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Lifelong education and its relevance to nursing
Nurse Education Today (2005) 25, 655–660
Nurse Education Today intl.elsevierhealth.com/journals/nedt
Lifelong education and its relevance to nursing
q
Peter Jarvis University of Surrey, Education of Adults, Surrey, United Kingdom
Summary This paper explores the distinction between education and learning in relation to the whole of the professional lifespan. After an initial conceptual discussion, there are two main sections: the first looks at lifelong learning and learners in relation to nursing while the second focuses upon lifelong education. It is argued that the prevalence of lifelong learning is unknown amongst nurses since little research exists on the subject, although it is frequently regarded as an essential component of professionalism. In order to create lifelong learners it is suggested that changes are necessary in nurse education and managerial practice. If lifelong learning were actually fostered in nursing then continuing education might be less necessary. However, continuing education is expanding and some principles for its implementation are considered in the second section. c 2005 Published by Elsevier Ltd.
Introduction The occupation of nursing is undergoing a process of professionalisation, a process that is evident in a number of ways such as: the. current emphasis being placed upon research, in order to expand nursing knowledge; the introduction of the nursing process to demarcate the areas which belong specifically to the nurse’s field of care; the fact that nursing is considering locating the preparation of its new recruits within educational institutions, especially higher educational ones; the decline in the significance of the term ‘training’ and the
q
First published in Nurse Education Today – 1987, vol. 7, 49–
55.
0260-6917/$ - see front matter c 2005 Published by Elsevier Ltd. doi:10.1016/j.nedt.2005.09.005
increasing importance being placed upon the idea of ‘education’. The last two of these examples both point to the idea of education and the educational institution. But in the same way that nursing is responding to the pressures of society and undergoing change, so is education. Education has become a very complex institution and what was frequently regarded as the province of education, i.e. the preparation of children for adulthood through schooling, is now recognised to be no more than a historical accident in the evolution of the concept of education itself. The complexity is such that Peters (1966, p. 23) claimed that education is too complex a phenomenon to be defined. However, he then proceeded to specify criteria which he believes constitute the basis of education, thereby indicating that he actually
656 has an operational definition of education. The purpose of this point is merely to illustrate the complexity of the educational institution which nursing is beginning to embrace. One of the most recent aspects of education that has come to the fore is the concept of lifelong education: a concept that is itself open to considerable debate. Lawson (1982) asked whether the term actually referred to a concept or a policy, and the question he raised may he seen to be relevant when some of the definitions of the term given by its proponents are examined. Lengrand (1976, p. 20) regards it as ‘the unity and the totality of the educational process’, but there is no society in the world which provides either a unified or a comprehensive educational system from the cradle to the grave. Indeed, such a system may not be very desirable because it might ‘imprison learners in a global classroom’ (Illich and Verne, 1976). However, this definition may only reflect Lengrand’s ideal of the policy of total, lifespan provision of education. In contrast, Dave (1976, p. 34) claims that it ‘is a process of accomplishing personal, social and professional development throughout the lifespan of individuals in order to enhance the quality of life of both individuals and their collectives’. But this rather idealistic, functional definition of lifelong education does nothing to distinguish education from learning. Hence, Lawson’s comments do appear apposite! More recently, however, Knapper and Cropley (1985, p. 17) have suggested that the term may be no more than ‘a unifying principle linking existing trends and tendencies’ in education. They go on to suggest that lifelong education ‘embraces a set of’ guidelines for developing educational practice. in order to foster learning throughout life’. While education may not embody a set of guidelines in the way that they suggest, it is certainly more satisfactory in the way that it distinguishes between education and learning. The authors thereafter develop their idea of learning but, unfortunately, they spend less time on the concept of education. A definition of education has been suggested elsewhere (Jarvis, 1983, p. 5) and that is adopted here and modified to relate specifically to the concept of lifelong education, which is ‘any planned series of incidents at any time in the lifespan, having a humanistic basis, directed towards the participants learning and understanding’. Since lifelong education may be any manifestation of education, it might be argued that the term ‘lifelong’ is superfluous. Indeed, it would be, were it not for the fact that for many people there is a conceptual confusion of education with initial education, so that it remains essential to retain the
P. Jarvis prefix to clarify the concept. Since lifelong education may be any planned series of incidents, then it is best employed as an ‘umbrella’ term incorporating within it a variety of ‘trends and tendencies’ in education, two of which constitute the focus of this paper. These two revolve around the distinction drawn earlier between the provision of learning opportunities throughout the lifespan (lifelong education) and the lifelong learner. This distinction is quite fundamental to the following discussion and this paper focuses first upon the lifelong learner and nursing and this is followed by an analysis of lifelong education and nursing.
