Continuing Professional Development Activities on Behavior Change and Autonomy among Nurses in a Level II Government Hospital
Authors
Graduate School of Allied Health Sciences, University of the Visayas (Philippines)
Graduate School of Allied Health Sciences, University of the Visayas (Philippines)
Article Information
DOI: 10.51584/IJRIAS.2026.11050163
Subject Category: Nursing
Volume/Issue: 11/5 | Page No: 1961-1974
Publication Timeline
Submitted: 2026-05-10
Accepted: 2026-05-16
Published: 2026-06-10
Abstract
This study examines how Continuing Professional Development (CPD) activities influence professional behavior change and nursing autonomy among 205 staff nurses in a Level II government hospital in Surigao City, Philippines. Utilizing a descriptive-correlational design, the research assessed levels of engagement in lifelong learning and its relationship to clinical independence and professional conduct. Findings revealed that nurses demonstrate a very high level of engagement in CPD, largely driven by a strong internal motivation to improve patient care rather than mere regulatory compliance. Correspondingly, the respondents exhibited a very high extent of professional behavior change particularly in accountability and ethical practice and reported high levels of clinical autonomy. Statistical analysis identified a significant positive relationship between CPD participation and professional autonomy, suggesting that as nurses update their clinical knowledge, they gain the confidence necessary to make independent, evidence-based decisions. While overall professionalism was high, communication was noted as a relative area for development. Based on these findings, a Professional Behavior and Autonomy Enhancement Plan was proposed to institutionalize specialized training and nurse-led case presentations. Ultimately, the study concludes that consistent investment in CPD is vital for empowering an accountable and autonomous nursing workforce in resource-constrained government settings.
Keywords
Continuing Professional Development (CPD)
Downloads
References
1. Al-Mutairi, A. F., Aljehani, Y. A., & Al-Harbi, M. F. (2024). Continuing professional development and its impact on nurses’ competence, confidence, and clinical decision-making in hospital settings. Journal of Nursing Management, 32(2), 412–421. https://doi.org/10.1111/jonm.13942 [Google Scholar] [Crossref]
2. Al-Mutairi, D. S., Almutairi, R. G., Aldusaeri, A. F., Aljaber, K. S., Alzahed, L. A., Alzahrani, M. S., ... & ALotaibe, M. J. (2024). The Role of Continuous Professional Development (CPD) in Enhancing Nursing Competence and Patient Care. Journal of International Crisis and Risk Communication Research, 7(S3), 553. [Google Scholar] [Crossref]
3. Al-Sbehat, A. M., Eshah, N. F., Rayan, A. H., Abu Raddaha, A. H., Al Omari, O., & Alhalaiqa, F. (2024). The Association Between Intensive Care Unit Nurses’ Perception of Nursing Professional Autonomy and Nursing Professionalism: A Descriptive Correlational Design. SAGE Open Nursing, 10, 23779608241305720. [Google Scholar] [Crossref]
4. Asl, N. R., Shakeri, N., & Dehghan-Nayeri, N. (2022). Professional autonomy and its relationship with clinical competence and job satisfaction among nurses. BioMed Center Nursing, 21(1), 1–9. https://doi.org/10.1186/s12912-022-00884-7 [Google Scholar] [Crossref]
5. Asl, R. G., Taghinejad, R., Parizad, N., & Jasemi, M. (2022). The relationship between professional autonomy and job stress among intensive care unit nurses: A descriptive correlational study. Iranian Journal of Nursing and Midwifery Research, 27(2), 119-124. [Google Scholar] [Crossref]
6. Ayivi-Vinz, G., Kanyinga, F. B., Bergeron, L., Décary, S., Adisso, É. L., Zomahoun, H. T. V., ... & Légaré, F. (2022). Use of the CPD-REACTION questionnaire to evaluate continuing professional [Google Scholar] [Crossref]
