r i g h t s T Y JThe i n d i v i d u a l i s the focus of e d u c a t i o n a l 0 IT e f f o r t s F i n d i v i d u a l development^—Emphasis i s pl a c e d on the process of L education r a t h e r than on any s p e c i f i e d 1 content F E The a d m i n i s t r a t i v e o r g a n i z a t i o n w i l l combine c e n t r a l and l o c a l f u n c t i o n s Each of the p r i n c i p l e s has, i n some form, been d e s c r i b e d i n • the l i t e r a t u r e r e l a t e d to l i f e l o n g e ducation although perhaps not under the t i t l e used here. Each of the p r i n c i p l e s encompasses a c o n s i d e r a b l e number of i m p l i c a t i o n s f o r p r a c t i c e many of which have been d e s c r i b e d i n the l i t e r a t u r e . The i m p l i c a t i o n s of each p r i n c i p l e w i l l be d i s c u s s e d and expanded 65 upon. 1) The need i s to provide systematic l e a r n i n g throughout l i f e . A c e n t r a l idea of l i f e l o n g education i s that s i g n i f i c a n t l e a r n i n g o p p o r t u n i t i e s should be a v a i l a b l e to people of a l l ages. Cropley (1980) p o i n t e d to "the establishment of a new r e l a t i o n s h i p between age and education" (p. 18) as being one of the key t e n e t s of l i f e l o n g education which d i f f e r e n t i a t e s i t from t r a d i t i o n a l e ducation. Faure et a l (1972) made s p e c i f i c recomendations concerning areas where t r a d i t i o n a l e d u c a t i o n a l i n s t i t u t i o n s can make m o d i f i c a t i o n s toward t h i s end. Faure et a l (1972) recommended the development of e d u c a t i o n a l o p p o r t u n i t i e s for. p r e - s c h o o l c h i l d r e n , a d u l t s , and the e l d e r l y — groups which have not t r a d i t i o n a l l y been the focus of the e d u c a t i o n a l e n t e r p r i s e — and i n d i c a t e d that l e a r n e r s should be able to move f r e e l y through an open e d u c a t i o n a l system. Cropley (1977) r e f e r e d to t h i s as v e r t i c a l i n t e g r a t i o n . Lowbeer (1978) c i t e d the Swedish example of g u i d e l i n e s f o r policy-making i n r e l a t i o n to t h i s very f a r - r e a c h i n g p r i n c i p l e of systematic l e a r n i n g throughout l i f e . That author i n d i c a t e d that one of the g u i d e l i n e s r e l a t e d to l i f e l o n g education i n Sweden i s that every c i t i z e n should have the r i g h t "to r e c e i v e as much education over as long a p e r i o d as he or she may p o s s i b l y use given the i n d i v i d u a l ' s i n t e l l e c t u a l c a p a c i t y and s o c i e t y ' s o v e r a l l p r i o r i t i e s i n terms of education r e s o u r c e s " (Lowbeer, 1978, p.30). T h i s g u i d e l i n e p l a c e s some q u a l i f i c a t i o n s , i n terms 66 of a n t i c i p a t e d b e n e f i t to s o c i e t y on the u t i l i z a t i o n of the p r i n c i p l e . C l e a r l y , however, the education of i n d i v i d u a l s of a l l ages w i t h i n a s o c i e t y i s , i n most cases, an advantage i n terms of the s o c i e t y ' s development. Faure et a l (1972) s t a t e d the p r i n c i p l e given above i n t h i s way: "Every i n d i v i d u a l must be i n a p o s i t i o n to keep l e a r n i n g throughout h i s l i f e " (p. 181). T h i s would i n d i c a t e that i f a person i s not i n such a p o s i t i o n , i t i s p o s s i b l e to get there e i t h e r by s e l f e f f o r t s or with the a s s i s t a n c e of the e d u c a t i o n a l system that e x i s t s . S o c i e t y has some r e s p o n s i b i l i t y and a vested i n t e r e s t i n promoting p e r s o n a l development. In order f o r the i n d i v i d u a l to continue to develop p e r s o n a l l y and to make a s i g n i f i c a n t c o n t r i b u t i o n to s o c i e t y throughout l i f e , l e a r n i n g must be a continuous process. The danger, and indeed, t h i s i s one of the c r i t i c i s m s of l i f e l o n g education i s that l e a r n i n g w i l l be equated with s c h o o l i n g and that the need to continue to l e a r n w i l l be equated with a p e r c e p t i o n of the i n d i v i d u a l as being permanently inadequate to deal with the world and r e q u i r i n g permanent s c h o o l i n g (Gueulette, 1972). T h i s would make l e a r n e r s dependent rather than the independent s e l f - d i r e c t e d l e a r n e r s that proponents of l i f e l o n g education e n v i s i o n . T h i s b r i n g s us to a second p r i n c i p l e of l i f e l o n g education — the emphasis being not on s c h o o l i n g as an end i n i t s e l f but an i n t e g r a t i o n of s c h o o l i n g and education with other aspects of l i f e . 67 2) Education i s l i n k e d with l i f e . As i n d i c a t e d i n F i g u r e 2, t h i s p r i n c i p l e stems d i r e c t l y from one of the goals of l i f e l o n g e d u c a t i o n , that of s o c i e t a l development. I f l e a r n i n g and education are to have any use, they must be r e l e v a n t to the s i t u a t i o n i n which i n d i v i d u a l s i n the s o c i e t y f i n d themselves. I f education i s to be l i n k e d with l i f e , i t becomes n e i t h e r p o s s i b l e nor d e s i r a b l e f o r a l l e d u c a t i o n a l experiences to take p l a c e under the au s p i c e s of s c h o o l s . The v a l i d i t y of e d u c a t i o n a l experiences o u t s i d e of the school must be r e c o g n i z e d . Thus, a key idea on which l i f e l o n g education i s based i s what Cropley (1977) d e s c r i b e d as " h o r i z o n t a l i n t e g r a t i o n " (p.33), an i n t e g r a t i o n , f o r the purposes of education, of a l l the components of s o c i e t y i n which l e a r n i n g o c c u r s . Skager and Dave (1977) d e s c r i b e d t h i s as " f u n c t i o n a l i n t e g r a t i o n of a l l s o c i a l agencies f u l f i l l i n g e d u c a t i o n a l f u n c t i o n s , as w e l l as among elements of the c u r r i c u l u m at any given l e v e l and among l e a r n e r s with d i f f e r e n t p e r s o n a l c h a r a c t e r i s t i c s " (p.50). Such a c o n c e p t u a l i z a t i o n c o u l d have profound i m p l i c a t i o n s fo r the working out i n p r a c t i c e of a philosophy of l i f e l o n g e d u c a t i o n . F i r s t , the emphasis i n terms of the l e a r n e r , w i l l not be to mold a given i n d i v i d u a l to the requirements of the p a r t i c u l a r e d u c a t i o n a l s i t u a t i o n , but to de a l with the l e a r n e r in whatever h i s present s t a t u s and s i t u a t i o n i n l i f e are (Di Paula, 1981). Teachers, as le a d e r s i n e d u c a t i o n a l experiences, w i l l make use of the l e a r n e r s l i f e e x p e r i e n c e s . I f as Alanen 68 suggested " s e l f - a c t u a l i z a t i o n can take p l a c e only through membership i n a community" (p.6) and s e l f - a c t u a l i z a t i o n i s one of the goals of l i f . e l o n g e ducation, then i t can be achieved only by making the e d u c a t i o n a l process meaningful i n terms of the s i t u a t i o n i n which the i n d i v i d u a l f i n d s h i m s e l f . Therefore formal s c h o o l i n g and e d u c a t i o n a l experiences must be i n t e g r a t e d with o p p o r t u n i t i e s o u t s i d e the formal s e t t i n g . T h i s may mean that there i s a decreased emphasis on s c h o o l i n g ( C h r i s t o f f e l , 1977) and an i n c r e a s e d emphasis on e d u c a t i o n a l o p p o r t u n i t i e s o u t s i d e of the school s i t u a t i o n . Such o p p o r t u n i t i e s have been r e f e r r e d to by Mocker and Spear (1982) as nonformal and inf o r m a l e d u c a t i o n a l o p p o r t u n i t i e s . Perhaps t h i s i s what Dave (1976) meant when s t a t i n g that " l i f e l o n g education seeks to view education i n i t s t o t a l i t y " (p.35). Education would have a r o l e i n a i d i n g the f u n c t i o n i n g of s o c i e t y and i n t u r n , s o c i e t y would have a hand i n the e d u c a t i o n a l p r o c e s s . G e l p i (1979) r e f e r r e d to t h i s as the d i a l e c t i c between s o c i e t y and ed u c a t i o n . Such a view would mean that under a system of l i f e l o n g e d u c a t i o n , there would have to be a c l o s e r r e l a t i o n s h i p between education and work. P r a c t i c a l outcomes of t h i s would have to i n c l u d e p o l i c i e s f a c i l i t a t i n g t r a n s i t i o n s between the school environment and the working s i t u a t i o n , academic c r e d i t f o r working experience, work/learn combinations (Gross,1977; O'Toole, 1974), on-the-job t r a i n i n g (0'Toole,1974), and c r e d i t f o r l i f e experiences (Dowd, 1979; Gross, 1977). Of course, the 69 i n t e g r a t i o n of education and work would not be without d i f f i c u l t i e s because there are b a s i c p h i l o s o p h i c a l d i f f e r e n c e s between the goals of e d u c a t i o n a l i n s t i t u t i o n s (presuming they have adopted l i f e l o n g education) and the goals of employers in the work s e t t i n g . Problems c o u l d a l s o a r i s e i n the areas of c e r t i f i c a t i o n and c r e d e n t i a l i n g . For the p r o f e s s i o n a l , the outcome would be the p u r s u i t of c o n t i n u i n g education i n the workplace, r a t h e r than, e x c l u s i v e l y , i n the classroom. Another p r a c t i c a l outcome of the l i n k i n g of education with l i f e i s the broadening of the c o n c e p t u a l i z a t i o n of the arena of e d u c a t i o n . Alanen (1982) r e f e r r e d to t h i s as a " g l o b a l way of t h i n k i n g " (p.5). Thus, any e d u c a t i o n a l endeavour w i l l s t r i v e to e n l i g h t e n on the i n t e r r e l a t i o n s h i p s present between v a r i o u s f a c t o r s being s t u d i e d . An o v e r a l l view of these f a c t o r s w i l l be important. Education w i l l no longer be c o n f i n e d to being one way of t h i n k i n g , but w i l l be i n t e r d i s c i p l i n a r y — a c h a r a c t e r i s t i c which the Faure Report (Faure et a l , 1972), Dougan (1978) and MacLean (1981) c a l l f o r . T h i s i n t e r d i s c i p l i n a r i t y w i l l be of importance i n the implementation of e d u c a t i o n a l a c t i v i t i e s and p l a n n i n g . 