Lifelong learning and nursing Knapper and Cropley (1985) make the distinction between the type of learning that occurs spontaneously and the type that occurs deliberately in lifetime learning. A similar distinction has been drawn elsewhere (Jarvis, 1986) between proactive and reactive learning. This distinction is important because it highlights two totally different approaches to learning. Little research has been undertaken into learning in the workplace, with the exception of Schon’s (1983) important study. In this study Schon shows that some practitioners, perhaps many, do reflect upon their practice and that their practice is actually reflection-inaction. Thus their practice generates new knowledge about practice rather than being merely the practical application of theory. The implications of this for the traditional view of knowledge are quite profound but they are even more significant in the understanding of learning and teaching, for here it is maintained that much, but by no means all, theoretical knowledge is generated from the practical situation and, therefore, the teacher’s role may include that of assisting practitioners to crystallise the ideas they have generated in practice. This may best take place in the practice setting and might well occur at any time during the career of the practitioner. The significance of this as nursing becomes more professional is that it may be in danger of embracing a so-called theory of scientific knowledge that can be taught in the classroom and applied in practice which is actually unrelated to the actual process of reactive lifelong learning. In contrast, considerable research now exists about the pro-active lifelong learner, some of this is anecdotal but much has been conducted under rigorous research conditions. Ronald Gross (1977, p. 24), for instance, recounts a number of biographical narratives about lifelong learners: one
Lifelong education and its relevance to nursing is Cornelius Hirschberg, who learned that a true liberal lifelong education could be achieved amidst a busy life since he ‘read on subways, trains and buses for forty years’, regarding life as his university. He (Gross, 1977, p. 27) claimed that: ‘. . .your education is the only thing that nothing can take from you in this life. You can lose your money, your wife, your children, your friends, your pride, your honour, and your life, but while you live you can’t lose your culture, such as it is.’ But what has this to do with nursing? Simply that – much of the research into self-directed learning in adulthood reveals that many of the learning projects are vocationally orientated (Tough, 1979, pp. 33–35). Tough gives an example of a learning project undertaken by a nurse educator in his own very small sample. ‘A nurse educator was a teacher in planning a new nursing curriculum. In order to plan an effective program, she learned about the characteristics of nursing duties and about the curriculum and organization of instruction in other schools of nursing.’ In order to equip herself to perform her role more effectively, and without anybody instructing her, she undertook her own learning project. Like many self-directed learners she was faced with something for which she required further information and so she went and learned it. This is not unusual. But that is the whole point, Tough’s research demonstrated that self-directed learning throughout the lifespan is not a rare phenomenon. But there is little research about self-directed learners in nursing practice, so that little reference is made to them. Yet it is quite possible that there are many in practice, even though they remain unrecognised and the resources from which they learn unacknowledged. However, it is possible to draw a number of inferences about them from a rather old but classic piece of research. In Rogers’ (1962) study of the diffusion of innovation among medical practitioners, it was shown that some 160%) of the sample were either innovators or early adapters of new innovation while approximately the same proportion were laggards who were reticent to introduce change. It was also noted that the former had a cosmopolitan outlook within the profession, while the latter had a local orientation; that the former had a different mental approach to their practice and that they endeavoured to keep up to date with recent developments while the latter failed to do so. Since this research has been replicated, it is highly likely that a similar picture might be discovered in nursing. Rogers’ work points to the significance of the self-directed learner,
657 who is a rather neglected species amid the present zest for continued professional education. Yet the self-directed, lifelong learners may be keeping abreast of changes that are occurring in nursing for no other reason than a commitment to their work, since they embody some of the ideals of professionalism just by virtue of this quest to keep up to date. That self-directed learners have become a neglected species in the current euphoria about continuing education, may be because some vocational educators are unaware of much of the research in adult education. Yet there are almost certainly many among the ranks of nurses, going about their task in a similar manner to those investigated by Tough, asking their friends and acquaintances, consulting books, journals and attending courses and conferences, etc. Tough (1979, p. 101) records how a ‘man preparing himself for his job as a national education director. . .obtained definite help from 39 books and pamphlets (through 5 libraries), 2 advertisements, 8 helpers, and 1 guided tour. . .a total of 55 particular resources’. Hence the significance of the more recent development of resource centres, that enable selfdirected learners to pursue their own concerns and learning needs at their own pace and in their own way. Not enough is known about these lifelong learners in nursing; not enough is known about the procedures they employ nor the people whom they consult; not enough is known about the manner in which they assist their colleagues to understand new developments in the field; not enough is known about their own innovations in practice. (At the present time, however, at the University of Surrey, a piece of post-graduate research is in the process of examining some of these aspects in another paramedical profession, with considerably important and interesting ideas emerging.) These points should not only have implications for research policy but they should also have implications for continuing education policy, a point to which further reference is made below. However, the existence of lifelong learners has considerable implications for nurse educators in terms of selection, skills and attitudes. Houle (1980, p. 82) claims that: ‘If continuing education is crucial to the profession and therefore to the people who are preparing to enter it, some attention should presumably be given in the admissions process to the selection of individuals who have already given evidence that they have a thirst for knowledge and that they are likely to retain that thirst throughout their careers.’
