Factors influencing continuing
professional development
A Delphi study among nursing experts
Gerard Brekelmans
Department of Research and Education, Erasmus MC, Rotterdam,
The Netherlands
Rob F. Poell
Department of Human Resource Studies, Tilburg University, Tilburg,
The Netherlands, and
Kees van Wijk
HRM and Healthcare Research Group, Erasmus University, Rotterdam,
The Netherlands
Purpose – The aim of this paper is to present an inventory of expert opinions on the factors that
influence the participation of registered nurses in continuing professional development (CPD)
Design/methodology/approach – A Delphi study was conducted among 38 Dutch experts
(nursing employers, managers, education institutions, and professional associations). Data collection
comprised three rounds: experts completed two consecutive rounds of questionnaires and participated
in a discussion meeting.
Findings – Main influencing factors were: a CPD registration system, the attractiveness of the
nursing profession, nurses’ identification with the nursing profession, opportunities for workplace
learning, the line manager as role model, and attractive education programs.
Research limitations/implications – Being part of a larger study, for the present paper only
nursing experts were asked their opinion about shaping CPD for nurses. Further research should bring
in the views of nurses themselves and investigate how the wider environment influences CPD
Practical implications – As all stakeholders were found to have their own roles in the CPD process,
collaboration among employers, managers, education institutions, and professional associations will
be crucial to create a conducive learning climate for nurses. HRD practitioners in healthcare can use
the study findings to advise hospitals about implementing the right conditions to support CPD for
Originality/value – A qualitative study using the Delphi method to discover factors influencing
CPD in nursing had not been conducted before. Unlike many studies looking essentially at formal
education, the present paper takes into account workplace learning among nurses as well.
Keywords Continuing professional development, Delphi study, Nurses, The Netherlands
Paper type Research paper
In nursing literature the terms continuing professional development (CPD) and
continuing professional education (CPE) are often used interchangeably (Perry, 1995).
While CPE is more focused on didactic principles and formal educational contexts,
CPD is more focused on self-directed learning, in which the nurse is the director of

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