1. Doucette, Jeffrey N. DNP, RN, LNHA, CENP, NEA-BC, FACHE

Article Content

Q What ideas do you have for enhancing continuing leadership development options?

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Lifelong learning is the cornerstone of exemplary leadership. Today's healthcare leader is called on to not only lead clinical teams, but also a complex and constantly changing business. The skills required to innovate, educate, and deliver key results within the complexities of changing models of payment, an increasingly diverse workforce, and constant pressures to contain costs can only be derived from continuous and ongoing learning. There are several ways to challenge your thinking away from more traditional approaches to frameworks that complement the ever-changing environments in which we work.


The history of continuing education in nursing dates back to Florence Nightingale, who encouraged nurses to always keep learning. With limited education opportunities available, the first U.S. nursing continuing-education course was established in 1894. From the late 19th century to the mid-20th century, the majority of postgraduate education for nurses was on-the-job training. The experiential learning of this time period was based on tradition as opposed to theoretical or evidence-based instruction. By 1960, federal funding programs enabled colleges and universities to begin offering short-term, continuing professional education. By the mid-2000s, over two-thirds of the United States and its territories required nurses to earn continuing education for relicensure.1


Blended learning is typically defined as a combination of traditional classroom learning with some form of virtual learning, such as webinars or online learning modules. There's been a significant decline in classroom-based, instructor-led training across U.S.-based companies, which has been offset by a rise in virtual classroom events and online self-study.2 Although these models have improved efficiency and, in many cases, reduced costs, the research outcomes on their effectiveness remain mixed.


Research from the Center for Creative Leadership explored how leaders learn, grow, and change over the course of their careers. This research led to the development of the 70-20-10 rule. This model suggests that the most successful leaders learn within three domains: challenging assignments (70%), developmental relationships (20%), and formal coursework and training (10%).3 The challenge with traditional continuing leadership education is that most falls within the 10% of formal coursework and training. Furthermore, few leaders, both experienced and emerging, recognize that the majority of learning comes from the largest and most prominent domain-challenging assignments. Using this framework, 90% of all learning is informal (challenging assignments and developmental relationships).


Coursework and training may consist of classroom-based education, virtual classroom events, gaming and simulation, and e-learning modules, as well as books and journals. Developmental relationships may include supervisors, peers, executive coaches, mentors, communities of practice, and professional networking. Finally, challenging assignments typically involve increases in scope, involvement in change management projects, leading new initiatives, or horizontal moves within the organizational structure. This learning approach isn't simply about mixing technology with traditional approaches; rather, it's about building an infrastructure to enable and support how leaders learn best.


Considering this model, leaders who are challenged and given new opportunities are in a constant learning mode. The shift from traditional classroom-based learning to experiential learning enabled by technology is an emerging trend in nursing leadership. Leaders should work to accelerate adoption and acceptance of nontraditional approaches to learning.




1. American Nurses Association. State legislative agenda. [Context Link]


2. O'Leonard K. The Corporate Learning Factbook 2013: Benchmarks, Trends, and Analysis of the U.S. Training Market. Oakland, CA: Bersin by Deloitte; 2013. [Context Link]


3. Rabin R. Blended learning for leadership: the CCL approach. [Context Link]