658 But even after selection it may be necessary to help the self-directed learners be more effective in their quest for knowledge because they may still need to acquire study skills. It is often assumed that these skills are innate or that they have been taught during initial education. Unfortunately the former is self-evidently not the case and the latter is not as frequent as it might be. Hence the teaching of study skills, so that recruits to the profession may acquire the skills to become effective lifelong learners, should be an integral part of professional preparation. Certainly it should constitute a major part of every induction programme, so that learners are given the opportunity to become more effective in their learning. Curriculum planners have sometimes claimed, however, that there is just not time to include this considering everything else that the students have to learn. But this is the point - if learners become both self-directed and effective they will be able to acquire that knowledge more efficiently and by themselves, so that there will be less need to overload the timetable. Throughout initial preparation learners should be given the opportunity to develop into selfdirected learners, rather than to become teacher dependent, so that they may acquire a problem-solving attitude that would equip them better for their career. Houle (1980, p. 84) claims that: ‘. . .it is probable that one way in which a basic professional program might enhance later competence would be by ensuring the fact that, during the years spent in the school’s sub-culture, the student’s personal commitment to lifelong learning is firmly established both by curricular changes and by efforts to alter the customs and behaviour patterns of the students.’ Too much emphasis upon attitude change might lead to the charge of indoctrination but students should be made aware of the significance of self-directed learning to their practice and consideration could be given to this with the inclusion in the curriculum of the study of the ethical implications of professionalism. Hence, one of the major roles of the school of nursing is to prepare recruits to become lifelong learners, and it must be recognised that: ‘Lifelong learning entails a cradle to the grave involvement of the individual with his or her learning and working environment. It implies a growth of all skills and a cumulative interweaving of knowledge and experience. This learning is not packaged and does not cease when the individual completes his/ her legal school requirements.’ (Benedict et al., 1984. vol 1, p. 25)
P. Jarvis Nurse educators might see changes in their own role, for indeed this is the case; they should no longer be teachers providing packaged knowledge to enable learners to pass their qualifying examinations but educators preparing professionals for a lifetime of service. Nursing needs also to recognise lifelong learners and managers must know how best to respond to them. Houle (1980, p. 164) makes the suggestion that managers and administrators need ‘to recruit pace setters and innovators and give them the freedom to work and learn effectively’. Without such freedom there would almost certainly be a decrease in job satisfaction, morale and effectiveness within the organisation.
Lifelong education and nursing The first part of this paper concentrated upon lifelong learning but it was recognised from the outset that learning and education are conceptually different. It was also suggested that lifelong education refers to the provision of learning opportunities throughout the lifespan rather than being a unified system. However, under that definition a variety of different concepts and approaches to education may be gathered including recurrent education, community education, continuing education, etc. Continuing education is itself a wide term, although in common usage it has tended to be restricted to continuing professional education, it is upon this term that the paper now focuses. It might be claimed that if everyone were a lifelong learner then there would be no need for continuing professional education. In part this might be true but many lifelong learners actually enrol in courses when it suits their and meets their learning requirements. The provision of continuing education is significant and increasing at a very rapid rate. In the USA, Doyle (1983, p. 30) claims that over the past 12 years there has been a considerable shift in the emphasis that commercial and industrial corporations have given to training and development, with some 74%, of Texas corporations surveyed claiming that they had increased their training budget over the previous year. Another survey conducted among 125 training directors among Fortune 500 companies and fast-growing small corporations revealed that 79% expect that their training budget will grow over the next five years. Doyle (1983, p. 29) estimated that in one recent year $36 billion was spent by industrial and commercial organisations on training. In contrast, Woodhall
Lifelong education and its relevance to nursing (1980, p. 11) estimated that in 1970 about £l200 million was spent in Britain on the education and training of adults, a lot less per person than in the USA. Even so, it is an expensive enterprise. But perhaps Shepherd (Titmus, 1985, p. 83), manager of education, training and personnel services at Ford Motor Company, has an eloquent reply to that: ‘If you think training is expensive, try ignorance.’ If that is true for the motor car industry, how much more should it be so for a caring profession? Continuing education courses should be provided, so that all nurses whether self-directed learner or laggards have opportunity either to develop their own interests or to be kept abreast with latest developments in nursing. Note that this provision is in itself a complex task because different nurses will have different orientations to learning in the workplace. Hence, continuing education provision needs to be placed in the hands of a highly skilled professional, rather than an educationally unqualified nurse, in order that it should result in effective educational provision being made for adults. This requires that a programme of continuing education should be systematically planned and developed in which adult learning principles and adult education procedures should be applied. In early continuing education, much of the provision was known to have failed to improve the quality of patient care because the courses did not contribute to change in the behaviour of health care professionals. This was, in turn, (Miller, 1967 cited by Walsh, 1984, p. 136), attributed to the use of a content model of education rather than a process model. Hence, two factors may be seen as significant here: that all teaching and learning should be conducted according to the best researched principles of the education of adults and that the programmes should be systematically produced and, always, in direct response to a practice-related problem. Naturally these two points are inter-related because they are but two facets of the emerging field of the study of the education of adults. It is impossible within the space of this brief paper to expound upon these two principles at great length and the following points contain no more than a brief summary of some of the factors that should always be considered within continuing education provision. Adults learn most effectively when: 1. They feel the need to learn. 2. An emotional and physical environment stimulates and supports the learning devised.