3) Learning and education are r i g h t s . In a s o c i e t y where education i s so c l o s e l y t i e d to the experience of l i f e , o p p o r t u n i t i e s f o r l e a r n i n g and education w i l l be c o n s i d e r e d as being " r i g h t s " f o r every i n d i v i d u a l . The process of education w i l l be "democratized" (Cropley, 1980; 70 Dave, 1983 ; G e l p i , 1979) so that each i n d i v i d u a l has access to education and l e a r n i n g o p p o r t u n i t i e s . The r i g h t to education i s enshrined, so to speak, i n s o c i e t y . T h i s d e m o c r a t i z a t i o n has two components. On the one hand, i t w i l l make p r o v i s i o n f o r e q u a l i t y of access to e d u c a t i o n a l o p p o r t u n i t y , so that such o p p o r t u n i t i e s are not l i m i t e d to a few. T h i s u n i v e r s a l i t y of access does not, however, guarantee u n c o n d i t i o n a l e q u a l i t y . That i s , there w i l l be some s e l e c t i v i t y in ensuring that i n d i v i d u a l s r e c e i v e an education w e l l s u i t e d to t h e i r unique set of c a p a b i l i t i e s and a p t i t u d e s . In essence, the placement of t h i s c o n d i t i o n on e q u a l i t y of access, while h e l p i n g the i n d i v i d u a l mature and grow i n a p p r o p r i a t e ways, a l s o conserves s o c i e t y ' s resources and thus c o u l d be in s t r u m e n t a l i n promoting the o v e r a l l goal of s o c i e t a l development. The aspect of d e m o c r a t i z a t i o n that ensures e q u a l i t y of access a l s o means that the e d u c a t i o n a l system must accept l e a r n e r s at any l e v e l of experience. I t must serve p a r t i c i p a n t s at any of a m u l t i t u d e of d i f f e r e n t l e v e l s . S i m i l a r to the way education i s l i n k e d with l i f e , i t must serve i n d i v i d u a l s where they a r e . While the d e m o c r a t i z a t i o n of education serves to ensure education as an i n d i v i d u a l r i g h t , i t a l s o r e q u i r e s of the i n d i v i d u a l t h e i r a c t i v e involvement i n the process of education. Thus, the l e a r n e r i s no longer a p a s s i v e r e c i p i e n t of education but has a r e s p o n s i b i l i t y to be an a c t i v e p a r t i c i p a n t . More than a consumer, the i n d i v i d u a l i s to be i n v o l v e d i n decision-making 71 and policy-making. One of the recommendations of the Faure Report ("Recommendations of the Faure 1972) was that "students and the p u b l i c as a whole should be given a greater say i n d e c i s i o n s a f f e c t i n g e d u cation" (p. 10). T h i s i s a recommendation f o r p a r t i c i p a t o r y democracy. I n d i v i d u a l s should be i n v o l v e d in running the e d u c a t i o n a l e n t e r p r i s e . Part of what Cropley (1980) saw as d e m o c r a t i z a t i o n i n v o l v e s the s e l f - d e t e r m i n a t i o n that comes with p a r t i c i p a t i o n . T h i s e d u c a t i o n a l process i s not imposed by e x t e r n a l f o r c e s but r e s u l t s i n a sense of ownership i n the e d u c a t i o n a l e n t e r p r i s e . So, while Faure et a l (1972) i n d i c a t e d that democracy in a p o l i t i c a l sense, w i l l p l a y an important p a r t i n the f u t u r e of v a r i o u s s o c i e t i e s , t h i s must not be confused with the d e m o c r a t i s a t i o n of education which can be c o n s i d e r e d an a p o l i t i c a l movement. A democratic e d u c a t i o n a l e n t e r p r i s e c o u l d e x i s t i n any of a v a r i e t y of p o l i t i c a l c o n t e x t s . I t i s one of the premises of l i f e l o n g education that the working out of the idea can and must be molded to the context i n which i t i s p l a c e d . Therefore, t h e o r e t i c a l l y at l e a s t , d e m o c r a t i z a t i o n of the e d u c a t i o n a l e n t e r p r i s e c o u l d take p l a c e i n any p o l i t i c a l s e t t i n g . 4) The i n d i v i d u a l i s the focus of e d u c a t i o n a l e f f o r t s . An outcome of viewing education as a r i g h t and the i n d i v i d u a l as an a c t i v e p a r t i c i p a n t i n the e d u c a t i o n a l process i s that t r u s t and r e l i a n c e (Di Paula, 1981) i s p l a c e d on the l e a r n e r . T h i s r e l a t e s back to the assumptions about man d i s c u s s e d p r e v i o u s l y . 72 The f i r s t p r e r e q u i s i t e of t h i s i s that the l e a r n e r s be conscious of themselves as l e a r n e r s throughout l i f e (McCannon, 1979) and understand themselves i n that r o l e (Cross, 1979). A c e r t a i n amount of the energy expended in accomplishing the goals of l i f e l o n g education must be d i r e c t e d toward developing these c h a r a c t e r i s t i c s i n the l e a r n e r , so t h a t , the g o als of l i f e l o n g education can, i n t u r n , be a chieved. The a t t i t u d e of the l e a r n e r i s c r u c i a l . Faure et a l (1972) i n d i c a t e d that the "study of m o t i v a t i o n i s the key to every modern e d u c a t i o n a l p o l i c y " (p. x x v i i i ) . These authors p o i n t e d out that i n d i v i d u a l m o t i v a t i o n i n r e l a t i o n to education depends on 1) the search f o r employment and 2) the d e s i r e f o r l e a r n i n g . T h i s would i n d i c a t e that m o t i v a t i o n f o r l e a r n i n g has e x t e r n a l and i n t e r n a l v a r i a b l e s . C l e a r l y , i f the i n d i v i d u a l i s to be an a c t i v e p a r t i c i p a n t i n the e d u c a t i o n a l process, as d e s c r i b e d above, and even s e l f - d i r e c t e d , any m o t i v a t i o n that e x i s t s must be c a p i t a l i z e d upon and f o s t e r e d . In regard to i n t e r n a l m o t i v a t i o n fo r l e a r n i n g , Shukla (1971) s t a t e d that "the f i r s t t a s k . . . i s to develop i n the p u p i l s a keeness to a c q u i r e more knowledge" (p.47). I n d i v i d u a l s as l e a r n e r s must be encouraged to value l e a r n i n g f o r i t s own sake. As w e l l , l e a r n e r s w i l l come to value l e a r n i n g f o r what i t can do f o r them in the context of t h e i r s o c i e t y . E x t e r n a l v a r i a b l e s that a f f e c t m o t i v a t i o n f o r l e a r n i n g w i l l become more powerful i f s o c i e t y as a whole e x h i b i t s a p o s i t i v e a t t i t u d e toward l e a r n i n g . The establishment of a dynamic l i n k between 73 education and work w i l l s t i m u l a t e m o t i v a t i o n f o r l e a r n i n g . The l e a r n e r i s the c e n t r a l focus of l i f e l o n g education. As i n d i c a t e d e a r l i e r , the l e a r n e r i s to be accepted as i s . I m p l i c a t i o n s of t h i s are that v a r i o u s l e a r n i n g s t y l e s are p e r f e c t l y a c c e p t a b l e and are taken i n t o c o n s i d e r a t i o n i n the e d u c a t i o n a l p r o c e s s . I n d i v i d u a l i z a t i o n of the e d u c a t i o n a l process, to make i t more meaningful i n terms of the unique c h a r a c t e r i s t i c s of the l e a r n e r i s important. O b v i o u s l y , i f one of the goals of l i f e l o n g education i s to f o s t e r p e r s o n a l development, then i t cannot be expected that a l l i n d i v i d u a l s w i l l develop i n the same d i r e c t i o n nor possess the same c h a r a c t e r i s t i c s . The l e a r n e r s and the unique c h a r a c t e r i s t i c s they possess are to be at the center of l i f e l o n g e d u c a t i o n . N e v e r t h e l e s s , s i n c e there i s a common goal of c o n t r i b u t i n g to the q u a l i t y of l i f e then there must be c e r t a i n common s k i l l s t h a t every l e a r n e r should achieve. For Cropley (1980), these d e s i r a b l e s k i l l s i n c l u d e d "the a b i l i t y to set goals and evaluate the extent to which they have been achieved, a r e a l i s t i c a p p r a i s a l of one's own p o t e n t i a l s , a c o n s t r u c t i v e l y c r i t i c a l a t t i t u d e to o n e s e l f , s o c i e t y , and knowledge" (p. 6,7). I t would seem l o g i c a l , i f l e a r n e r s are to be a c t i v e p a r t i c i p a n t s and planners, as i n d i c a t e d p r e v i o u s l y , they must possess these s k i l l s . In essence, people must become s e l f - d i r e c t e d i n t h e i r approach to l e a r n i n g . L i f e l o n g education i s a form of s e l f - d i r e c t e d education (Cross, 1979; G e l p i , 1979). 74 If the l e a r n e r i s to be at the centre of the e n t i r e process, he must be supported i n h i s r o l e . Such support s e r v i c e s as the p r o v i s i o n of i n f o r m a t i o n on l e a r n i n g o p p o r t u n i t i e s and c o u n s e l l i n g ( G i l d e r , 1979; Peterson et a l , 1979) r e l a t e d to d i r e c t i o n s and means w i l l be c r u c i a l . Along these l i n e s , the t r a d i t i o n a l r o l e of a teacher w i l l change s i g n i f i c a n t l y . Faure et a l (1972) noted that the person in the educator r o l e w i l l no longer act as the t r a n s m i t t e r of knowledge s i n c e the goal of the e d u c a t i o n a l process i s no longer to f i l l the student with a p r e s c r i b e d content. Instead, educators w i l l a ct as l i a s o n s between l e a r n e r s and the resources which they r e q u i r e (Galosy, 1978). The t r a d i t i o n a l student/teacher r e l a t i o n s h i p w i l l have to be r e - e v a l u a t e d i n terms of the new goals of education and i n l i g h t of some of the p r i n c i p l e s which have been d e s c r i b e d . In some r e s p e c t s , the teacher w i l l be as much a student as the l e a r n e r i s (Shukla, 1971) . Not only w i l l the r o l e of the teacher change, but the number of i n d i v i d u a l s who can a c t i n that r o l e w i l l i n c r e a s e s u b s t a n t i a l l y . G e l p i (1979) p o i n t e d out that educators c o u l d , i n f a c t , be members of the community who have not been f o r m a l l y admitted i n t o the te a c h i n g p r o f e s s i o n . Under t h i s system, the e x p e r t i s e and experience of s k i l l e d workers i n the tra d e s and p r o f e s s i o n s c o u l d w e l l be tapped. 