International Journal of Nursing Studies 42 (2005) 97–106 Illuminating continuing professional education: unpacking the black box Lorraine Ellis*, Mike Nolan School of Nursing and Midwifery, University of Sheffield, Bartolome House, Winter Street, Sheffield, S3 7ND, UK Received 10 November 2003; received in revised form 22 April 2004; accepted 11 May 2004 Abstract This paper reports on a longitudinal study of continuing professional education (CPE) in nursing using a case study approach operationalised within an illuminative evaluation model. Using a short focussed programme as an instrumental case study, the project gathered data from three major groups of stakeholders over an 18 month period in order to explore the context within which CPE operates, and to highlight those factors which appear to influence the outcomes of CPE over time. Data were collected using documentary analysis and in-depth semi-structured interviews with educators, students on the programme (the ENB 941), and their managers. The latter two groups were interviewed at four points in time (prior to the course, immediately post course, 6 and 12 months post course). Data analysis revealed that a complex set of factors interact to influence the outcomes of CPE, including the nature of the selection process, students’ expectations of the programme, the nature of the educational experience, and the receptivity of the practice environment to change. This paper identifies those factors that shape the outcomes of CPE and considers their implications for policy and practice. r 2004 Elsevier Ltd. All rights reserved. Keywords: Continuing professional education; Illuminative evaluation; Longitudinal case study; Practice change 1. Introduction The last 20 years have seen significant changes to the education of nurses at both pre- and post-registration levels. The impetus for this change has come from different and varied sources both within and outside the nursing profession. Under successive Governments the National Health Service (NHS) in the UK has been the subject of continuous review and modernisation that has necessi- tated the examination and revisioning of the provision of education for nurses. The modernisation of the NHS has its origins in a programme of reforms legislated for in the NHS and the Community Care Act in 1990, arguably one of the most radical and far reaching legislative changes of its time (Fields, 1991; Sunter, 1993). This act emerged, in part, in response to advances in research and technology, demographic changes such as an ageing population (WHO, 1979) and the concomitant changing health care needs of the United Kingdom. Hard on the heels of the NHS Act followed a series of NHS policies and reforms spanning the next decade (DoH, 1994, 1997, 1998a, b, 1999, 2001). The most recent of these is the NHS Plan that is designed to give the people of Britain a health service fit for the 21st century (DoH, 2002a, b). A major reconfiguration of the NHS workforce has followed as a consequence of these reforms resulting in a reduction in the working hours of doctors (DoH, 1991), the introduction of new roles such as the nurse consultant, and the inception of the modern matron role (DHSS, 1986; DoH, 1989, 1995; COD, 2002). ARTICLE IN PRESS *Corresponding author. E-mail address: l.b.ellis@sheffield.ac.uk (L. Ellis). 0020-7489/$ - see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ijnurstu.2004.05.006