659 3. They see that the goals of a learning experience are their own. 4. They have shared the responsibility for planning and operating that learning experience. 5. They participate actively in the learning process. 6. They draw upon, and relate their learning to, their own experience. 7. They share with the educator the responsibility for their own progress (Benedict et al., 1984, pp. 22–24). But at the same time, continuing educators need to plan with care the courses that they offer and these require a systematic planning process to: (a) Identify problems that focus upon health care. (b) Analyse needs/problems to determine if there is a potential educational solution. (c) Identify potential facilitators of, or barriers to, the learning process. (d) Select educational needs based on a priority system. (e) State educational goals and objectives for the selected needs. (f) Select or design a learning experience to meet the goals and objectives. (g) Implement the learning experience. (h) Evaluate the extent to which learners achieved objectives. (i) Determine the extent to which the original problem has been reduced. (j) Identify any additional task necessary to meet the need based upon the evaluation of data (Walsh, 1984, pp. 140–145). Obviously these points only indicate the complexity and the sophistication necessary to make continuing professional education relevant to and effective in nursing. Continuing education can be no mere afterthought to professional preparation, it is an essential part of the life and needs of the nurse educator. Society is changing rapidly. Nursing practice is also changing rapidly. No practitioner prepared for nursing now can expect to be performing precisely the same job in ten years time. The more technical nursing becomes the more rapidly it will change and the more important both lifelong learners and continuing professional education will become.
Conclusion This paper opened with a discussion of lifelong education, it was shown to be a difficult concept to define: indeed, it was even questioned whether it
660 was a concept at all or merely a policy. Certainly it should be a policy in nurse education but it is also a concept – a unifying principle linking existing trends in education. Two of these trends have been discussed here, other developments in education might have just as legitimately been included, but it was argued that these two are the most relevant to nursing. It has also been recognised that education, and by implication, nurse education is also changing. Hence, this affects the nurse educators. Lifelong education is as relevant to their practice as it is to nursing. Nurse educators need to keep up to date both with the changes in nursing and the developments in the education of adults. Like their learners, they need also to be lifelong learners and to undertake continuing professional education, so that they can be highly professional educators of adults. It was pointed out at the outset that in the process of professionalisation, nursing is considering locating its initial preparation in higher education. Traditionally in the UK, higher education has been didactic, subject-centred and orientated towards young adults. But the clientele of higher education is also changing and so its approach to education must respond to this change in the direction that has been advocated in this paper. Therefore, highly professional educators of adults in nursing may well bring to higher education skills and understanding that higher education needs, since it may be concluded that the concept of lifelong education is relevant not only to nursing but to all forms of occupational practice in this rapidly changing society. (This paper was delivered as the Annual Lecture at the Radcliffe School of Nursing, Oxford, December 1985.)
