Research on the Implementation Dilemmas and Countermeasures of Nursing Continuing Education Policies Based on the Smith Model

Abstract

Objective: This study aims to analyze the practical dilemmas encountered in the implementation of nursing continuing education policies and propose policy optimization suggestions. It provides theoretical support and practical references for optimizing the implementation path of nursing continuing education policies, improving the mechanism for the continuous development of nursing talent, and enhancing the quality of nursing professional development. Methods: Using the Smith Policy Implementation Model as the theoretical framework, a multidimensional analytical framework was constructed from four aspects: idealized policy, implementing agency, target group, and external environment. Combining the latest national continuing education policy documents, a questionnaire was designed, reviewed by experts, and pre-tested on a small scale. The questionnaire was revised multiple times to ensure its quality. The survey was conducted among registered nurses working at Taizhou Second People’s Hospital, who completed the questionnaire anonymously online. Results: During the implementation of continuing education policies, approximately 29.67% of nurses reported that the latest policy introduced in 2025 (uniform 25 credits) was unreasonable, particularly unfriendly to junior nurses, and that the continuing education content lacked specificity and practicality, as well as specialization. Nearly 92.31% of nurses reported that their motivation to participate in continuing education was solely driven by the need for career advancement and regular assessments. Difficulties encountered in personal continuing education included busy clinical work schedules, fragmented learning, and boring and useless content. Nearly half (45.58%) of nurses reported a lack of continuing education resources in their hospitals, and that hospitals mandated credit fulfillment without recognizing the value of high-credit/high-education individuals. Approximately 40.58% of nurses reported that economic downturns increased family burdens, and high course fees discouraged participation in nursing continuing education. Conclusion: Through targeted analysis of the above four aspects, future policy formulation and implementation should focus on addressing the specificity and practicality of nursing continuing education, emphasizing specialized training in key areas; enhancing nurses’ motivation to participate in nursing continuing education by diversifying and enriching learning content to increase its appeal; improving hospital educational and training resources, such as inviting renowned experts from other hospitals to teach and breaking down regional resource-sharing barriers through university-hospital collaborations; and increasing the availability of free or low-cost continuing education options.