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The “curious practitioner”: effective lifelong learning

Sue Spencer
RGN NDN PWT BA MSc PGCE
Senior Lecturer in Primary Care
University of Northumbria

The purpose of this article is to explore how you might document your commitment to providing well-informed and up-to-date practice and also provide evidence of engagement with lifelong learning to your colleagues, employers and, possibly more importantly, to the Nursing and Midwifery Council (NMC) and the general public.

This is not an article telling you how to "get" learning; nor is it an instruction manual for evidencing lifelong learning. What I hope it will do is help you provide evidence of engagement with lifelong learning and also explore some creative ways of transferring learning in all domains of your life to your professional practice. I perceive lifelong learning as an integral part of being a curious practitioner and not an add-on that gets in the way.1

If you are a curious and questioning practitioner, you cannot help but be engaged with lifelong learning, as each day generates questions that need answers. Finding the answers to those questions is the start of lifelong learning and continuing professional development.

So why do we think lifelong learning is so important? There is no doubt that over the last 10 years, the phrase "lifelong learning" has become a key component within quality improvement in health and social care and has been stated as a pivotal to transforming health and social care delivery.2
Despite the promotion of lifelong learning within the healthcare profession, I cannot be the only one who gets frustrated at the lack of clarity and direction as to how and what we might access to "prove" we are indeed engaging with lifelong learning. Also, you may well have attended taught sessions and felt you were not learning anything new and felt frustrated at the time you were wasting being there.

There is no doubt that, as registered nurses, we are required to engage with continuing professional development and lifelong learning. The new NMC Code clearly states, "You must keep your knowledge and skills up to date throughout your working life. You must take part in appropriate learning and practice activities that maintain and develop your competence
and performance."3

What is lifelong learning?
Lifelong learning is not just about attending courses, collecting certificates of attendance and going to college. Learning does not always take place in this way, as information is provided and received but we don't always know how to convert this into our practice. It also does not take into account that adults often learn from experience and this "experiential" learning is often where we interpret and make sense of previous, more
formal learning.4

It can be very frustrating not being able to see how we can translate information given into our skills and understanding within practice. I am sure some of you have sat through talks and felt that you were not learning anything - and, as such, your mind wanders and the next slide you notice is much further on in the talk and you cannot see the links. Do you see this as a waste of time or a blessed relief from the day-to-day pressures of clinical work? If it is the former, have you ever identified how you might use your time better? If it is the latter, and you thought about what the pressures are and noticed how different you feel away from that pressure. If you have been through either of these, discussed them and then documented them either in a journal or in a portfolio, you have engaged in lifelong learning.

So lifelong learning can be seen as attendance at study days, workshops and conferences (instrumental) OR it can be seen as a way of approaching your practice and how you undertake your practice using experiences at work, reading articles in journals, listening to programmes on the radio or watching television. Thinking about what we have learnt from reading etc can demonstrate what is has taught us something new and how we are considering integrating this into our professional and personal life (reflective and integrative).

Professional responsibilities
As has been noted, the NMC requires us to engage with lifelong learning and provide documentation and guidance as to how we go about it. So how can we turn this from a chore into something edifying and nurturing? Part of it involves shifting the focus from lifelong education to learning within and for practice, a subtle but significant difference into the perception of what we need to do in order to "prove" that we our continuing to engage with lifelong learning and continuing professional development.

Curious practice and asking questions
It might seem quite challenging to ask questions of ourselves and our practice - but I bet you are doing this anyway. The questions you ask are probably critical and negative. Why not turn those questions into more constructive ones - don't be so hard on yourself. If you think about each day in detail, there are always affirming activities happening as well as the negative ones. Also, recognising while in the middle of things how you are feeling and what you think might be going on for you and those you are interacting with is what Donald Schon calls "reflection-in-action" and as skilled and expert practitioners you may well be doing this without realising.5 You might find that you subtly change the questions you are asking within an assessment/patient interview as you "notice" how someone responds to what you are saying and you feel that the questions you normally ask might not be working
as anticipated.

You can put yourself into the shoes of the six-year-old child who persistently asks questions about the world around them. Many of you will have been on car trips or shopping with the inquisitive child and the trick here is to make the familiar strange.6 Taking a step back and asking naive questions about how and what you practice is a really good way of noticing the issues you take for granted. Although having students or new staff observing your practice can be intrusive, it is often when you are explaining why you do things in a particular way that you understand things more clearly yourself. Writing down these questions, as well as some initial answers, and how you went about finding these answers, will all provide documentary evidence of your lifelong learning.

Techniques and tips
Keep a diary/journal/notebook of questions and observations or just to note things down. You don't have to name anybody, but putting things in writing stops thoughts and feelings being too elusive and provides the possibility to revisit your notes and link things together later.

Find yourself some fellow travellers in lifelong learning. Learning alongside others is "value-added" and sharing experiences and ideas with colleagues can often provide additional material for your journal and learning.

Don't be afraid to write notes on articles you are reading and annotate them. If you are completing a portfolio, this evidence of thinking about what you have read, possibly making links with other articles and also commenting in how it relates to your practice and the patients you see in your practice all demonstrates a thoughtful approach to your practice.

Use clinical supervision sessions or practice meetings not just as an opportunity to talk about issues in practice but also to identify questions that have come up and possible sources of answers. Explore what local classes are available in subjects in which you are interested. Sitting with fellow potters/painters/knitters can often lead to conversations about life and work that can add to your understanding and insight into both. This leads to the transferability of learning, which further enriches our life and work, and also leads to a more satisfying and less frustrating time within professional practice. If you make a habit of writing notes about it all you can always go back to it and link it to more formal learning.

Consider using creative and imaginative ways of documenting your learning to date and possible learning for the future. Explore the use of more visual approaches to capturing your professional journey.7 Maps can be drawn exploring where you have been and where you might go with your professional and personal development. I write short notes and make lists of words and link them together using Mind Maps.8

Find a safe place to store the musings you have and articles you have read and then find yourself to organise your thoughts and ideas into a coherent portfolio of your journey in learning. Make it fun and remember it is your learning so it has to be meaningful to you. Being able to communicate all this to someone else is also learning in itself and helps clarify and make sense of a lot of what we are doing and where we are going in our professional development.

Conclusion
I hope that this article expands the possibilities of engaging with lifelong learning rather than putting off the activity. Let's make the issue of lifelong learning integral to what we do and help create a habit of capturing that learning through writing and thus providing documentary evidence of that learning and engagement. Make it fun and make it a habit, and you might find that you can transfer this enthusiasm to those around you and then you will have fellow travellers on the way. l

References
1. Johns C. The value of reflective practice for nursing Journal of Clinical Nursing 4(1):23-30.
2. Department of Health. High Quality Care For All: NHS Next Stage Review Final Report 2008. London: DH; 2008.
3. Nursing and Midwifery Council (NMC). The Code: Standards of conduct, performance and ethics for nurses and midwives 2008. London: NMC; 2008.
4. Fowler J. Experiential learning and its facilitation Nurse Education Today 2007.
5. Schon D. The Reflective Practitioner. San Francisco: Jossey-Bass; 1983.
6. Bolton Gillie. Reflective Practice Writing and Professional Development. London: Sage Publications; 2005.
7. Rolfe G, Freshwater D, Jasper M. Critical reflection for nursing and the helping professionals: A user's guide. Basingstoke: Palgrave; 2001.
8. Buzan T. The Mind Map as a Creative Thinking Mechanism accessed from http://www.imindmap.com/ 19/08/09