75 5) Emphasis i s p l a c e d on the process of education rather than on any s p e c i f i e d c ontent. The development in the i n d i v i d u a l of the s k i l l s r e l a t e d to f o s t e r i n g the a b i l i t y to " l e a r n how to l e a r n " w i l l go much f u r t h e r i n accomplishing the goals of l i f e l o n g education and f o s t e r i n g the development of an i n d i v i d u a l who i s adaptable to changing s o c i a l c o n d i t i o n s , than w i l l any requirement f o r d e a l i n g with a s p e c i f i e d c ontent. L i f e l o n g education i s a process of s k i l l development. The s k i l l s developed are g e n e r a l i z a b l e to a v a r i e t y of s i t u a t i o n s i n which the i n d i v i d u a l may f i n d h i m s e l f . D e s i r a b l e s k i l l s r e l a t e to the a b i l i t y to i d e n t i f y and l o c a t e needed i n f o r m a t i o n , p r o b l e m - s o l v i n g s t r a t e g i e s , being s e l f - d i r e c t e d i n s e t t i n g goals as w e l l as i d e n t i f y i n g a p p r o p r i a t e g o a l s , and c a p a b i l i t i e s f o r s e l f - e v a l u a t i o n . Faure et a l (1972) i d e n t i f i e d the common thread i n a l l u s e f u l e d u c a t i o n a l experiences as being t r a i n i n g " i n s c i e n c e and in the s c i e n t i f i c s p i r i t " (p. 148), presumably meaning the methods and techniques of s c i e n t i f i c thought. The authors went as f a r as advocating "the p r i n c i p l e of a g e n e r a l , p o l y t e c h n i c a l education at secondary l e v e l — an education which would guarantee p r o f e s s i o n a l m o b i l i t y and l e a d to l i f e l o n g e d u c a t i o n " (Faure et a l , 1972, pp. 67,68). In a s l i g h t l y d i f f e r e n t v e i n , s e v e r a l authors advocate the u s e f u l n e s s of a general l i b e r a l e d ucation. As Cross (1979) p o i n t e d out, "the academic d i s c i p l i n e s form too narrow a base on 76 which to b u i l d a s o c i e t y " (p. 28). I t does seem l o g i c a l that the adoption of the g l o b a l p e r s p e c t i v e that c o u l d be p r o v i d e d by a l i b e r a l education i s a sound approach to d e a l i n g with an ever- changing s o c i e t y and i s c o n s i s t e n t with the other ideas of l i f e l o n g e d u c a t i o n . 6) The a d m i n i s t r a t i v e o r g a n i z a t i o n w i l l combine c e n t r a l and l o c a l f u n c t i o n s . The a p p l i c a t i o n of the p r i n c i p l e s of l i f e l o n g education w i l l c r e a t e a d m i n i s t r a t i v e d i f f i c u l t i e s f o r o r g a n i z e r s . By i t s very nature, that of p o s s e s s i n g and r e q u i r i n g h o r i z o n t a l and v e r t i c a l i n t e g r a t i o n among and between d i f f e r e n t elements of the t r a d i t i o n a l e d u c a t i o n a l system and s o c i e t y , i t would be unwieldy to implement. In the l i t e r a t u r e r e l a t e d to the t o p i c , authors (Cross, 1979; Faure, 1972) seemed to agree that an a p p r o p r i a t e a d m i n i s t r a t i v e s t r u c t u r e i s one which has a c e n t r a l body but which g i v e s c o n s i d e r a b l e freedom to l o c a l a u t h o r i t i e s . T h i s i s c o n s i s t e n t with some of the c h a r a c t e r i s t i c s of l i f e l o n g e ducation. T h i s can be i l l u s t r a t e d by c o n s i d e r i n g the c r i t e r i a , taken from l i f e l o n g e d u c a t i o n , that would r e l a t e to an i d e a l o r g a n i z a t i o n a l s t r u c t u r e . The c r i t e r i a a r e : 1) l i f e l o n g education i s attempting to achieve optimum usage of resources so that i t i s p o s s i b l e u l t i m a t e l y to ensure access to e d u c a t i o n a l experience f o r everyone 2) a wide v a r i e t y and scope of o r g a n i z a t i o n s c o u l d c o n c e i v a b l y make a c o n t r i b u t i o n to the e d u c a t i o n a l process under a system of l i f e l o n g education 3) education can be accomplished i n numerous ways 77 T h e r e f o r e , the most d e s i r a b l e system and the one which c o u l d best ensure that these c r i t e r i a are met would have a strong c e n t r a l o r g a n i z a t i o n -- strong i n terms of ensuring the enforcement of the p r i n c i p l e s of l i f e l o n g education and e s t a b l i s h i n g d i r e c t i v e s i n that regard — but nonetheless f l e x i b l e i n terms of a l l o w i n g f o r a v a r i e t y of approaches on the l o c a l l e v e l . For example, the c e n t r a l o r g a n i z a t i o n would have a r o l e i n o u t l i n i n g the general s k i l l s that i t i s d e s i r a b l e to f o s t e r i n i n d i v i d u a l s , while the l o c a l o r g a n i z a t i o n would work out how to accomplish those ends i n a given c o n t e x t . Such a d i s t r i b u t i o n of a d m i n i s t r a t i v e d u t i e s would combine the ideas presented by authors who have w r i t t e n about the o r g a n i z a t i o n a l problem r e l a t e d to l i f e l o n g education and would at the same time be c o n s i s t e n t with the p r i n c i p l e s of l i f e l o n g education that have been o u t l i n e d p r e v i o u s l y . C o n c l u s i o n An examination of h i s t o r i c a l thought i n d i c a t e s that the idea of l i f e l o n g l e a r n i n g has been present f o r c e n t u r i e s . The need f o r concepts of l i f e l o n g l e a r n i n g and l i f e l o n g education i n our modern-day e x i s t e n c e has been e s t a b l i s h e d on the b a s i s of changes t a k i n g p l a c e i n our s o c i e t y . The l i t e r a t u r e r e l a t e d to the t o p i c i n d i c a t e s that the goals of l i f e l o n g l e a r n i n g and i t s supporting e d u c a t i o n a l philosophy, l i f e l o n g education, are d i r e c t e d toward per s o n a l and s o c i e t a l development, both u l t i m a t e l y c o n t r i b u t i n g to an improvement i n q u a l i t y of l i f e . 78 In an attempt to d i s c e r n how these goals can be met, the d i v e r s e l i t e r a t u r e of l i f e l o n g e ducation has been examined and d e f i n i t e p r i n c i p l e s of o p e r a t i o n have been d i s t i l l e d . These general p r i n c i p l e s should be a p p l i c a b l e i n a v a r i e t y of s i t u a t i o n s . The concern i n the next chapter w i l l be to apply the concept of l i f e l o n g education to CNE. 79 CHAPTER FOUR APPLICATION OF A PHILOSOPHY OF LIFELONG EDUCATION TO CONTINUING NURSING EDUCATION An assessment of the present s t a t e of c o n t i n u i n g education in n u r s i n g c l e a r l y i n d i c a t e s that i t c o u l d b e n e f i t from a coherent approach. The problem with CNE does not stem from a lack of energy or imagination but from lac k of d i r e c t i o n . Lysaught (1974) noted that i f CNE " i s to be soundly planned and conducted, there must be some more systematic approach taken i n the f u t u r e than there has i n the pa s t " (p. 296). CNE needs a v i s i o n to i n f l u e n c e g o a l s , means, cont-ent, a d m i n i s t r a t i o n , and the approach to l e a r n e r s . Such a p e r s p e c t i v e c o u l d be pro v i d e d by an a p p r o p r i a t e p h i l o s o p h y . Some authors have i d e n t i f i e d what they deem to be a p p r o p r i a t e c h a r a c t e r i s t i c s f o r a philosophy of CNE. Loucks (1973) i n d i c a t e d that CNE must u t i l i z e a democratic approach. The c h o i c e of philosophy must be i n f l u e n c e d by concern " f o r the development of persons based on a deep c o n v i c t i o n of the worth of every i n d i v i d u a l " (Loucks, 1973, p. 26). T h i s b e l i e f w i l l be demonstrated i n the ed u c a t i v e environment that w i l l u l t i m a t e l y e x i s t . P o p e i l (1976) s t a t e d the b e l i e f that CNE must be viewed as a b a s i c human r i g h t . P h i l o s o p h i c a l p e r s p e c t i v e s w i l l flow from t h i s . Cooper and Hornback (1973) s t a t e d that "a v i a b l e philosophy of c o n t i n u i n g education encompasses v a r i o u s aspects of l i f e and i s not l i m i t e d to p r o f e s s i o n a l e d u c a t i o n " (p. 47). Further to t h i s , an a p p r o p r i a t e philosophy would be one that 80 focuses on the l e a r n e r . F i n a l l y , Cooper (1983) i n d i c a t e d that i t must encompass a wide range of b e l i e f s r e l a t i n g to n u r s i n g , nursing education, education, and c o n t i n u i n g e d u c a t i o n . Many of these ideas are i n c l u d e d i n the philosophy of l i f e l o n g education d e s c r i b e d i n Chapter Three. W r i t e r s i n c o n t i n u i n g education i n n u r s i n g have acknowledged the need f o r a t t i t u d e s c o n s i s t e n t with l i f e l o n g l e a r n i n g and have i s s u e d "motherhood" statements i n d i c a t i n g that to improve c o n t i n u i n g education i n n u r s i n g , there should be a commitment to l i f e l o n g l e a r n i n g . There i s l i t t l e evidence that t h i s has o c c u r r e d . Perhaps t h i s i s because, f o r nursing, the concepts of l i f e l o n g l e a r n i n g and l i f e l o n g education have not been w e l l understood. T h i s chapter represents an attempt to apply the p r i n c i p l e s of a philosophy of l i f e l o n g education to c o n t i n u i n g education i n n u r s i n g . The a p p l i c a t i o n of such a conceptual framework was made in an e f f o r t to provide a u s e f u l system on which to base a c t i o n . A Philosophy of CNE Based on L i f e l o n g Education Goals D e l i n e a t i n g the goals of c o n t i n u i n g education i n n u r s i n g as they would be under a philosophy of l i f e l o n g education can be c o n c e p t u a l i z e d as an a p p l i c a t i o n of a general model i n a s p e c i f i c case. T h i s i s i l l u s t r a t e d i n F i g u r e 3. 81 F i g u r e 3_: Philosophy of L i f e l o n g Education - A p p l i c a t i o n p e r s o n a l development General Model (A) I soc i e t a l development q u a l i t y l i f e of (C) i n d i v i d u a l nurse development Philosophy of CNE Based on L i f e l o n g Education S p e c i f i c Case (D) pro f e s s i o n a l q u a l i t y of s e r v i c e (F) development Whereas the goals of l i f e l o n g education are p e r s o n a l development (A) and s o c i e t a l development (B) both of which u l t i m a t e l y c o n t r i b u t e to an improvement of q u a l i t y of l i f e (C) f o r a l l , the goals of CNE i n the context of a l i f e l o n g education philosophy w i l l i n c l u d e i n d i v i d u a l nurse development (D) both on a p e r s o n a l l e v e l and i n terms of knowledge r e q u i r e d f o r p r a c t i c e in the p r o f e s s i o n , and development of the p r o f e s s i o n ( E ) , both u l t i m a t e l y c o n t r i b u t i n g to the q u a l i t y of s e r v i c e (F) p r o v i d e d . Thus, the c o n t i n u i n g education of the i n d i v i d u a l nurse should c o n t r i b u t e to development on three l e v e l s : 1) the development of the nurse as a person, 2) the development of the nurse as a 82 p r a c t i t i o n e r , and 3) the development of the nurse as a member of the p r o f e s s i o n . Thus, r a t h e r than the c o n t i n u i n g educator being concerned s o l e l y with whether or not the i n d i v i d u a l nurse has the necessary knowledge and s k i l l s to be competent, he or she must a l s o be concerned with the development of the nurse as a person. At the minimum, there must be acknowledgement of the personhood of the i n d i v i d u a l nurse p r a c t i t i o n e r i n terms of unique per s o n a l developmental needs. I d e a l l y , there should be a melding of pe r s o n a l development and f u r t h e r a n c e of the nurse as a competent p r a c t i t i o n e r . I n d i v i d u a l nurse development (D), both on personal and p r a c t i c e l e v e l s , w i l l have a r o l e i n the development of the p r o f e s s i o n (E) as a whole. In a d d i t i o n , as the p r o f e s s i o n i t s e l f develops, a c o n t r i b u t i o n w i l l be made to the development of the i n d i v i d u a l nurse. As the importance of the i n t e r a c t i o n between development of the p r o f e s s i o n and the development of the i n d i v i d u a l nurse i s recog n i z e d and f o s t e r e d by c o n t i n u i n g educators, there w i l l be a c o n t r i b u t i o n to the enhancement of the u l t i m a t e goal of CNE, q u a l i t y of s e r v i c e . A d m i n i s t r a t i o n The most a p p r o p r i a t e a d m i n i s t r a t i v e o r g a n i z a t i o n f o r implementing l i f e l o n g education would be one which d i s t r i b u t e s f u n c t i o n s c e n t r a l l y and l o c a l l y . The major purpose of such a s t r u c t u r e i s t o c o o r d i n a t e a c t i v i t i e s and a v o i d d u p l i c a t i o n and 83 gaps, while a l l o w i n g l o c a l needs to take precedence. A p p l i e d to n u r s i n g , i t i s obvious that j u s t as l i f e l o n g education, on a broader s c a l e , i s to provide c o o r d i n a t e d o p p o r t u n i t i e s f o r education f o r people of a l l ages and walks of l i f e , so CNE should, i n a c o o r d i n a t e d way, p r o v i d e access to e d u c a t i o n a l o p p o r t u n i t i e s f o r a l l nurses. There should be a body designated as having the c e n t r a l p l a n n i n g f u n c t i o n . There are at l e a s t two p o s s i b i l i t i e s as to what body c o u l d be u t i l i z e d f o r t h i s purpose. Kotaska (1981) noted t h a t , f o r B.C., the M i n i s t r i e s of Education, H e a l t h , and U n i v e r s i t i e s c o u l d do w e l l to cooperate in the area of p o s t - b a s i c n u r s i n g e d u c a t i o n . The RNABC ("Continuing Education f o r R e g i s t e r e d 1978) recommended that a " d e c i s i o n making s t r u c t u r e to c o o r d i n a t e the d e l i v e r y of c o n t i n u i n g education i n B r i t i s h Columbia be organized at two l e v e l s : a. a d e c e n t r a l i z e d l e v e l , with a c o n t i n u i n g education c o o r d i n a t i n g c o u n c i l f o r each community c o l l e g e r e g i o n ; b. a c e n t r a l i z e d l e v e l , with a p r o v i n c i a l a u t h o r i t y (eg. a p r o v i n c i a l a d u l t education c o u n c i l ) " (p.15). Probably the most obvious p o s s i b i l i t y i s that a n u r s i n g a s s o c i a t i o n r e p r e s e n t i n g the p r o f e s s i o n assume t h i s f u n c t i o n . In Canada, t h i s a s s o c i a t i o n c o u l d be e i t h e r the Canadian Nurses A s s o c i a t i o n or a p r o v i n c i a l a s s o c i a t i o n . A d i f f i c u l t y with having the Canadian Nurse's A s s o c i a t i o n assume t h i s r o l e i s the dramatic r e g i o n a l d i f f e r e n c e s i n Canada. Problems with having 8 4 i n d i v i d u a l p r o v i n c i a l o r g a n i z a t i o n s as c o o r d i n a t i n g bodies r e l a t e to the same r e g i o n a l s i m i l a r i t i e s and d i f f e r e n c e s . Thus, r e g i o n a l c o o r d i n a t i o n of CNE a c t i v i t i e s would seem more a p p r o p r i a t e . Obvious g e o g r a p h i c a l c o n s i d e r a t i o n s make t h i s a f e a s i b l e p r o p o s a l . In the n u r s i n g s i t u a t i o n i n the U n i t e d S t a t e s , there has a l r e a d y been some c o n s i d e r a t i o n of r e g i o n a l c o o r d i n a t i o n . Cooper and Byrns (1973), i n making recommendations f o r a plan f o r c o n t i n u i n g education i n 5 s t a t e s , recommended that a r e g i o n a l center w i t h i n a Department of Nursing be e s t a b l i s h e d . Lysaught (1974) recommends i n t e r s t a t e o r g a n i z a t i o n of CNE. Having a n u r s i n g o r g a n i z a t i o n r e s p o n s i b l e f o r c o o r d i n a t i o n of CNE a c t i v i t i e s may not, however, be the i d e a l approach. Goldberg (1975) suggested that perhaps an e d u c a t i o n a l i n s t i t u t i o n might be b e t t e r equipped than a n u r s i n g o r g a n i z a t i o n as a c o o r d i n a t i n g body f o r CNE. C l e a r l y , as Tobin (1976b) i n d i c a t e d , to achieve the goals of CNE r e q u i r e s c o l l a b o r a t i o n of more than j u s t n u r s i n g o r g a n i z a t i o n s . C o o r d i n a t i o n of CNE r e q u i r e s the support of c o l l e g e s , u n i v e r s i t i e s , h e a l t h , and community o r g a n i z a t i o n s , and, of course, government. However, a consortium of c o n t r i b u t i n g o r g a n i z a t i o n s c o u l d be overseen by e i t h e r a n u r s i n g or an e d u c a t i o n a l o r g a n i z a t i o n . C o n s i d e r i n g other c h a r a c t e r i s t i c s of l i f e l o n g education ( i e . that o p p o r t u n i t i e s f o r broader forms of education should be a v a i l a b l e ) , t h i s type of approach c o u l d have advantages for n u r s i n g . Use of an e d u c a t i o n a l i n s t i t u t i o n as the c e n t r a l agency 85 might r e s u l t i n g r e a t e r i n t e r d i s c i p l i n a r i t y . The use of a consortium approach, i n which there i s agreement on the s h a r i n g of personnel, p h y s i c a l and f i s c a l r esources, c o u l d reduce c o n f l i c t . What would the c o o r d i n a t i n g f u n c t i o n of the c e n t r a l agency i n v o l v e ? Beyond a v o i d i n g d u p l i c a t i o n , the c o o r d i n a t i n g f u n c t i o n would i n v o l v e the development of g u i d e l i n e s to determine f u t u r e d i r e c t i o n s f o r CNE so e f f o r t s c o u l d be aimed at common g o a l s . The c e n t r a l agency would be r e s p o n s i b l e f o r the development of these g u i d e l i n e s i n the context of broader h e a l t h - r e l a t e d needs and resources a v a i l a b l e . Thus, in the broader sense, c o n t i n u i n g education o p p o r t u n i t i e s would be l i n k e d with the l i f e of the s o c i e t y i n which nurses e x i s t . In a d d i t i o n , long-range p l a n n i n g would tend to decrease the i n c i d e n c e of c o n t i n u i n g education o p p o r t u n i t i e s developed i n response to the onset of c r i s i s . The c e n t r a l agency i t s e l f may not be r e s p o n s i b l e f o r the p r o v i s i o n of c o n t i n u i n g education o p p o r t u n i t i e s . Instead, a p p l i c a t i o n of a philosophy of l i f e l o n g education w i l l r e s u l t i n an expansion of p o s s i b l e p r o v i d e r s . A broader c o n c e p t u a l i z a t i o n of what i s a p p r o p r i a t e education would c o n t r i b u t e to t h i s . The purpose of the c e n t r a l agency w i l l be to ensure adequate access and a v a i l a b i l i t y of c o n t i n u i n g education o p p o r t u n i t i e s to nurses in a l l areas. A major r e s p o n s i b i l i t y of the c e n t r a l agency w i l l be the d i s s e m i n a t i o n of i n f o r m a t i o n about e d u c a t i o n a l o p p o r t u n i t i e s . Cropley (1980) noted, i n r e l a t i o n to l i f e l o n g e ducation, that 86 planning i s " e s s e n t i a l l y a matter of p r o v i d i n g i n f o r m a t i o n to those who have to make the necessary d e c i s i o n s (p. 83). Along these l i n e s , McNally (1972) suggested that the c r e a t i o n of a cle a r i n g h o u s e f o r CNE in f o r m a t i o n would be v a l u a b l e . A cl e a r i n g h o u s e would have to in c l u d e a r e g i s t r y of c o n t i n u i n g education o f f e r i n g s i n the area that the c e n t r a l agency ser v e s . T h i s would r e q u i r e c o o p e r a t i o n of a l l p r o v i d e r s of c o n t i n u i n g education s e r v i c e s . A c e n t r a l o f f i c e would have to be e s t a b l i s h e d f o r t h i s purpose. There would have to be development of mechanisms f o r d i s s e m i n a t i o n of i n f o r m a t i o n . C a r l l e y (1974) suggested p u b l i s h i n g a calendar of CNE a c t i v i t i e s . Regional c o o r d i n a t i o n of CNE would in c r e a s e the l i k e l i h o o d that c r e d i t f o r CNE a c t i v i t i e s would be t r a n s f e r a b l e ("Standards ...",1975). T h i s would prove p a r t i c u l a r l y important i n a po p u l a t i o n of workers who are as mobile as nurses. A l s o , r e g i o n a l c o o r d i n a t i o n might in c r e a s e acceptance of the need f o r CNE by acknowledging p a r t i c i p a t i o n . The o r g a n i z a t i o n of CNE on a l o c a l b a s i s would a l s o allow f o r s e n s i t i v i t y to s p e c i f i c needs among the nur s i n g p o p u l a t i o n . Keeney (1980) poi n t e d out that i t would a l s o allow the maintenance of a "sense of program ownership" (p. 3). T h i s would undoubtedly c o n t r i b u t e to the q u a l i t y of the o f f e r i n g s and might even e f f e c t p a r t i c i p a t i o n p a t t e r n s . 87 The Learners Cropley's (1977) ideas of l i f e l o n g education included what were r e f e r r e d to as h o r i z o n t a l and v e r t i c a l i n t e g r a t i o n . E f f o r t s to implement h o r i z o n t a l i n t e g r a t i o n were d e s c r i b e d in the p r e v i o u s s e c t i o n where a d m i n i s t r a t i v e arrangements to c o o r d i n a t e e d u c a t i o n a l o p p o r t u n i t i e s f o r nurses were d i s c u s s e d . V e r t i c a l i n t e g r a t i o n , which r e l a t e s s p e c i f i c a l l y to the l e a r n e r , i s an area which must be d i s c u s s e d i n r e l a t i o n to CNE. C o o r d i n a t i o n on a broad l e v e l can be accomplished by a d m i n i s t r a t i v e and o r g a n i z a t i o n a l arrangements, but c o o r d i n a t i o n of CNE a c t i v i t i e s i n the l i v e s of s p e c i f i c i n d i v i d u a l s has not yet been d e a l t with. There must be coherence i n the l i f e of the i n d i v i d u a l nurse i n seeking and p a r t i c i p a t i n g i n e d u c a t i o n a l o p p o r t u n i t i e s . Cooper (1972b) s a i d that " e f f e c t i v e c o n t i n u i n g education f o r the i n d i v i d u a l r e q u i r e s c o n t i n u i t y , and t h i s depends upon p l a n n i n g " (p. 580). One of the b e n e f i t s of such p l a n n i n g i s that i t w i l l f a c i l i t a t e an " e a s i e r flow of l i f e f o r a l l persons from one endeavour to another" (Carnegie p. 15). T h i s " e a s i e r " flow c o u l d i n i t s e l f be a m o t i v a t i n g f o r c e i n c o n t i n u i n g education a c t i v i t i e s . If i n d i v i d u a l s are aware that the goals sought are l i k e l y to be reached, they are more i n c l i n e d to p a r t i c i p a t e . Of course, n e i t h e r agencies f o