7. Basit, G., Erkuş Küçükkelepçe, G., & Arslan Şeker, S. (2022, November). The relationship between nurses' professional values and caring behaviors. In Nursing Forum (Vol. 57, No. 6, pp. 1044-1051). [Google Scholar] [Crossref]
8. Bujang, M. A. B., Kamaluddin, M. R., Mat Basir, S., Munusamy, S., & Jhee Jiow, H. (2024). Impacts of workplace culture on deviant workplace behavior: A systematic review. Sage Open, 14(2), 21582440241247976. [Google Scholar] [Crossref]
9. Esmailpour Moalem, A., Shafipour, V., Shafipour, L., & Jafari, H. (2024). Factors Associated with Nurses’ Professional Autonomy: A Narrative Review. Current Psychosomatic Research, 2(3), 163-172. [Google Scholar] [Crossref]
10. Faridi, K., Mohamadi, M. A., Mehri, S., & Dadkhah, B. (2025). Assessing the relationship between happiness and professional autonomy among clinical nurses: an analytical cross-sectional study. BioMed Center nursing, 24(1), 320. [Google Scholar] [Crossref]
11. Faridi, S., Iqbal, S., & Khan, M. A. (2025). Professional autonomy, happiness, and work engagement among hospital nurses: A cross-sectional study. Journal of Advanced Nursing, 81(1), 178–189. https://doi.org/10.1111/jan.15984 [Google Scholar] [Crossref]
12. Guillaume, D., Troncoso, E., Duroseau, B., Bluestone, J., & Fullerton, J. (2022). Mobile-social learning for continuing professional development in low-and middle-income countries: integrative review. JMIR medical education, 8(2), e32614. [Google Scholar] [Crossref]
13. Haji Mustapa, F., Ahmad, N., & Yusoff, M. Z. (2021). Barriers and facilitators to continuing professional development among nurses in hospital settings. Nurse Education in Practice, 55, 103161. https://doi.org/10.1016/j.nepr.2021.103161 [Google Scholar] [Crossref]
14. Haji Mustapa, M. B., Teo, Y. C., Haji-Abdul-Rahman, H. K., Abdul-Mumin, K. H., & Rahman, H. A. (2021). Enablers and Barriers of Continuous Professional Development (CPD) Participation among Nurses and Midwives. International Journal of Nursing Education, 13(3). [Google Scholar] [Crossref]
15. Hakvoort, L., Dikken, J., Cramer-Kruit, J., Molendijk-van Nieuwenhuyzen, K., van der Schaaf, M., & Schuurmans, M. (2022). Factors that influence continuing professional development over a nursing career: A scoping review. Nurse Education in Practice, 65, 103481. [Google Scholar] [Crossref]
16. Hakvoort, L., van der Heijden, B. I. J. M., & de Lange, A. H. (2022). Continuing professional development across nursing career stages: A systematic review. Human Resources for Health, 20(1), 1–15. https://doi.org/10.1186/s12960-022-00722-4 [Google Scholar] [Crossref]
17. Hosseini Choupani, S. S., Ghaffari, S., Jafari, H., Bazarafshan, M., & Gholampour, M. H. (2024). Professional ethics and ethical challenges related to nurses and patients: A narrative review. Journal of Nursing Reports in Clinical Practice, 3(4), 383-389. [Google Scholar] [Crossref]
18. Jackson, C., & Manley, K. (2022). Contemporary Challenges of Nursing CPD: Time to change the model to meet citizens’ needs. Nursing Open, 9(2), 880-891. [Google Scholar] [Crossref]
19. Khademi, E., Abdi, M., Saeidi, M., Piri, S., & Mohammadian, R. (2021). Emotional intelligence and quality of nursing care: A need for continuous professional development. Iranian Journal of Nursing and Midwifery Research, 26(4), 361-367. [Google Scholar] [Crossref]
20. Kim, S. O., & Kim, J. S. (2021). Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study. Journal of Clinical Nursing, 30(7-8), 1037-1045. [Google Scholar] [Crossref]
21. King, R., Taylor, B., & Talley, L. (2021). Leadership, learning culture, and continuing professional development in nursing practice. Journal of Nursing Management, 29(6), 1624–1633. https://doi.org/10.1111/jonm.13314 [Google Scholar] [Crossref]
