If you have ever been involved in the selection and interviewing of people wanting to become nurses then you will know one of the standard questions asked is, why do you want to be a nurse? I must have asked that question hundreds of times and no one has ever given me the answer, ‘I like doing paperwork and keeping records.’
Nursing is a practice-based profession which, as such, attracts people who are practical and people-focused. While we acknowledge the importance of clinical record keeping and often stay on at work after our shift to make sure our patient records are up-to-date, we rarely find the same commitment, time and energy for our own records relating to our continuing professional development (CPD).
The value of evidence
Soon after I qualified as a nurse I undertook two different types of CPD. One was a part-time taught diploma, which had lectures and examinations validated by the University of London. The second involved being a scribe and non-participant observer for 12 months in a weekly psychotherapy group run by a clinical psychotherapist, where my role was to take notes and discuss various interactions with the therapist after the group finished. Although I learnt a lot from both of these experiences, the only one I have any evidence of is the post-registration diploma, and this evidence enabled me to become a nursing lecturer.
The nature of evidence
With any structured course, be it a day, a week or two years, there will be documented evidence of attendance, aims and outcomes of the programme and, depending on the type of course, some form of assessment or examination with subsequent certificates. This form of evidence is relatively straightforward, and a simple filing system will keep it in one place until it is needed for revalidation or job applications and interviews. But what about my example of being an observer in a psychotherapy group, or general clinical work in a surgical ward, or helping at a luncheon club, or being a member of a clinical development group? How do we keep evidence of such experiential activities?
This is the element of evidence and record keeping that most nurses are not good at. As a general rule, nurses undertake the practical aspect of CPD and enjoy developing their experience and skills, but are not so good at collecting the evidence for future reference. If you undertake a structured course, you have to attend or participate in e-learning, and if you complete the assignments an appropriate certificate is produced for you. However, with the more experiential activities any learning or record keeping requires self-discipline and some form of hard evidence.
If I were undertaking that psychotherapy experience today, I would want to keep some or all of the following as evidence: firstly, I would ask the clinical psychotherapist to provide me with written evidence of my role, the time involved and a reference as to my ability as the observer; then, I would keep a simple record of any articles or books I read relating to the subject. This would be improved if I then wrote a one-page, simple reflection on what I had learnt from the role. If I could summon the time and commitment, then the next level would be for me to write an article for publication relating to group psychotherapy.
Do we collect evidence of CPD just to tick a revalidation box?
If I had invested time and energy into reflecting on that psychotherapy experience, either in the one-page reflection or by undertaking the reading and research to produce a 3000-word article, then I would not have simply produced evidence of my CPD, but also enhanced and deepened my understanding of the subject. If we reflect in a meaningful way on any of our clinical or life experiences, then we will learn far more from them than if we just simply experience them.
One of the most efficient ways to enable this reflection to enhance our understanding and learning is to undertake some form of written, reflective exercise. Somehow, the discipline of reflecting on and turning experiences into written words enhances our depth of understanding and our learning of the event. Collecting evidence by using a written reflection becomes far more valuable than just writing something so we can tick a box on our annual review or Nursing and Midwifery Council revalidation.
Is evidence restricted to the written word?
The written word is convenient and its validity is understood by managers and lecturers in a fairly straightforward way. However, I have seen a portfolio of photographs made by a nurse manager chronicling a time sequence of changes to her ward environment that she was responsible for. I have also seen a painting by a clinical nurse specialist capturing the recovery stages of a patient following a stroke, as well as many picture-based PowerPoint presentations of clinical procedures.
Evidence can take many forms. It will predominantly be the written word, but try to be creative in how you capture and keep records of what you do, experience and learn.