r whom i n d i v i d u a l s work nor i n d i v i d u a l i n s t i t u t i o n s can accomplish t h i s planning f o r i n d i v i d u a l s . And t h i s i s as i t should be, s i n c e i n the context of l i f e l o n g education, the primary r e s p o n s i b i l i t y f o r l e a r n i n g 88 r e s t s with the i n d i v i d u a l (Houle, 1970; Jessup, 1969). The type of p l a n n i n g r e q u i r e d i s that which only an i n d i v i d u a l can do. As i n d i c a t e d p r e v i o u s l y , c o o r d i n a t i n g agencies, l o c a l i n s t i t u t i o n s of e d u c a t i o n , and workplaces can and should p r o v i d e i n d i v i d u a l s with i n f o r m a t i o n on which to base t h e i r p l a n n i n g . However, only i n d i v i d u a l s can choose d i r e c t i o n s and personal goals which w i l l i n f l u e n c e s e l e c t i o n of o p p o r t u n i t i e s . T h i s f i t s i n w e l l with the UNESCO (1978) c o n c e p t u a l i z a t i o n of l i f e l o n g e ducation that i t i s not " p e r i o d i c f o r c e d f e e d i n g " but rather " i t s f i n a l o b j e c t i v e must be to s t i m u l a t e an a p t i t u d e f o r continuous enrichment throughout l i f e " (p. 11). One of the assumptions behind these ideas i s that i n d i v i d u a l s possess the t o o l s and m o t i v a t i o n s r e q u i r e d to plan c o n t i n u i n g education a c t i v i t i e s . I f the i n d i v i d u a l does not possess these a t t r i b u t e s , then steps must be taken to h e l p the i n d i v i d u a l a c q u i r e or develop them. The nurse must be able to s e l e c t goals f o r p e r s o n a l and p r o f e s s i o n a l development. As n u r s i n g changes, the nurse must be able and w i l l i n g to s p e c i f y the d i r e c t i o n most s u i t a b l e f o r h i s or her a b i l i t i e s and d e s i r e s . T h i s i s not to say, n e c e s s a r i l y , that a l l nurses w i l l have as a primary concern a d i r e c t i o n of p r o f e s s i o n a l development. However, f o r reasons r e l a t e d to how r a p i d l y obsolescence i n any job can occur, anyone who p r a c t i c e s n u r s i n g must r e a l i z e t h a t to not pick, a d i r e c t i o n f o r development i s to take a step backwards. Once d i r e c t i o n s have been s e l e c t e d , the i n d i v i d u a l must i d e n t i f y the r o l e that formal 89 c o n t i n u i n g education can p l a y i n h e l p i n g to achieve the goals s p e c i f i e d . A f u r t h e r c h a r a c t e r i s t i c that a philosophy of l i f e l o n g e ducation i n CNE r e q u i r e s of nurses i s that they are s e l f - d i r e c t e d , not only in s e l e c t i n g g o a l s , but i n seeking resources for t h e i r c o n t i n u i n g e d u c a t i o n . Continuing education can i n c l u d e f o r m a l l y planned a c t i v i t i e s such as c l a s s e s and workshops, as w e l l as those that i n d i v i d u a l s design f o r themselves. Such s e l f - d i r e c t i o n r e q u i r e s that the i n d i v i d u a l possess a c e r t a i n amount of confidence i n t h e i r own a b i l i t i e s i n that regard. I n d i v i d u a l s must a l s o possess s k i l l s i n a c q u i r i n g or knowing how to a c q u i r e i n f o r m a t i o n on other resources a v a i l a b l e . These t r a i t s are l e a r n a b l e . The i n d i v i d u a l who has not p r e v i o u s l y a c q u i r e d these t r a i t s through experience, can do so through an a p p r o p r i a t e process. F i n a l l y , the i n d i v i d u a l must possess the m o t i v a t i o n r e q u i r e d to be i n v o l v e d i n c o n t i n u i n g education a c t i v i t i e s . Without m o t i v a t i o n , the p r i o r p l a n n i n g i s not l i k e l y to take p l a c e . If m o t i v a t i o n i s absent, expenditure of energy in the d i r e c t i o n of c o n t i n u i n g education a c t i v i t i e s i s not l i k e l y to occur. Such m o t i v a t i o n has i n t e r n a l and e x t e r n a l determinants. An i n t e r n a l determinant i s the i n d i v i d u a l ' s b e l i e f i n the value of f u r t h e r e d u c a t i o n . There are many i n d i c a t i o n s ( B e v i s , 1975) that nurses do not n e c e s s a r i l y possess t h i s b e l i e f which i s at the heart of the idea of l i f e l o n g e d u c a t i o n . Much work should be 90 done i n a s s i s t i n g nurses to value l i f e l o n g education (Schweer, 1978). E x t e r n a l determinants i n c l u d e rewards for c o n t i n u i n g education. These rewards are r e l a t e d to the c h a r a c t e r i s t i c s of the environment and expected outcomes. These, then, are the areas that the nurse educator must co n s i d e r i n r e l a t i o n to being of a s s i s t a n c e to the l e a r n e r and i n promoting the cause of c o n t i n u i n g education i n n u r s i n g . Cooper and Hornback (1973) p o i n t e d out that when a nurse educator accepts l i f e l o n g e ducation as a philosophy, a more l i m i t e d r o l e i s a l s o accepted. Obviously, the r o l e of the educator i s more l e a r n e r - o r i e n t e d . The nurse educator i n c o n t i n u i n g education w i l l continue to assess needs, p l a n , implement, and evaluate programs. However, the educator w i l l a l s o have to deal with the aspects of the l e a r n e r d e s c r i b e d here. Educators and/or p r o v i d e r s of c o n t i n u i n g education i n n u r s i n g w i l l have to a s s i s t nurses to value l e a r n i n g . T h i s can be accomplished and might be approached i n s e v e r a l ways. F i r s t , educators and persons i n prominent p o s i t i o n s i n nursing w i l l themselves have to model a p p r o p r i a t e behavior. Cooper (1972) s t a t e d that nurses have not yet l e a r n e d to respect each other's knowledge and s k i l l . T h i s i s d e t r i m e n t a l when t r y i n g to c r e a t e a s i t u a t i o n where l e a r n i n g i s to be a l t r u i s t i c a l l y valued for i t s own sake and where c o n t i n u i n g education i s to c o n t r i b u t e to improvement of p r a c t i c e . 91 Secondly, i n order to take i n t o c o n s i d e r a t i o n personal goals and a s p i r a t i o n s , educators w i l l have to p l a c e more emphasis on the personhood of the l e a r n e r . Although i t i s not p o s s i b l e f o r each educator to have personal c o n t a c t with each l e a r n e r , f l e x i b i l i t y must be b u i l t i n t o CNE. Requests fo r a l t e r a t i o n s of formal c o n t i n u i n g education o f f e r i n g s on an i n d i v i d u a l b a s i s w i l l have to be d e a l t with. T h i s c o u l d c r e a t e an unwieldy system of c o n t i n u i n g education. A l t e r n a t i v e l y , i t c o u l d r e s u l t i n the c r e a t i o n of a' system of c o n t i n u i n g education where i n s t r u c t i o n a l planning i s conducted with the need for f l e x i b i l i t y i n mind. One s o l u t i o n to the need f o r emphasis on the unique person of the l e a r n e r while c l i n g i n g to the tenet that the i n d i v i d u a l i s p r i m a r i l y r e s p o n s i b l e f o r the choice of d i r e c t i o n i n c o n t i n u i n g education i s the p r o v i s i o n of c o u n s e l l i n g s e r v i c e s f o r l e a r n e r s . T h i s area has l a r g e l y been d i s r e g a r d e d i n CNE. However, with the changes i n the n u r s i n g p r o f e s s i o n i t s e l f and the i n c r e a s i n g d i v e r s i t y of c o n t i n u i n g education as w e l l as the requirement of the philosophy of l i f e l o n g e ducation that the i n d i v i d u a l develop s k i l l s r e l a t e d to seeking education, c o u n s e l l i n g w i l l assume i n c r e a s i n g importance. A comprehensive car e e r and c o n t i n u i n g education c o u n s e l l i n g scheme f o r a l l nurses w i l l b e n e f i t p o t e n t i a l l e a r n e r s and CNE p l a n n e r s . Content Under a philosophy of l i f e l o n g education the goals of 92 c o n t i n u i n g education i n nu r s i n g w i l l r e l a t e to the development of competence i n the f i e l d and per s o n a l development but the concern w i l l be d i r e c t e d more toward the development of a " c o n t i n u i n g " competence and a " c o n t i n u i n g " p e r s o n a l development. T h i s purpose must, of n e c e s s i t y , be r e f l e c t e d i n the content of CNE. No longer w i l l c o n t i n u i n g education be used as a f i r e f i g h t i n g mechanism i n which courses are used to meet immediate and p r e s s i n g needs. Instead c o n t i n u i n g education w i l l be used to meet the a n t i c i p a t e d needs of the f u t u r e . T h i s approach w i l l a l t e r the content of CNE so that rather than a c o n c e n t r a t i o n on the d i s t r i b u t i o n and storage of a knowledge base r e q u i r e d by the immediate s i t u a t i o n , there w i l l be more emphasis on g e n e r a l i z a b l e s k i l l s r e l a t e d to a c q u i r i n g knowledge. The nu r s i n g focus w i l l , however, be preserved and the knowledge requirements of "immediate" s i t u a t i o n s that nurses may f i n d themselves i n w i l l be acknowledged. Se v e r a l authors have i d e n t i f i e d the g e n e r a l i z a b l e content that would have to be i n c l u d e d i n CNE i f a philosophy of l i f e l o n g education i s u t i l i z e d . Cooper and Byrns (1973) have i d e n t i f i e d one area that nurses need f u r t h e r h e l p i n . T h i s area i s r e l a t e d to l e a r n i n g how to l e a r n . They i n d i c a t e d that "nurses need.to l e a r n how to gain access to a v a i l a b l e i n f o r m a t i o n and how to use i t a f t e r i t i s secured" (Cooper & Byrns, 1973, p. 27). They a l s o need a s s i s t a n c e i n i d e n t i f y i n g t h e i r own l e a r n i n g needs. 