22. King, R., Taylor, B., Talpur, A., Jackson, C., Manley, K., Ashby, N., ... & Robertson, S. (2021). Factors that optimise the impact of continuing professional development in nursing: A rapid evidence review. Nurse education today, 98, 104652. [Google Scholar] [Crossref]
23. Kurtović, A., Žigić Antić, L., & Vukelić, J. (2024). Employment status and participation in continuing professional development among hospital nurses. BioMed Center Nursing, 23(1), 1–10. https://doi.org/10.1186/s12912-024-01406-3 [Google Scholar] [Crossref]
24. Kurtović, B., Gulić, P., Čukljek, S., Sedić, B., Smrekar, M., & Ledinski Fičko, S. (2024, February). The commitment to excellence: Understanding nurses’ perspectives on continuous professional development. In Healthcare (Vol. 12, No. 3, p. 379). MDPI. [Google Scholar] [Crossref]
25. Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC nursing, 20(1), 158. [Google Scholar] [Crossref]
26. Lockwood, E. B., & Schober, M. (2024). Factors Influencing the impact of nurse practitioners’ clinical autonomy: a self-determining perspective. International nursing review, 71(2), 375-395. [Google Scholar] [Crossref]
27. Lu, Y., Zhai, S., Liu, Q., Liu, J., & Chen, C. (2025). The impact of head nurse empowerment on clinical nurses’ innovative behavior: the mediating role of organizational climate and professional autonomy. BMC nursing, 24(1), 574. [Google Scholar] [Crossref]
28. Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BioMed Center nursing, 20(1), 62. [Google Scholar] [Crossref]
29. Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development: A metasynthesis. Nurse Education Today, 97, 104706. https://doi.org/10.1016/j.nedt.2020.104706 [Google Scholar] [Crossref]
30. Mohammed Shehata, D., Faisal Fakhry, S., & Abdelghaafar, G. (2022). Factors influencing staff nurses participation in continuing professional development programs. Egyptian Journal of Health Care, 13(3), 912-922. [Google Scholar] [Crossref]
31. Mrayyan, M. T., Abu Khait, A., Rababa, M., Algunmeeyn, A., Al-Rawashdeh, S., AL-Atiyyat, N., ... & Al-Rjoub, S. (2024). Professional autonomy in nursing: a concept analysis. Sage Open, 14(4), 21582440241302129. [Google Scholar] [Crossref]
32. Nyelisani, M., Makhado, L., & Luhalima, T. (2023). Professional Nurses’ Experiences Regarding Continuing Professional Development (CPD) Opportunities at Public Hospitals of Limpopo Province, South Africa. Sage Open, 13(4), 21582440231210614. [Google Scholar] [Crossref]
33. Nyelisani, M., Ngcobo, M., & Makhado, L. (2023). Organizational support and professional development outcomes among nurses in public hospitals. International Journal of Nursing Sciences, 10(2), 215–222. https://doi.org/10.1016/j.ijnss.2023.03.005 [Google Scholar] [Crossref]
34. Ozkalay, G., & Karaca, A. (2021). Nurses’ attitudes toward change and the affecting factors. International Journal of Caring Sciences, 14(1), 362-369. [Google Scholar] [Crossref]
35. Philippa, R., Ann, H., Jacqueline, M., & Nicola, A. (2021). Professional identity in nursing: A mixed method research study. Nurse education in practice, 52, 103039. [Google Scholar] [Crossref]
36. Professional Regulation Commission. (2021). Revised guidelines on the implementation of the Continuing Professional Development Act of 2016. https://doi.org/10.13140/RG.2.2.21568.51207 [Google Scholar] [Crossref]
37. Pursio, K., Kankkunen, P., & Kvist, T. (2021). Nurses’ perceptions of professional autonomy in hospital settings: A cross-sectional study. Journal of Nursing Management, 29(5), 1180–1189. https://doi.org/10.1111/jonm.13261 [Google Scholar] [Crossref]
38. Pursio, K., Kankkunen, P., Mikkonen, S., & Kvist, T. (2024). Organizational characteristics of nursing practice environments related to registered nurses’ professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: structural equation modeling study. BioMed Center nursing, 23(1), 100. [Google Scholar] [Crossref]