P. Jarvis
References Benedict, D., Collier, F., Masar, B., Wilkinson, L., 1984. Learning a living in Canada (vol 1). Report to the Minister of Employment and Immigration, Canada. Dave, R.H. (Ed.), 1976. Foundations of Lifelong Education. Pergamon Press, Oxford. Doyle, M., 1983. Thoughts on developing America’s human resources for the future. In: Smith, W.L., (Eds.), Collaboration in Lifelong Learning. Gross, R., 1977. The Lifelong Learner. Touchstone Books, New York. Houle, C.O., 1980. Continuing Learning in the Professions. Jossey Bass, San Francisco. Illich, I., Verne, E., 1976. Imprisoned in a Global Classroom. Writers and Readers Publishing Co., London. Jarvis, P., 1983. Professional Education. Groom Helm, London. Jarvis, P., 1986. A Sociology of Lifelong Education and Lifelong Learning. Department of Adult Education, University of Georgia, Georgia. Knapper, C.K., Cropley, A.J., 1985. Lifelong Learning and Higher Education. Groom Helm, London. Lawson, K., 1982. Lifelong Education: concept or policy? International Journal of Lifelong Education 1 (2), 97–108. Lengrand, P., 1976. An Introduction to Lifelong Education. Groom Helm, London. Peters, R.S., 1966. Ethics and Education. George Allen and Unwin, London. Rogers, E.H., 1962. Diffusion of Innovations. The Free Press, Glencoe. Schon, D.A., 1983. The Reflective Practitioner. Basic Books Inc., New York. Titmus, C. (Ed.), 1985. Widening the field: Continuing education in higher education. SRNE and NFER-Nelson, University of Surrey, Surrey. Tough, A. (Ed.), 1979. The Adult’s Learning Projects. second ed. Ontario Institute for Studies in Education. Walsh, P.L., 1984. Planning and developing programs systematically. In: Green, et al. (Ed.), Continuing Education for the Health Professions. Woodhall, M., 1980. The scope and costs of the education and training of adults in Britain. Leicester Advisory Council for Adult and Continuing Education.
Nurse Education Today intl.elsevierhealth.com/journals/nedt
Lifelong education and its relevance to nursing
q
Peter Jarvis University of Surrey, Education of Adults, Surrey, United Kingdom
Summary This paper explores the distinction between education and learning in relation to the whole of the professional lifespan. After an initial conceptual discussion, there are two main sections: the first looks at lifelong learning and learners in relation to nursing while the second focuses upon lifelong education. It is argued that the prevalence of lifelong learning is unknown amongst nurses since little research exists on the subject, although it is frequently regarded as an essential component of professionalism. In order to create lifelong learners it is suggested that changes are necessary in nurse education and managerial practice. If lifelong learning were actually fostered in nursing then continuing education might be less necessary. However, continuing education is expanding and some principles for its implementation are considered in the second section. c 2005 Published by Elsevier Ltd.
Introduction The occupation of nursing is undergoing a process of professionalisation, a process that is evident in a number of ways such as: the. current emphasis being placed upon research, in order to expand nursing knowledge; the introduction of the nursing process to demarcate the areas which belong specifically to the nurse’s field of care; the fact that nursing is considering locating the preparation of its new recruits within educational institutions, especially higher educational ones; the decline in the significance of the term ‘training’ and the
q
First published in Nurse Education Today – 1987, vol. 7, 49–
55.
0260-6917/$ - see front matter c 2005 Published by Elsevier Ltd. doi:10.1016/j.nedt.2005.09.005
increasing importance being placed upon the idea of ‘education’. The last two of these examples both point to the idea of education and the educational institution. But in the same way that nursing is responding to the pressures of society and undergoing change, so is education. Education has become a very complex institution and what was frequently regarded as the province of education, i.e. the preparation of children for adulthood through schooling, is now recognised to be no more than a historical accident in the evolution of the concept of education itself. The complexity is such that Peters (1966, p. 23) claimed that education is too complex a phenomenon to be defined. However, he then proceeded to specify criteria which he believes constitute the basis of education, thereby indicating that he actually
656 has an operational definition of education. The purpose of this point is merely to illustrate the complexity of the educational institution which nursing is beginning to embrace. One of the most recent aspects of education that has come to the fore is the concept of lifelong education: a concept that is itself open to considerable debate. Lawson (1982) asked whether the term actually referred to a concept or a policy, and the question he raised may he seen to be relevant when some of the definitions of the term given by its proponents are examined. Lengrand (1976, p. 20) regards it as ‘the unity and the totality of the educational process’, but there is no society in the world which provides either a unified or a comprehensive educational system from the cradle to the grave. Indeed, such a system may not be very desirable because it might ‘imprison learners in a global classroom’ (Illich and Verne, 1976). However, this definition may only reflect Lengrand’s ideal of the policy of total, lifespan provision of education. In contrast, Dave (1976, p. 34) claims that it ‘is a process of accomplishing personal, social and professional development throughout the lifespan of individuals in order to enhance the quality of life of both individuals and their collectives’. But this rather idealistic, functional definition of lifelong education does nothing to distinguish education from learning. Hence, Lawson’s comments do appear apposite! More recently, however, Knapper and Cropley (1985, p. 17) have suggested that the term may be no more than ‘a unifying principle linking existing trends and tendencies’ in education. They go on to suggest that lifelong education ‘embraces a set of’ guidelines for developing educational practice. in order to foster learning throughout life’. While education may not embody a set of guidelines in the way that they suggest, it is certainly more satisfactory in the way that it distinguishes between education and learning. The authors thereafter develop their idea of learning but, unfortunately, they spend less time on the concept of education. A definition of education has been suggested elsewhere (Jarvis, 1983, p. 5) and that is adopted here and modified to relate specifically to the concept of lifelong education, which is ‘any planned series of incidents at any time in the lifespan, having a humanistic basis, directed towards the participants learning and understanding’. Since lifelong education may be any manifestation of education, it might be argued that the term ‘lifelong’ is superfluous. Indeed, it would be, were it not for the fact that for many people there is a conceptual confusion of education with initial education, so that it remains essential to retain the
P. Jarvis prefix to clarify the concept. Since lifelong education may be any planned series of incidents, then it is best employed as an ‘umbrella’ term incorporating within it a variety of ‘trends and tendencies’ in education, two of which constitute the focus of this paper. These two revolve around the distinction drawn earlier between the provision of learning opportunities throughout the lifespan (lifelong education) and the lifelong learner. This distinction is quite fundamental to the following discussion and this paper focuses first upon the lifelong learner and nursing and this is followed by an analysis of lifelong education and nursing.
