The aim of this study was to measure professional nurses’ readiness for lifelong learning and identify contextual factors influencing CPD participation in Gauteng public healthcare settings. Specific objectives were to:

This study contributes empirical evidence addressing critical knowledge gaps regarding CPD dynamics in resource-constrained public healthcare. By integrating psychometric measurement of learning readiness with contextual barrier analysis, findings inform multilevel interventions targeting individual capacity building, organisational support enhancement, and policy-level workforce planning. The results advance understanding of nursing management and workforce development, areas of critical importance in healthcare practice. The study’s significance extends beyond Gauteng to similar resource-limited settings globally where healthcare workforce development challenges persist.

Lifelong learning in nursing encompasses formal continuing education, informal workplace learning, and self-directed professional development activities enabling nurses to maintain and enhance competence throughout their careers (Gopee 2005; Shahhosseini & Hamzehgardeshi 2015). Knowles’ andragogy theory provides a foundational understanding of adult learning principles, emphasising self-directed learning as central to professional development (Knowles, Holton & Swanson 2015). Self-directed learning readiness – the degree to which individuals possess attitudes, abilities, and personality characteristics necessary for autonomous learning – significantly influences CPD engagement (Fisher, King & Tague 2001; Guglielmino 1977).

This study employs an integrated conceptual framework to examine CPD engagement as the outcome of interactions between individual factors and contextual moderators. Individual factors comprise self-directed learning readiness and desire for learning (intrinsic motivation), representing nurses’ internal capacity and drive for professional development. Contextual moderators encompass organisational support dimensions (staffing adequacy, protected learning time, managerial encouragement), infrastructure availability (technology access, learning resources), and systemic conditions (workload pressures, financial constraints). The framework posits that high individual readiness is necessary but insufficient for sustained CPD participation; enabling contextual conditions are essential for translating motivation into action. This perspective aligns with situated learning theory (Lave & Wenger 1991), which emphasises that learning occurs within and is shaped by organisational and social contexts.

Intrinsic learning motivation, operationalised as desire for learning, represents the internal drive to engage in learning for inherent satisfaction rather than purely external rewards (Deci & Ryan 2000; Ryan & Deci 2020). Research demonstrates that nurses with higher self-directed learning readiness and intrinsic motivation engage more consistently in CPD activities and demonstrate superior clinical competence (Khodamoradi et al. 2019; Slater, Cusick & Louie 2017).

International literature identifies multiple barriers to nurse CPD, including time constraints, financial limitations, family responsibilities, inadequate organisational support, and accessibility challenges (Govranos & Newton 2014; Pool et al. 2016). In African contexts, these barriers intensify because of severe staff shortages, limited budgets, inadequate infrastructure and competing healthcare priorities (Bvumbwe & Mtshali 2018; Nsemo et al. 2013).

South African studies indicate that public sector nurses face particularly acute challenges. Armstrong and Rispel (2015) documented that nurse-patient ratios in Gauteng public hospitals frequently exceed safe levels, creating workload pressures that prevent learning participation. Rispel and Bruce (2015) identified inadequate managerial support and the absence of protected learning time as significant constraints. Mlambo et al. (2021) highlighted that while nurses value CPD conceptually, structural barriers render participation episodic rather than sustained.

Despite this evidence, limited research quantitatively measures the gap between nurses’ readiness for learning and actual participation rates, or systematically examines how organisational factors moderate the relationship between individual motivation and CPD engagement. This study addresses this gap through integrated measurement of individual dispositions and contextual constraints.

The coronavirus disease 2019 (COVID-19) pandemic accelerated the adoption of online and blended learning approaches in nursing CPD (Shen et al. 2021). While technology-enhanced learning offers flexibility, potentially overcoming traditional barriers, it requires adequate infrastructure and digital literacy (Rouleau et al. 2019). In resource-constrained settings, technology access inequities may create additional barriers, with CPD opportunities becoming accessible only to nurses with personal resources for devices and internet connectivity. Understanding nurses’ technology access and learning format preferences is essential for designing equitable contemporary CPD interventions.

A quantitative, descriptive, cross-sectional design was employed to measure professional nurses’ learning readiness and to explore contextual factors at a single time point. The study was conducted in three purposively selected Gauteng province public hospitals representing diverse contexts: Hospital A (tertiary, Charlotte Maxeke Cluster, 1000 beds), Hospital B (tertiary, Steve Biko Cluster, 800 beds), and Hospital C (district, George Mukhari Cluster, 200 beds). These hospitals serve predominantly resource-constrained communities and employ large professional nursing workforces.

