Although the threat of human obsolescence confronts all of humanity, given the accelerating pace of change in our society, it has a particularly strong impact on the professions--especially the health professions. The half-life of the knowledge, skills, attitudes, and values required by physicians, nurses, allied health professionals, and pharmacists is shrinking with increasing speed. Citizens worry about being treated by health practitioners who have not kept up to date and have reacted by passing laws mandating relicensing and continuing professional education. The health care professions and institutions have responded to the threat by mounting massive programs of continuing professional education; in fact, this is probably the fastest-growing aspect of all of education. And, since the clientele of continuing professional education consists exclusively of adults, these programs have tended increasingly to be based on principles of adult learning. This chapter opens with a description of a pilot project for physicians at the University of Southern California, in which the central theme is self-directed learning. The selection presents the need for and assumptions and goals of the project and the major program components, including needs assessment, individualized learning plans, information brokering, and the use of peer resource groups. Then follow three selections focused on the continuing education of nurses. Selection 2, by the American Nurses' Association, sets forth a policy statement and guidelines for self-directed continuing education in nursing. Its provisions could easily be adapted to other professions. The application of the andragogical model to highly technical training in cardiovascular nursing at Doctors Hospital in Little Rock is presented in selection 3, and selection 4 describes an innovative inservice education program in which primary responsibility is placed on the clinical nursing units at St. Mary's Hospital in Waterbury, Connecticut.
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