Enhancing continuing nursing education: a participatory action research approach in Iran

Continuing nursing education is a crucial tool for advancing the nursing profession. Numerous studies have highlighted the suboptimal quality of continuing education programs. The purpose of this study was to identify the problems in continuing nursing education and develop solutions and implement them through active stakeholder engagement.

The Kemmis and Mactaggart action research model was implemented at Jahrom University of Medical Sciences in Iran from 2017 to 2020. For the quantitative part of the study, convenience sampling was employed, with a total of 200 participants, including 126 nurses, 44 head nurses, and 30 nursing trainers. For the qualitative part of the study, purposive sampling was used, with a total of 114 participants. Participants engaged in one cycle of reflection, and data were collected and analyzed using both qualitative and quantitative methods. Qualitative data were gathered from 14 semi-structured interviews and 10 focus group discussions. A Satisfaction Questionnaire and Quality Assessment of Continuing Nursing Education were utilized. Special techniques such as Train The Trainer, education booster doses, and evaluating outcomes (clinical indicators) of education were used during the action phase. Data analysis was performed using MAXQDA software version 8 and SPSS software version 16.

The initial qualitative analysis during the assessment phase identified three overarching themes: planning challenges, implementing challenges, and evaluation challenges. Similarly, the final phase revealed three refined themes: planning in recovery, fixed implementation, and improving the evaluation. The total average satisfaction score of participants in continuous nursing education programs significantly improved after the actions (Before action: 19.66 ± 3.96, during action: 27.12 ± 3.64, one month after action: 23.74 ± 3.7, P < 0.001). The total quality score of continuous education programs also increased significantly post-action (Before action: 97.55 ± 23.1, after action: 197.29 ± 13.55, P < 0.001).

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