93 Nurses must be helped i n l e a r n i n g how to gain access to l e a r n i n g r e s o u r c e s , such as l i b r a r i e s . Once these types of s k i l l s have been adequately developed, a t t e n t i o n can be turned to higher l e v e l s k i l l s such as p r o b l e m - s o l v i n g . Problem-solving i s a g e n e r a l i z a b l e s k i l l many n u r s i n g s i t u a t i o n s demand. I t r e q u i r e s an a n a l y t i c a l and c r i t i c a l approach which can be used in almost any p r a c t i c a l n u r s i n g s i t u a t i o n . Because i t i s g e n e r a l i z a b l e , the a b i l i t y to problem-solve i s an asset to any p r a c t i c i n g nurse. A focus on problem-solving i s not l i m i t e d to or s p e c i f i c to any one p r o f e s s i o n . E d u c a t i o n a l o p p o r t u n i t i e s p r o v i d i n g p r a c t i c e i n p r o b l e m - s o l v i n g c o u l d be i n t e r d i s c i p l i n a r y . To t h i s p o i n t , the content of CNE based on a philosophy of l i f e l o n g education has been i d e n t i f i e d as i n c l u d i n g the a c q u i s i t i o n of s k i l l s r e l a t e d to problem-solving, o b t a i n i n g resources, and u t i l i z i n g them. These two areas would seem to be requirements of a philosophy of l i f e l o n g e d u c a t i o n . However, i t may be found that i n c l u d i n g these types of s k i l l s w i l l do much to a i d the n u r s i n g p r o f e s s i o n i t s e l f , i n a d d i t i o n to the development of the i n d i v i d u a l p r o f e s s i o n a l as a person and as a p r a c t i t i o n e r . As Chapman (1983) i n d i c a t e d , i n d i v i d u a l nurses need to be fre e to "pursue t h e i r own c o n t i n u i n g education by the p r o v i s i o n of the a p p r o p r i a t e t o o l s " (p. v ) . Once these t o o l s are a c q u i r e d , the nurse i s i n a powerful p o s i t i o n , both in her p r a c t i c e and in her a c t i o n s as a p r o f e s s i o n a l . The p o s s e s s i o n of these 94 g e n e r a l i z a b l e s k i l l s w i l l mean t h a t , i n t h e i r a c t i o n s , nurses w i l l be able to take i n t o account both the requirements of t h e i r own p e r s o n a l i t i e s and the needs of the s o c i e t y i n which they f i n d themselves (Houle, 1980). T h i s i s an i d e a l which Houle (1980) i n d i c a t e d as being an a p p r o p r i a t e outcome of c o n t i n u i n g p r o f e s s i o n a l e d u c a t i o n . Thus, the content of CNE based on a philosophy of l i f e l o n g education broadens the content of CNE c o n s i d e r a b l y . In f a c t , the content i s the process of a c q u i r i n g the s k i l l s i n d i c a t e d . Aside from the g e n e r a l i z a b l e s k i l l s d e s c r i b e d above, CNE i n the context of l i f e l o n g education w i l l a l s o have a l i b e r a l education component. Such a component i s c o n s i s t e n t with the goal of the development of the i n d i v i d u a l as a person. I t i s assumed that a person with a well-rounded knowledge and l i f e - s k i l l base w i l l be a b e t t e r p r a c t i t i o n e r . The person who f e e l s p e r s o n a l l y f u l f i l l e d w i l l be a more v a l u a b l e p r o f e s s i o n a l . As F e l t o n (1980) p o i n t e d out, most n u r s i n g academics seem to agree that there should be a focus on l i b e r a l e d u c a t i o n . The focus i s not on s p e c i f i c f a c t s , but a broader understanding of s i t u a t i o n s and the development of " i n s i g h t , understanding, and a t t i t u d e s " (Cooper & Hornback, 1973, p. 56) that are a p p r o p r i a t e to p r o f e s s i o n a l p r a c t i c e and u t i l i z a b l e i n a v a r i e t y of s i t u a t i o n s . Such an approach to content i n CNE can go a long way toward p r e p a r i n g nurses who are ready and able to work on the " u n p r e d i c t a b l e , complex, and dynamic problems of the f u t u r e " ( F e l t o n , 1980, p.7) that may appear i n t h e i r p e r s o n a l l i v e s or 95 in the p r o f e s s i o n as a whole. In a d d i t i o n , the development of i n d i v i d u a l s who are prepared to " t h i n k " and u t i l i z e a framework i n approaching t h e i r p r a c t i c e w i l l f a c i l i t a t e the development of theory i n n u r s i n g -- a f u r t h e r s t e p toward p r o f e s s i o n a l i z a t i o n . Means The changes in a d m i n i s t r a t i o n , g o a l s , approaches to l e a r n e r s , and content that have been d i s c u s s e d i n p r e v i o u s s e c t i o n s of t h i s chapter w i l l not e x i s t without changes i n the "means" or approaches. To make the changes p r e v i o u s l y d e s c r i b e d as being needed without implementing changes i n "means" would d i m i n i s h the impact of the whole approach p r e s c r i b e d by l i f e l o n g e d u c a t i o n . Before any of the p r e v i o u s l y d e s c r i b e d changes i n the system of c o n t i n u i n g education i n n u r s i n g can be implemented with great impact, there must be changes in b a s i c n u r s i n g e d u c a t i o n . To i n t r o d u c e the ideas of l i f e l o n g education only i n a p p l i c a t i o n to c o n t i n u i n g education would be another " f i r e - f i g h t i n g " mechanism. The o v e r a l l approach to n u r s i n g education, from the i n i t i a t e onwards, must be a l t e r e d . B e l l and Rix (1979) recommended t h a t t r a i n i n g r e l a t e d to the s k i l l s r e q u i r e d f o r l i f e l o n g e d u c a t i o n be i n c o r p o r a t e d i n t o b a s i c n u r s i n g e d u c a t i o n . Once these s k i l l s have i n f i l t r a t e d the beginning l e v e l s of n u r s i n g e d u c a t i o n , i t i s more l i k e l y that a f o l l o w - t h r o u g h to c o n t i n u i n g e d u c a t i o n can occur. Before the tenets of l i f e l o n g education can be put i n 96 p l a c e , there w i l l a l s o have to be changes i n the n u r s i n g p r o f e s s i o n i t s e l f . For example, c a r e e r paths i n n u r s i n g w i l l have to be c r e a t e d so i n d i v i d u a l s can i d e n t i f y s p e c i f i c goals toward which they wish to work. McNally (1972), Russel (1971), Lysaught (1974), and Goldberg (1975) a l l i d e n t i f i e d the need f o r c a r e e r paths i n n u r s i n g . These w i l l serve to f u r t h e r motivate nurses to p a r t i c i p a t e i n l i f e l o n g education a c t i v i t i e s s i n c e i n t e r n a l m o t i v a t i o n w i l l be s t i m u l a t e d by obvious e x t e r n a l m o t i v a t o r s . D e f i n i t e c a r e e r paths and c a r e e r m o b i l i t y are m o t i v a t o r s . In a d d i t i o n , the i d e n t i f i c a t i o n of d e f i n i t e career paths w i l l s t i m u l a t e systematic p l a n n i n g f o r c o n t i n u i n g education by i n d i v i d u a l s and i n s t i t u t i o n s . However, other changes i n the system in which nurses p r a c t i c e w i l l have to occur. Changes i n ways of l o o k i n g at g o a l s , ways of approaching content, and i n s k i l l s that are i d e n t i f i e d as being d e s i r a b l e cannot occur without the o v e r a l l s t r u c t u r e of n u r s i n g changing i n the same d i r e c t i o n . Cranstoun (1981) s t a t e d that although changes can be i n t r o d u c e d i n c o n t i n u i n g education a c t i v i t i e s , c o rresponding changes must occur where the i n d i v i d u a l a c t u a l l y p r a c t i c e s . Cooper (1982) i d e n t i f i e d b a s i c a l l y the same requirements of the o v e r a l l s t r u c t u r e of n u r s i n g . One s t r u c t u r a l change that must occur i s a f u r t h e r i n t e g r a t i o n of education and s e r v i c e i n n u r s i n g . I t was i n d i c a t e d e a r l i e r that the goals of these two f a c e t s of n u r s i n g are somewhat d i f f e r e n t . These two f a c t i o n s must agree on goals 97 and pool resources to meet them. T h i s a c t i o n w i l l r e s u l t i n more e f f i c i e n t u t i l i z a t i o n of r e s o u r c e s . CNE i n the context of l i f e l o n g education w i l l mean that the p r o v i d e r s w i l l make grea t e r use of c l i n i c a l p r a c t i c e than at p r e s e n t . The f a c t that l e a r n i n g w i l l take p l a c e in the workplace in which a nurse f i n d s h e r s e l f i s an a p p l i c a t i o n of the p r i n c i p l e t h a t ' l e a r n i n g should be a s s o c i a t e d with the l i f e ( i n t h i s case, the work) of the l e a r n e r . Such p r a c t i c a l a p p l i c a t i o n of l e a r n i n g i s more l i k e l y to r e s u l t i n changes i n n u r s i n g p r a c t i c e . (Cooper, 1 982). Huber. (1972) emphasized the ANA's p o s i t i o n on t h i s by i n d i c a t i n g that " p u t t i n g new knowledge i n t o p r a c t i c e i n v o l v e s f a r more than j u s t r e q u i r i n g a person to be exposed to a l e a r n i n g s i t u a t i o n .... o p p o r t u n i t i e s must be a v a i l a b l e i n the a c t u a l work s e t t i n g to share knowledge, to t r y i t out, to succeed, and to f a i l " (p. 29,30). An NLN paper ("The community ...", 1978) i n d i c a t e d that "not having an o p p o r t u n i t y to use what one has learned can i n h i b i t an i n d i v i d u a l ' s m o t i v a t i o n to continue l e a r n i n g " (p. 13). Nurses must be a b l e to expect to apply what they l e a r n i n CNE a c t i v i t i e s . Since the i n d i v i d u a l i s the focus of l i f e l o n g e d u c a t i o n , i t i s the i n d i v i d u a l who w i l l have to be s t i m u l a t e d and motivated to p a r t i c i p a t e i n CNE. More emphasis w i l l have to be p l a c e d on rewards and i n c e n t i v e s f o r p a r t i c i p a t i o n i n CNE. Such changes in n ursing as the i d e n t i f i c a t i o n of c a r e e r paths, and the a p p l i c a t i o n of l e a r n i n g i n , at l e a s t , p r a c t i c e s i t u a t i o n s , w i l l be important means toward implementing l i f e l o n g e d ucation. 98 As Huber (1972) noted, t h i s kind of a p p l i c a t i o n r e q u i r e s teamwork. I t may be that the type of "teamwork" of most use to CNE w i l l be t hat of the i n t e r d i s c i p l i n a r y v a r i e t y . The type of problem-solving s k i l l s that w i l l comprise the content of CNE in the context of l i f e l o n g e ducation w i l l not n e c e s s a r i l y be unique to n u r s i n g . T h e r e f o r e , i n t e r d i s c i p l i n a r y e f f o r t s at c o n t i n u i n g education w i l l p l a y an important r o l e . T h i s i s c o n s i s t e n t with the p r i n c i p l e s of l i f e l o n g education which s t a t e that "emphasis i s p l a c e d on the process of education r a t h e r than on any s p e c i f i e d content" and "education i s l i n k e d with l i f e " . L i f e i s l i n k e d to r e a l i t y and the r e a l i t y of nurses' working c o n d i t i o n s are that they work with other p r o f e s s i o n a l s . I f an o v e r a l l goal of l i f e l o n g education i s that s o c i e t y w i l l b e n e f i t , then a goal of c o n t i n u i n g p r o f e s s i o n a l (and nursing) education must be s i m i l a r . T h i s can be b e t t e r accomplished i f the p r o f e s s i o n s work together. Hence, i t appears that one means of implementing l i f e l o n g education i n CNE w i l l be i n t e r d i s c i p l i n a r y approaches. Cooper and Byrns (1973) r e a f f i r m e d t h i s by s t a t i n g that " i n the f o r e s e e a b l e f u t u r e , i t i s the i n t e r p r o f e s s i o n a l a c t i v i t y that needs a t t e n t i o n ... programs should be b u i l t on the process of i n q u i r y i n t o p a t i e n t care i n which the p r o f e s s i o n a l s are j o i n t l y