Access the NHS Five Year Forward View and consider how it outlines developing a workforce fit for purpose (www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf)

In the section on workforce development the Five Year Forward View suggested new roles should be developed to create a ‘flexible workforce that can provide high quality care wherever and whenever the patient needs it’ (p.30).

• Can you think of any new roles that have been developed that may have an impact on how nurses practice?

Answer: Assistant practitioner; Higher apprentice; Nursing associate

Malcolm Knowles (1984) describes five assumptions about the adult learner:

1. Self-concept: The adult learner differs from the child learner as they become more self-directed
2. Adult learner experience: The adult learner has more resources available to them through their own experiences
3. Readiness to learn: As a mature adult this relates their learning to the development of their social roles
4. Orientation to learning: The learner moves from focused on the subject to focus on a problem-solving approach
5. Motivation to learn: An adult learner motivates themselves to learn using an andragogical approach to learning, that is, using your own experience to inform but also as an autonomous learner seek out the evidence you need

Answer the questions below:

• What does the evidence say about using antipyretics when a child is pyrexial?

Answer: There are also evidence-based approaches to education and there are several theoretical approaches to learning that can be used in nursing. The principles of andragogy, introduced by Malcolm Knowles in 1980 and developed further in 1984, emphasises the learning strategy of facilitating autonomous learning. Rather than a passive approach to learning, the learner has to seek out the new knowledge for themselves. They may be aided in doing so by lecturers sign-posting their way, but the responsibility is their own. In this approach the nurse makes sense of what they learn by applying this knowledge to their practice. Many nurses find it easier to learn if they can make sense of their learning. An example might be that a nurse learns the theory related to caring for a child who is pyrexial and the debate about the use of antipyretic medication when a child is pyrexial. It makes more sense and they are able to recall details only after they have been involved in the care of a child who is pyrexial (Wragg et al., 2014; Shann et al., 2003). Their experience adds to the resources they have to draw from. The andragogical learner has to see the relevance and value in their learning experience.

Use an andragogical approach to learning, that is, use your own experience to inform but also as an autonomous learner seek out the evidence you need. 

• What does the evidence say about using antipyretics when a child is pyrexial?

Answer: little evidence to support and no convincing evidence to support using ibuprofen and paracetamol concomitantly.

References

Shann, F., Curtis, N. and Mulholland, K. (2003) ‘Evidence on the use of paracetamol in febrile children’, Bulletin of the World Health Organization, 81 (5), 367–72.

Wragg, E., Francis, J. and Amblum, J. (2014) ‘Managing paediatric patients with pyrexia’, Emergency Nurse, 22 (8): 20–3.

Drawing on an experience from your practice, use Kolb’s (1984) experiential learning cycle as an individual to explore and understand it better.

As a group you can do the same with a case or problem from practice (do you recognise that this is what we do every day in practice as part of the multi-professional group?) 

Answer: Both learning theories are more applicable to CPD and relevant to nursing as they involve the ability to reflect and learn from practice. The student applies their evidence-based learning to enhance their practice.