Lifelong learning and nursing Knapper and Cropley (1985) make the distinction between the type of learning that occurs spontaneously and the type that occurs deliberately in lifetime learning. A similar distinction has been drawn elsewhere (Jarvis, 1986) between proactive and reactive learning. This distinction is important because it highlights two totally different approaches to learning. Little research has been undertaken into learning in the workplace, with the exception of Schon’s (1983) important study. In this study Schon shows that some practitioners, perhaps many, do reflect upon their practice and that their practice is actually reflection-inaction. Thus their practice generates new knowledge about practice rather than being merely the practical application of theory. The implications of this for the traditional view of knowledge are quite profound but they are even more significant in the understanding of learning and teaching, for here it is maintained that much, but by no means all, theoretical knowledge is generated from the practical situation and, therefore, the teacher’s role may include that of assisting practitioners to crystallise the ideas they have generated in practice. This may best take place in the practice setting and might well occur at any time during the career of the practitioner. The significance of this as nursing becomes more professional is that it may be in danger of embracing a so-called theory of scientific knowledge that can be taught in the classroom and applied in practice which is actually unrelated to the actual process of reactive lifelong learning. In contrast, considerable research now exists about the pro-active lifelong learner, some of this is anecdotal but much has been conducted under rigorous research conditions. Ronald Gross (1977, p. 24), for instance, recounts a number of biographical narratives about lifelong learners: one
Lifelong education and its relevance to nursing is Cornelius Hirschberg, who learned that a true liberal lifelong education could be achieved amidst a busy life since he ‘read on subways, trains and buses for forty years’, regarding life as his university. He (Gross, 1977, p. 27) claimed that: ‘. . .your education is the only thing that nothing can take from you in this life. You can lose your money, your wife, your children, your friends, your pride, your honour, and your life, but while you live you can’t lose your culture, such as it is.’ But what has this to do with nursing? Simply that – much of the research into self-directed learning in adulthood reveals that many of the learning projects are vocationally orientated (Tough, 1979, pp. 33–35). Tough gives an example of a learning project undertaken by a nurse educator in his own very small sample. ‘A nurse educator was a teacher in planning a new nursing curriculum. In order to plan an effective program, she learned about the characteristics of nursing duties and about the curriculum and organization of instruction in other schools of nursing.’ In order to equip herself to perform her role more effectively, and without anybody instructing her, she undertook her own learning project. Like many self-directed learners she was faced with something for which she required further information and so she went and learned it. This is not unusual. But that is the whole point, Tough’s research demonstrated that self-directed learning throughout the lifespan is not a rare phenomenon. But there is little research about self-directed learners in nursing practice, so that little reference is made to them. Yet it is quite possible that there are many in practice, even though they remain unrecognised and the resources from which they learn unacknowledged. However, it is possible to draw a number of inferences about them from a rather old but classic piece of research. In Rogers’ (1962) study of the diffusion of innovation among medical practitioners, it was shown that some 160%) of the sample were either innovators or early adapters of new innovation while approximately the same proportion were laggards who were reticent to introduce change. It was also noted that the former had a cosmopolitan outlook within the profession, while the latter had a local orientation; that the former had a different mental approach to their practice and that they endeavoured to keep up to date with recent developments while the latter failed to do so. Since this research has been replicated, it is highly likely that a similar picture might be discovered in nursing. Rogers’ work points to the significance of the self-directed learner,
657 who is a rather neglected species amid the present zest for continued professional education. Yet the self-directed, lifelong learners may be keeping abreast of changes that are occurring in nursing for no other reason than a commitment to their work, since they embody some of the ideals of professionalism just by virtue of this quest to keep up to date. That self-directed learners have become a neglected species in the current euphoria about continuing education, may be because some vocational educators are unaware of much of the research in adult education. Yet there are almost certainly many among the ranks of nurses, going about their task in a similar manner to those investigated by Tough, asking their friends and acquaintances, consulting books, journals and attending courses and conferences, etc. Tough (1979, p. 101) records how a ‘man preparing himself for his job as a national education director. . .obtained definite help from 39 books and pamphlets (through 5 libraries), 2 advertisements, 8 helpers, and 1 guided tour. . .a total of 55 particular resources’. Hence the significance of the more recent development of resource centres, that enable selfdirected learners to pursue their own concerns and learning needs at their own pace and in their own way. Not enough is known about these lifelong learners in nursing; not enough is known about the procedures they employ nor the people whom they consult; not enough is known about the manner in which they assist their colleagues to understand new developments in the field; not enough is known about their own innovations in practice. (At the present time, however, at the University of Surrey, a piece of post-graduate research is in the process of examining some of these aspects in another paramedical profession, with considerably important and interesting ideas emerging.) These points should not only have implications for research policy but they should also have implications for continuing education policy, a point to which further reference is made below. However, the existence of lifelong learners has considerable implications for nurse educators in terms of selection, skills and attitudes. Houle (1980, p. 82) claims that: ‘If continuing education is crucial to the profession and therefore to the people who are preparing to enter it, some attention should presumably be given in the admissions process to the selection of individuals who have already given evidence that they have a thirst for knowledge and that they are likely to retain that thirst throughout their careers.’