i n v o l v e d " (P. 23). The "process of i n q u i r y " r e f e r r e d to above c o u l d be taken to mean the process of problem-solving which i s so c e n t r a l to l i f e l o n g e d u c a t i o n . T h i s does not mean that by p a r t i c i p a t i n g i n 99 i n t e r p r o f e s s i o n a l c o n t i n u i n g education the n u r s i n g p r o f e s s i o n w i l l loose i t s i d e n t i t y . In f a c t , Cooper and Byrns (1973) went on to s t a t e that the "concept of c o n t i n u i n g i n t e r p r o f e s s i o n a l l e a r n i n g , i n which p a t i e n t - c e n t e r e d d i a l o g u e and study with one's p r o f e s s i o n a l c o l l e a g u e s should a l s o r e s u l t i n f u r t h e r i n d i v i d u a l study. For to c o n t r i b u t e to the group, each p r o f e s s i o n a l must pursue h i s own unique knowledges and s k i l l s " (p. 23). An advantage of i n t e r d i s c i p l i n a r y e d u c a t i o n a l o f f e r i n g s are that they are c o n s e r v a t i v e of e d u c a t i o n a l resources, time, and money. Con c l u s i o n The preceding pages have p r o v i d e d a d e s c r i p t i o n of CNE as i t would be i n the context of l i f e l o n g e d u c a t i o n . Changes to the g o a l s , means, treatment of l e a r n e r s , content and a d m i n i s t r a t i o n of CNE stem from p r i n c i p l e s c h a r a c t e r i z i n g l i f e l o n g e ducation. From a c o n s i d e r a t i o n of the changes, i t would seem that l i f e l o n g education may be a v i a b l e a l t e r n a t i v e f o r CNE. The c o n c l u d i n g chapter examines q u e s t i o n s r e l a t e d to the a p p r o p r i a t e n e s s of the a p p l i c a t i o n . 100 CHAPTER FIVE CONCLUSION An examination of CNE has r e v e a l e d d e f i c i e n c i e s . I t s o r g a n i z a t i o n l a c k s a framework on which to base a c t i o n i n p r o v i d i n g c o n t i n u i n g education o p p o r t u n i t i e s . There i s a demonstratable need f o r change. L i f e l o n g education has been examined as a s o l u t i o n to the dilemma which CNE f a c e s . T h i s concept has been i d e n t i f i e d as an e d u c a t i o n a l philosophy which w i l l i n f l u e n c e g o a l s , content, means, a d m i n i s t r a t i o n , and treatment of l e a r n e r s . As an e d u c a t i o n a l p h i l o s o p h y , l i f e l o n g e ducation i s s u i t a b l e f o r use in s i t u a t i o n s where change i s a f a c t o r . The d i f f i c u l t y i n a p p l y i n g l i f e l o n g education stems from the apparent nebulous nature of the concept and the l a c k of c l e a r l y i d e n t i f i e d p r i n c i p l e s r e l a t e d to i t . I t has been necessary to i d e n t i f y , from a review of the l i t e r a t u r e , such " p r i n c i p l e s " , or the c h a r a c t e r i s t i c s of the philosophy which suggest s t r a t e g i e s f o r implementat i o n . T e s t i n g as a Framework Assuming that a commitment i s made to l i f e l o n g education as being s u i t a b l e f o r adoption as a philosophy of CNE, c e r t a i n c o n s i d e r a t i o n s w i l l have to be taken i n t o account i n determining i t s u s e f u l n e s s as a framework. In the e a r l y stages, i t ' s f e a s i b i l i t y would need to be examined. F o l l o w i n g adoption, outcomes would need to be c o n s i d e r e d . 101 F e a s i b i l i t y As has been p o i n t e d out i n previous chapters, the a p p l i c a t i o n of l i f e l o n g education w i l l r e q u i r e that r a d i c a l changes in the c u r r e n t s t a t e of CNE take p l a c e . C e r t a i n p r e r e q u i s i t e s must be met i n order f o r implementation to occur. As i n a l l change s i t u a t i o n s , i t i s c o n c e i v a b l e that attempts to implement l i f e l o n g education w i l l meet r e s i s t a n c e . Although i t has been demonstrated i n previous chapters that l i f e l o n g education can, i n p r i n c i p l e , be a p p l i e d to CNE, i t may be that r e s i s t a n c e to the number and types of changes r e q u i r e d would overwhelm any move i n that d i r e c t i o n . One of the f i r s t p r e r e q u i s i t e s to implementation must be f l e x i b i l i t y and open- mindedness on the p a r t of i n d i v i d u a l s and i n s t i t u t i o n s i n v o l v e d . Because l i f e l o n g e ducation i s a philosophy, there i s a " b e l i e f " f a c t o r which must be acknowledged when c o n s i d e r i n g implementation. L i f e l o n g education i s an untested b e l i e f system and a c e r t a i n amount of " f a i t h " i s r e q u i r e d before a commitment can be made to i t . I n d i v i d u a l s , whether p o t e n t i a l p a r t i c i p a n t s or educators, w i l l more l i k e l y be induced to adopt l i f e l o n g e d ucation as a philosophy i f they can be convinced that the c u r r e n t s t a t e of CNE i s inadequate. T h i s w i l l be the f i r s t step to c r e a t i n g a s i t u a t i o n i n which i t i s f e a s i b l e to think that l i f e l o n g education can be adopted. An important p r e r e q u i s i t e to implementation i s c o o p e r a t i o n among i n s t i t u t i o n s . I n s t i t u t i o n s w i l l have to demonstrate 1 02 decreased t e r r i t o r i a l i t y . An i n t e r e s t i n a common goal — to promote the knowledge l e v e l of p r o f e s s i o n a l s and thereby improve q u a l i t y of s e r v i c e - must be f o s t e r e d . Cooperation w i l l have to e x i s t between s i m i l a r and d i f f e r e n t types of i n s t i t u t i o n s . For example, nu r s i n g s e r v i c e and n u r s i n g education i n s t i t u t i o n s w i l l have to plan mutually determined g o a l s . S e r v i c e i n s t i t u t i o n s w i l l have to f o r e s t a l l some of the demand fo r immediate r e a c t i o n to s i t u a t i o n s i n which education would be of he l p . These i n s t i t u t i o n s must be i n v o l v e d in longer term planning and a n t i c i p a t i o n of needs. Education i n s t i t u t i o n s w i l l have to be prepared to work c l o s e l y with s e r v i c e i n s t i t u t i o n s i n the p l a n n i n g p r o c e s s . C o n s u l t a t i o n between the two types of i n s t i t u t i o n s must take p l a c e . The p r o b a b i l i t y of such c o o p e r a t i o n i n c r e a s e s as p u r s e - s t r i n g s are ti g h t e n e d and i n s t i t u t i o n s are f o r c e d i n t o s i t u a t i o n s i n which they must use c r e a t i v e means to be of s e r v i c e . The f e a s i b i l i t y of the a p p l i c a t i o n of l i f e l o n g education w i l l a l s o depend on the a b i l i t y of d i f f e r e n t groups of h e a l t h p r o f e s s i o n a l s to c o l l a b o r a t e . Vested i n t e r e s t s (and the a b i l i t y to give them up) would be important. Changes i n s o c i e t y , such as those induced by consumer r i g h t s and sexual e q u a l i t y movements, incr e a s e the l i k e l i h o o d that c o l l a b o r a t i o n between p r o f e s s i o n a l groups w i l l occur. A f u r t h e r p r e r e q u i s i t e to implementation i s the need to adopt a more g l o b a l and long-term p e r s p e c t i v e on p l a n n i n g . E d u c a t i o n a l i n s t i t u t i o n s w i l l have to be allowed to spend money 103 on areas where r e s u l t s may not be h i g h l y or immediately v i s i b l e . For example, i n s t i t u t i o n s might h i r e n u r s i n g education planning a d v i s o r s to h e l p nurses decide on c a r e e r d i r e c t i o n s . A l s o , funds would need to be d i r e c t e d to d e v e l o p i n g i n d i v i d u a l s as l e a r n e r s . Since l i f e l o n g education p l a c e s emphasis on and t r u s t i n the l e a r n e r ' s c a p a b i l i t i e s , t h i s would be p a r t i c u l a r l y important. Along the same l i n e s , funding, e d u c a t i o n a l , and s e r v i c e agencies must be i n v o l v e d i n long-range and a n t i c i p a t o r y p l a n n i n g , t a k i n g i n t o account changes in the h e a l t h care system as a whole and i d e n t i f y i n g d i r e c t i o n s c o n s i s t e n t with the o v e r a l l goals of l i f e l o n g e d u c a t i o n . Although the emphasis i n CNE based on l i f e l o n g education w i l l always be on developing the i n d i v i d u a l , there w i l l be a need for a master p l a n to organize t h i s on a l a r g e s c a l e . In order f o r l i f e l o n g education to be s u c c e s s f u l l y implemented, there w i l l a l s o have to be changes i n the work s e t t i n g so that the ideas are r e i n f o r c e d and supported i n the workplace. Examples of such changes c o u l d i n c l u d e more acknowledgement of l e a r n i n g that has taken p l a c e and encouragement of s h a r i n g of knowledge between nurses themselves. T h i s kind of a c t i v i t y would be p a r t i c u l a r l y important i n c l i n i c a l s i t u a t i o n s . In c l i n i c a l s i t u a t i o n s , an a t t i t u d e of i n q u i r y c o u l d be s t i m u l a t e d by c l i n i c a l i n s t r u c t o r s d e v e l o p i n g t h e i r e x p e r t i s e i n asking l e a d i n g and thought-provoking q u e s t i o n s of nurses, thus s t i m u l a t i n g them to t h i n k f o r themselves. T h i s s o r t of outcome 104 can o n l y occur as educators change t h e i r conceptions of the "teacher" r o l e . Educators w i l l be resource persons f o r l e a r n e r s but not the only resource. They w i l l be supporters of the l e a r n i n g p r o c e s s . T h i s w i l l r e q u i r e a dramatic change i n approach on the p a r t of some educators. Perhaps the most c r u c i a l p r e r e q u i s i t e to implementation i s r e l a t e d to development of m o t i v a t i o n f o r l e a r n i n g . As has been emphasized p r e v i o u s l y , the l e a r n e r i s a c e n t r a l component in the scheme of l i f e l o n g e d u c a t i o n . Without l e a r n e r p a r t i c i p a t i o n , l i f e l o n g education cannot be implemented. Learner m o t i v a t i o n can stem from innate c u r i o s i t y and i n t e r e s t but i s more l i k e l y to be s t i m u l a t e d as l e a r n e r s see t a n g i b l e and i n t a n g i b l e e x t e r n a l b e n e f i t s and rewards from involvement i n l e a r n i n g . F i n a l l y , such changes to CNE as would occur under a philosophy of l i f e l o n g education would be most u s e f u l and u l t i m a t e l y s u c c e s s f u l only i n the context of s i m i l a r changes to the b a s i c n u r s i n g education system. T h i s has been e l a b o r a t e d upon p r e v i o u s l y . P r o v i d i n g these types of changes occur, the a p p l i c a t i o n of l i f e l o n g education to CNE i s a f e a s i b l e p r o p o s a l . I t may be that the changes w i l l have to be i n t r o d u c e d over a number of years i n an attempt to f o r e s t a l l r e s i s t a n c e . I t may be that the assumption that these•changes can and w i l l take p l a c e , i s only an assumption. 