39. Pursio, K., Kankkunen, P., Sanner‐Stiehr, E., & Kvist, T. (2021). Professional autonomy in nursing: An integrative review. Journal of nursing management, 29(6), 1565-1577. [Google Scholar] [Crossref]
40. Samuel, A., Cervero, R. M., Durning, S. J., & Maggio, L. A. (2021). Effect of continuing professional development on health professionals’ performance and patient outcomes: a scoping review of knowledge syntheses. Academic Medicine, 96(6), 913-923. [Google Scholar] [Crossref]
41. Samuel, A., Odinga, J., & Maina, P. (2021). Continuing professional development and evidence-based practice among healthcare professionals. BioMed Center Medical Education, 21(1), 1–8. https://doi.org/10.1186/s12909-021-02832-6 [Google Scholar] [Crossref]
42. Sufyani, H. A., Oqdi, Y. A., Alblowi, B. H., Alharbi, H. S., Albarqi, A. A., Al Saadi, E. S., ... & Alshomrany, Y. S. (2024). Theoretical Insights into the Role of Continuous Professional Development in Nursing Competency Enhancement. Journal of International Crisis and Risk Communication Research, 7(S6), 1910. [Google Scholar] [Crossref]
43. Tarhan, M. (2025). The relationship between attitudes towards professional autonomy and nurse–nurse collaboration: A cross‐sectional study. International Nursing Review, 72(2), e13039. [Google Scholar] [Crossref]
44. van der Cingel, M., & Brouwer, J. (2021). What makes a nurse today? A debate on the nursing professional identity and its need for change. Nursing philosophy, 22(2), e12343. [Google Scholar] [Crossref]
45. Vázquez-Calatayud, M., Errasti-Ibarrondo, B., & Choperena, A. (2021). Nurses’ continuing professional development: A systematic literature review. Nurse education in practice, 50, 102963. [Google Scholar] [Crossref]
46. Vázquez-Calatayud, M., Errasti-Ibarrondo, B., & Choperena, A. (2021). Nurses’ continuing professional development: A systematic review of international evidence. Journal of Clinical Nursing, 30(15–16), 2219–2234. https://doi.org/10.1111/jocn.15714 [Google Scholar] [Crossref]
47. Walter, J. K., & Terry, L. M. (2021). Factors influencing nurses' engagement with CPD activities: a systematic review. British Journal of Nursing, 30(1), 60-68. [Google Scholar] [Crossref]
48. Walter, S., & Terry, L. (2021). Continuing professional development in nursing: A concept analysis. Nurse Education Today, 102, 104907. https://doi.org/10.1016/j.nedt.2021.104907 [Google Scholar] [Crossref]
49. Wiisak, J., Stolt, M., Igoumenidis, M., Chiappinotto, S., Gastmans, C., Keogh, B., ... & Promocon Consortium. (2024). Factors contributing to the promotion of moral competence in nursing. Nursing Ethics, 31(8), 1367-1388. [Google Scholar] [Crossref]
50. Yu, F., Raphael, D., & Mackay, L. (2022). Nurses’ perceptions of continuing professional development: A cross-national study. Journal of Nursing Regulation, 13(1), 34–43. https://doi.org/10.1016/S2155-8256(22)00006-8 [Google Scholar] [Crossref]
51. Yu, X., Huang, Y., & Liu, Y. (2022). Nurses’ perceptions of continuing professional development: a qualitative study. BioMed Center nursing, 21(1), 162. [Google Scholar] [Crossref]
Metrics
Views & Downloads
Similar Articles
- Knowledge and Attitude of Undergraduate Nursing Students towards Organ Donation
- Cold Hip Bath Therapy for Labor Pain Management: A Review of Non-Pharmacological Interventions in Women's Health
- Work Settings Utilizing the S.C.O.R.E Model on the Psychological Empowerment of Hospital Nurses in Cebu City
- An Assessment on the Quality of Life of PLHIV Residents in Digos City Barangays: Basis for Health Teaching Program
- Work-Related Stress and Its Psychodermatological Impact on Nursing Professionals