658 But even after selection it may be necessary to help the self-directed learners be more effective in their quest for knowledge because they may still need to acquire study skills. It is often assumed that these skills are innate or that they have been taught during initial education. Unfortunately the former is self-evidently not the case and the latter is not as frequent as it might be. Hence the teaching of study skills, so that recruits to the profession may acquire the skills to become effective lifelong learners, should be an integral part of professional preparation. Certainly it should constitute a major part of every induction programme, so that learners are given the opportunity to become more effective in their learning. Curriculum planners have sometimes claimed, however, that there is just not time to include this considering everything else that the students have to learn. But this is the point - if learners become both self-directed and effective they will be able to acquire that knowledge more efficiently and by themselves, so that there will be less need to overload the timetable. Throughout initial preparation learners should be given the opportunity to develop into selfdirected learners, rather than to become teacher dependent, so that they may acquire a problem-solving attitude that would equip them better for their career. Houle (1980, p. 84) claims that: ‘. . .it is probable that one way in which a basic professional program might enhance later competence would be by ensuring the fact that, during the years spent in the school’s sub-culture, the student’s personal commitment to lifelong learning is firmly established both by curricular changes and by efforts to alter the customs and behaviour patterns of the students.’ Too much emphasis upon attitude change might lead to the charge of indoctrination but students should be made aware of the significance of self-directed learning to their practice and consideration could be given to this with the inclusion in the curriculum of the study of the ethical implications of professionalism. Hence, one of the major roles of the school of nursing is to prepare recruits to become lifelong learners, and it must be recognised that: ‘Lifelong learning entails a cradle to the grave involvement of the individual with his or her learning and working environment. It implies a growth of all skills and a cumulative interweaving of knowledge and experience. This learning is not packaged and does not cease when the individual completes his/ her legal school requirements.’ (Benedict et al., 1984. vol 1, p. 25)
P. Jarvis Nurse educators might see changes in their own role, for indeed this is the case; they should no longer be teachers providing packaged knowledge to enable learners to pass their qualifying examinations but educators preparing professionals for a lifetime of service. Nursing needs also to recognise lifelong learners and managers must know how best to respond to them. Houle (1980, p. 164) makes the suggestion that managers and administrators need ‘to recruit pace setters and innovators and give them the freedom to work and learn effectively’. Without such freedom there would almost certainly be a decrease in job satisfaction, morale and effectiveness within the organisation.