105 E v a l u a t i o n Another p a r t of t e s t i n g the u t i l i t y of l i f e l o n g education as a framework f o r CNE w i l l be an e v a l u a t i o n of the a p p l i c a t i o n i t s e l f . Two major que s t i o n s w i l l have to be answered r e l a t e d to those areas. The f i r s t area f o r q u e s t i o n i n g r e l a t e s to whether or not CNE was a l t e r e d i n the d i r e c t i o n s t h a t the context of l i f e l o n g education would r e q u i r e . Questions stemming from t h a t w i l l d e a l with whether or not g o a l s , content, means, and a d m i n i s t r a t i o n used are c o n s i s t e n t with l i f e l o n g e d u c a t i o n . The second area of q u e s t i o n i n g w i l l r e l a t e to the goals and purpose of using l i f e l o n g education as a framework. The goal of using l i f e l o n g education i n a p p l i c a t i o n to CNE i s to meet the c o n t i n u i n g l e a r n i n g needs of nurses so that q u a l i t y of s e r v i c e can be maintained and improved. Whether or not t h i s outcome has occu r r e d w i l l have to be t e s t e d . T h i s w i l l be d i f f i c u l t , s i n c e e v a l u a t i o n techniques f o r CNE are not w e l l developed. What w i l l be sought a f t e r i s a d i f f e r e n t i a l e v a l u a t i o n i n an attempt to i d e n t i f y whether CNE based on l i f e l o n g education i s any more u s e f u l than any other type of approach. Given these o v e r a l l q u e s t i o n s f o r e v a l u a t i o n , some s p e c i f i c areas to be explored can be presented. Bennett's (1975) h i e r a r c h y of e v a l u a t i o n evidence p r o v i d e s a framework f o r s p e c i f i c e x p l o r a t i o n s . 106 Inputs F a c i l i t i e s 1) Are f a c i l i t i e s being used to t h e i r maximum p o t e n t i a l ? 2) Do l e a r n e r s have access to f a c i l i t i e s at a v a r i e t y of times? 3) Are a v a r i e t y of d i f f e r e n t f a c i l i t i e s being u t i l i z e d ? 4) Are work s e t t i n g s being used f o r c o n t i n u i n g education a c t i v i t i e s ? I n s t r u c t o r s 1) Are educators t a k i n g a p o s i t i v e view of l e a r n e r s ' c a p a b i l i t i e s ? 2) Are educators spending more time h e l p i n g l e a r n e r s f i n d resources? 3) Are the c o u n s e l l i n g s k i l l s of educators being developed and u t i l i z e d ? I n d i v i d u a l s 1) Are nurses spending time p l a n n i n g t h e i r own CE? Costs 1) Does the monetary expenditure r e q u i r e d outweigh any p o s s i b l e present or f u t u r e b e n e f i t of l i f e l o n g education? 2) Is there an o v e r a l l p l a n f o r CNE? 3) Do the a d m i n i s t r a t i v e d i f f i c u l t i e s i n v o l v e d i n o r g a n i z i n g l i f e l o n g education outweigh any p o s s i b l e present or f u t u r e b e n e f i t s ? A c t i v i t i e s 1) Are the a d m i n i s t r a t i v e tasks i n v o l v e d i n o r g a n i z i n g CNE under a philosophy of l i f e l o n g education overwhelming? 2) Do the g o a l s and content of CNE offering's r e f l e c t a p h i l o s o p h y of l i f e l o n g education? 3) In p r e s e n t i n g content, i s there an emphasis on proble m - s o l v i n g and process? 4) Do s t a t e d o b j e c t i v e s of formal CNE o f f e r i n g s r e f l e c t an emphasis on process? People Involvement 1) Do educators and a d m i n i s t r a t o r s acknowledge the importance of problem-solving? 1 07 2) Do educators and a d m i n i s t r a t o r s support the implementation of l i f e l o n g education? 3) Compared to c u r r e n t CNE a c t i v i t i e s , what are the e f f e c t s of implementation of l i f e l o n g education on p a r t i c i p a t i o n i n CNE a c t i v i t i e s ? 4) Is there i n c r e a s e d p a r t i c i p a t i o n i n formal CNE a c t i v i t i e s ? 5) Are d i f f e r e n t people i n v o l v e d i n CNE a c t i v i t i e s ? (Are d i f f e r e n t p o p u l a t i o n s of nurses being reached?) 6) Is there i n c r e a s e d p a r t i c i p a t i o n i n nonformal a c t i v i t i e s ? eg. use of l i b r a r i e s , s u b s c r i p t i o n to j o u r n a l s , study-groups? 7) Is there ease of access to e d u c a t i o n a l o p p o r t u n i t i e s f o r i n d i v i d u a l s i n remote areas? Reactions 1) Is there i n c r e a s e d s a t i s f a c t i o n with formal CE a c t i v i t i e s ? 2) Are i n d i v i d u a l nurses demonstrating more enthusiasm about seeking l e a r n i n g o p p o r t u n i t i e s ? 3) Do nurses acknowledge the c o n t r i b u t i o n that c o l l e a g u e s can make to t h e i r own CNE? Lear n i n g Change 1) Do nurses e x h i b i t more n u r s i n g knowledge? 2) Do nurses e x h i b i t more knowledge r e l a t e d to the p h y s i c a l and s o c i a l s c i e n c e s which border on nursing? 3) Are nurses more knowledgeable about the world i n which they l i v e ? P r a c t i c e Change 1) Can nurses demonstrate g r e a t e r a b i l i t y to problem- so l v e i n c l i n i c a l s i t u a t i o n s ? eg. Are they i d e n t i f y i n g problems more a c c u r a t e l y ? Are they using a wider range of resources i n seeking answers to q u e s t i o n s ? 2) Are nurses more t o l e r a n t of change i n the workplace? 3) Are nurses more able t o adapt to change? End R e s u l t s 1) 2) Is there an i n c r e a s e d p e r c e p t i o n of nurses as knowledgeable p r o f e s s i o n a l s ? Is there a gre a t e r i d e n t i t y with the p r o f e s s i o n 1 08 among nurses? 3) Is the quality of health care enhanced? 4) Are more nurses staying in nursing? 5) Do more nurses have i d e n t i f i a b l e career goals? Conclusion Lifelong education, as a choice of educational philosophy on which to base CNE, has much to o f f e r . Careful examination proves i t to be an i n t e r n a l l y consistent philosophy, the c h a r a c t e r i s t i c s of which, y i e l d p r i n c i p l e s which can be u t i l i z e d to influence actions in several areas. Lifelong education could very well be an appropriate organizing p r i n c i p l e for CNE. The question of whether or not l i f e l o n g education can be applied to CNE can be answered in the affirmative. Such an application i s a mechanical task of defining and delineating the p r i n c i p l e s of l i f e l o n g education and applying them to the various aspects of the process of continuing education. This study was i n i t i a t e d in the hope that, in the f i n a l analysis, i t would be possible to make such an application. Having answered that question, another a r i s e s . Whether or not l i f e l o n g education should be applied to CNE i s a q u a l i t a t i v e , value-laden question. The answer i s dependent on the value c r i t e r i a being used to measure outcomes. Value c r i t e r i a used may be economic in nature. There are at least three possible approaches from an economic perspective and, for each, the answer to the "should" question w i l l be d i f f e r e n t . Economic value c r i t e r i a which involve consideration 109 of only short-term c o s t s to the education system may r e s u l t i n the c o n c l u s i o n that l i f e l o n g education i s not an a p p r o p r i a t e approach. A l t e r n a t i v e l y , economic value c r i t e r i a may take i n t o account c o s t to the e d u c a t i o n a l system on a more long-term b a s i s . F i n a l l y , and these may be the c r i t e r i a which are most l i k e l y to r e s u l t i n an a f f i r m a t i v e answer regarding the p o s s i b l e a p p l i c a t i o n of l i f e l o n g education, economic c r i t e r i a used in making the judgement may take i n t o account c o s t and b e n e f i t s to the education system as w e l l as to the h e a l t h care system as a whole. A l t e r n a t i v e l y , value c r i t e r i a used may be humanistic. Questions that would a r i s e from t h i s approach to c o n s i d e r i n g the u s e f u l n e s s of l i f e l o n g education to CNE i n c l u d e "Are i n d i v i d u a l s d eveloping as people?" and "Are those i n d i v i d u a l s b e t t e r a b l e to serve o t h e r s ? " and "Are those i n d i v i d u a l s making a g r e a t e r c o n t r i b u t i o n to the p r o f e s s i o n as a whole?" Value c r i t e r i a used to make the judgement as to whether l i f e l o n g education f o r CNE i s an a p p r o p r i a t e philosophy may be p u r e l y pragmatic and s e r v i c e - o r i e n t e d . Questions that would have to be asked i n e v a l u a t i n g l i f e l o n g education from t h i s p e r s p e c t i v e would be "What e f f e c t i s CNE under a philosophy of l i f e l o n g e ducation having on the q u a l i t y of s e r v i c e d e l i v e r e d by nurses?" and "Is p a t i e n t care improving?" There are s e v e r a l p o s s i b l e approaches to judging the a p p r o p r i a t e n e s s of l i f e l o n g education as a philosophy f o r CNE. No matter which approach i s f i n a l l y decided upon, i t s use as an 110 e d u c a t i o n a l philosophy has two advantages which are p a r t i c u l a r l y important to CNE and the n u r s i n g p r o f e s s i o n as a whole. One advantage i s the emphasis on processes r a t h e r than a s p e c i f i e d content. Resultant l e a r n i n g w i l l be u s e f u l i n a v a r i e t y of s i t u a t i o n s . In l i g h t of the c u r r e n t s p e c i a l i z a t i o n of n u r s i n g p r a c t i c e , t h i s would be p a r t i c u l a r l y h e l p f u l . Secondly, l i f e l o n g education emphasizes the development of the i n d i v i d u a l as a person. I t i s reasonable to assume that an i n d i v i d u a l who has reached a higher l e v e l of p e r s o n a l development than would o r d i n a r i l y be the case w i l l be b e t t e r prepared to make a c o n t r i b u t i o n to the p r o f e s s i o n of which they are a p a r t . The n u r s i n g p r o f e s s i o n can only b e n e f i t from having such i n d i v i d u a l s i n i t s ranks. The f i n a l a n a l y s i s of CNE may r e s u l t i n the c o n c l u s i o n that n u r s i n g educators have few a l t e r n a t i v e s but to grapple with the p r i n c i p l e s of l i f e l o n g education and begin to apply them. The c u r r e n t s i t u a t i o n i n CNE c l e a r l y r e q u i r e s a c t i o n on the p a r t of educators. L i f e l o n g education can serve as a b l u e p r i n t f o r t h i s . I t i s c o n c e i v a b l e that i t c o u l d a l s o be a p p l i e d as a framework in other p r o f e s s i o n s . 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