The Importance of Creating a Culture of Learning: Page 2 of 2

April 13, 2012

Insufficient Personal Responsibility

Professionals who have been students in university settings often gain an appreciation of the need to take personal responsibility for lifelong learning. They realize the importance of joining professional associations, reading journals, and attending continuing education programs. Unfortunately, this personal commitment to sustaining and improving one’s competencies is uncommon among LTC nursing staff, as is exemplified by DONs, who represent the highest position in the nursing department. Most DONs possess basic nursing degrees. Survey data indicate that the education levels of DONs are as follows: 56% hold an associate’s degree or diploma in nursing, 30% a baccalaureate degree in nursing, 5% a master’s degree in nursing, and 13% a non-nursing bachelor’s or master’s degree. Approximately one-third of DONs hold some type of certification, with only 12% holding certification in nursing administration in LTC. Less than half belong to specialty nursing organizations.5 The percentage of nurses with degrees, certifications, and involvement in professional associations is significantly less for other levels of nursing in LTC. These realities present obstacles to nurses in satisfying the IOM recommendation that they engage in lifelong learning to gain and sustain the competencies needed to provide care to the populations they serve.

Creating a Culture of Learning

Limitations in the academic preparation of nursing employees, onsite educational resources, preparation of staff development educators, and support for education by leadership challenge the ability of facilities to provide care that is reflective of current best practices. Aggressive efforts to develop a culture of learning in LTC settings are needed and the initial action is for leadership to support this effort. Some ways to demonstrate this support include: assuring every job description includes an expectation of continuing education, supporting participation in educational activities for all levels of staff, recognizing continuing education efforts, and budgeting for educational activities and products.

Staff development directors need to enhance their competencies for their unique role. This includes an awareness of the principles of adult education, techniques for needs assessments, fundamendals of effective planning, and use of various approaches for presentation and evaluation. The AALTCN offers an LTC Staff Development Specialist Certification that provides this preparation, which has proved useful for many nurses in this role. More information on this certification can be found at www.ltcnursing.org.

A commitment to being a lifelong learner needs to be nurtured in all employees, which can be achieved by having employees recognize how quickly knowledge on geriatric care issues is expanding, helping employees develop personalized educational plans based on their individual needs and learning style, and rewarding their efforts. Knowledge and skills, particularly in healthcare, change too rapidly for anyone to think that education stops upon graduation. Nurses and their employers need to understand that time, effort, and money are necessary investments to ensure continued competency and that the demands of an increasingly complex resident population are met.


1. Committee on the Future Health Care Workforce for Older Americans; Institute of Medicine. Retooling for an Aging America: Building the Health Care Workforce. Washington, DC: The National Academies Press, 2008.

2. Utley R, Anderson R, Atwell J. Implementing transformational leadership in long-term care. Geriatr Nurs. 2011;32(3):212-219.

3. National Commission for Quality Long-Term Care.The long-term care workforce: can the crisis be fixed? www.ncqltc.org/pdf/ltc_workforce.pdf. Accessed March 29, 2012.

4. The Coalition of Geriatric Nursing Organizations. Hartford Institute for Geriatric Nursing Website. Published 2008. http://hartfordign.org/advocacy/cgno. Accessed March 16, 2012.