Lifelong education and nursing The first part of this paper concentrated upon lifelong learning but it was recognised from the outset that learning and education are conceptually different. It was also suggested that lifelong education refers to the provision of learning opportunities throughout the lifespan rather than being a unified system. However, under that definition a variety of different concepts and approaches to education may be gathered including recurrent education, community education, continuing education, etc. Continuing education is itself a wide term, although in common usage it has tended to be restricted to continuing professional education, it is upon this term that the paper now focuses. It might be claimed that if everyone were a lifelong learner then there would be no need for continuing professional education. In part this might be true but many lifelong learners actually enrol in courses when it suits their and meets their learning requirements. The provision of continuing education is significant and increasing at a very rapid rate. In the USA, Doyle (1983, p. 30) claims that over the past 12 years there has been a considerable shift in the emphasis that commercial and industrial corporations have given to training and development, with some 74%, of Texas corporations surveyed claiming that they had increased their training budget over the previous year. Another survey conducted among 125 training directors among Fortune 500 companies and fast-growing small corporations revealed that 79% expect that their training budget will grow over the next five years. Doyle (1983, p. 29) estimated that in one recent year $36 billion was spent by industrial and commercial organisations on training. In contrast, Woodhall
Lifelong education and its relevance to nursing (1980, p. 11) estimated that in 1970 about £l200 million was spent in Britain on the education and training of adults, a lot less per person than in the USA. Even so, it is an expensive enterprise. But perhaps Shepherd (Titmus, 1985, p. 83), manager of education, training and personnel services at Ford Motor Company, has an eloquent reply to that: ‘If you think training is expensive, try ignorance.’ If that is true for the motor car industry, how much more should it be so for a caring profession? Continuing education courses should be provided, so that all nurses whether self-directed learner or laggards have opportunity either to develop their own interests or to be kept abreast with latest developments in nursing. Note that this provision is in itself a complex task because different nurses will have different orientations to learning in the workplace. Hence, continuing education provision needs to be placed in the hands of a highly skilled professional, rather than an educationally unqualified nurse, in order that it should result in effective educational provision being made for adults. This requires that a programme of continuing education should be systematically planned and developed in which adult learning principles and adult education procedures should be applied. In early continuing education, much of the provision was known to have failed to improve the quality of patient care because the courses did not contribute to change in the behaviour of health care professionals. This was, in turn, (Miller, 1967 cited by Walsh, 1984, p. 136), attributed to the use of a content model of education rather than a process model. Hence, two factors may be seen as significant here: that all teaching and learning should be conducted according to the best researched principles of the education of adults and that the programmes should be systematically produced and, always, in direct response to a practice-related problem. Naturally these two points are inter-related because they are but two facets of the emerging field of the study of the education of adults. It is impossible within the space of this brief paper to expound upon these two principles at great length and the following points contain no more than a brief summary of some of the factors that should always be considered within continuing education provision. Adults learn most effectively when: 1. They feel the need to learn. 2. An emotional and physical environment stimulates and supports the learning devised.
659 3. They see that the goals of a learning experience are their own. 4. They have shared the responsibility for planning and operating that learning experience. 5. They participate actively in the learning process. 6. They draw upon, and relate their learning to, their own experience. 7. They share with the educator the responsibility for their own progress (Benedict et al., 1984, pp. 22–24). But at the same time, continuing educators need to plan with care the courses that they offer and these require a systematic planning process to: (a) Identify problems that focus upon health care. (b) Analyse needs/problems to determine if there is a potential educational solution. (c) Identify potential facilitators of, or barriers to, the learning process. (d) Select educational needs based on a priority system. (e) State educational goals and objectives for the selected needs. (f) Select or design a learning experience to meet the goals and objectives. (g) Implement the learning experience. (h) Evaluate the extent to which learners achieved objectives. (i) Determine the extent to which the original problem has been reduced. (j) Identify any additional task necessary to meet the need based upon the evaluation of data (Walsh, 1984, pp. 140–145). Obviously these points only indicate the complexity and the sophistication necessary to make continuing professional education relevant to and effective in nursing. Continuing education can be no mere afterthought to professional preparation, it is an essential part of the life and needs of the nurse educator. Society is changing rapidly. Nursing practice is also changing rapidly. No practitioner prepared for nursing now can expect to be performing precisely the same job in ten years time. The more technical nursing becomes the more rapidly it will change and the more important both lifelong learners and continuing professional education will become.
Conclusion This paper opened with a discussion of lifelong education, it was shown to be a difficult concept to define: indeed, it was even questioned whether it
660 was a concept at all or merely a policy. Certainly it should be a policy in nurse education but it is also a concept – a unifying principle linking existing trends in education. Two of these trends have been discussed here, other developments in education might have just as legitimately been included, but it was argued that these two are the most relevant to nursing. It has also been recognised that education, and by implication, nurse education is also changing. Hence, this affects the nurse educators. Lifelong education is as relevant to their practice as it is to nursing. Nurse educators need to keep up to date both with the changes in nursing and the developments in the education of adults. Like their learners, they need also to be lifelong learners and to undertake continuing professional education, so that they can be highly professional educators of adults. It was pointed out at the outset that in the process of professionalisation, nursing is considering locating its initial preparation in higher education. Traditionally in the UK, higher education has been didactic, subject-centred and orientated towards young adults. But the clientele of higher education is also changing and so its approach to education must respond to this change in the direction that has been advocated in this paper. Therefore, highly professional educators of adults in nursing may well bring to higher education skills and understanding that higher education needs, since it may be concluded that the concept of lifelong education is relevant not only to nursing but to all forms of occupational practice in this rapidly changing society. (This paper was delivered as the Annual Lecture at the Radcliffe School of Nursing, Oxford, December 1985.)
P. Jarvis
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