The target population comprised all professional nurses employed in the selected hospitals (N = 270). Inclusion criteria were: (1) registered professional nurse with SANC, (2) employed full-time at study site, and (3) minimum 6 months’ experience at current facility. Exclusion criteria were: (1) student nurses, enrolled nurses, or nursing assistants, (2) nurses on extended leave and (3) temporary or locum staff.

Proportional stratified sampling ensured representation across hospital types and sizes. The target sample was 270 nurses (Hospital A: n = 135; Hospital B: n = 109; Hospital C: n = 26). The final sample comprised 158 respondents (Hospital A: n = 89; Hospital B: n = 53; Hospital C: n = 16), yielding a 58.5% response rate.

A self-administered questionnaire comprised four sections:

Section A: Demographic information: Eight items capturing gender, age, ethnicity, work experience, hospital affiliation, and qualifications.

Section B: Self-directed learning readiness: Seventeen items adapted from Fisher et al.’s (2001) Self-Directed Learning Readiness Scale, rated on a five-point frequency scale (‘I feel this way all the time’ to ‘I feel this way less than usually’). Items measured learning autonomy, responsibility-taking, information-seeking skills, and theory-practice integration.

Section C: Desire for learning: Eight items adapted from Fisher et al.’s (2001) scale measuring intrinsic learning motivation, rated on a five-point agreement scale (‘Strongly agree’ to ‘Strongly disagree’). Items assessed learning enjoyment, persistence, openness to new ideas, and reflective practice.

Section D: Workplace learning opportunities: Mixed-format items (yes/no questions, multiple-choice, open-ended responses) explore availability of CPD opportunities, participation patterns, barriers encountered, learning preferences, technology access, and future learning interests.

Instrument adaptation involved language simplification for the South African context, removal of problematic items identified in pilot testing, and addition of context-specific barrier questions.

Face and content validity were established through expert review by nursing education faculty (n = 3) and practising nurse managers (n = 2). Pilot testing with 30 professional nurses from non-study hospitals revealed initial reliability coefficients of α = 0.66 (Section B) and α = 0.71 (Section C). Item analysis identified poorly performing items that were revised or removed.

The main study’s reliability analysis demonstrated excellent internal consistency for Sections B (α = 0.95) and C (α = 0.92). Exploratory factor analysis of Section C revealed a single dominant factor explaining 65.9% of variance (Kaiser–Meyer–Olkin measure = 0.89; Bartlett’s test χ²(28) = 893.57, p < 0.001), confirming construct validity. All items demonstrated factor loadings > 0.62, indicating strong relationships with the underlying construct.

Data were collected from June– to December 2025 using dual-mode administration (online via Google Forms and paper-based formats) to maximise accessibility. Nurse managers distributed study information and links to the questionnaire. Voluntary participation and anonymity were emphasised. Completed questionnaires were returned directly to researchers, bypassing management to ensure confidentiality.

Data were analysed using Stata 17. Descriptive statistics (frequencies, percentages, means, standard deviations) summarised demographic characteristics and questionnaire responses. Reliability analysis employed Cronbach’s alpha coefficients and item-total correlations. Exploratory factor analysis used principal component factoring with Kaiser criterion (eigenvalue > 1) for factor retention. Exploratory factor analysis was prioritised for the desire for learning scale because of its adaptation and theoretical centrality to intrinsic motivation. Open-ended responses underwent content analysis with thematic categorisation and frequency counts.

Ethical clearance to conduct this study was obtained from the University of Johannesburg’s Faculty of Health Sciences Research Ethics Committee on 14 November 2024. The ethical clearance number is REC-3223-2024; and Gauteng Department of Health (Protocol number: GP_202405_012). All participants provided written informed consent after receiving comprehensive study information. Participation was voluntary with no consequences for declining or withdrawing. Anonymity was maintained through coded responses without personal identifiers. Data were stored securely on password-protected devices accessible only to researchers. The study posed minimal risk to participants, involving only the completion of a questionnaire. No vulnerable populations were included. Findings will be disseminated through publications and presentations while maintaining participant confidentiality.

The sample (n = 158) comprised predominantly female (80.4%) and black African (94.9%) nurses of diverse ages (19.6% aged 21–29 years; 55.0% aged 30–44 years; 25.3% aged 45+ years). Work experience ranged from 1–5 years (15.2%) to 21+ years (13.9%), with the largest representation in the 6–10 years category (27.8%). Hospital distribution was: Hospital A 56.3% (n = 89), Hospital B 33.5% (n = 53), and Hospital C 10.1% (n = 16). The majority held nursing diplomas as a basic qualification, consistent with South Africa’s nursing education transition from diploma to degree pathways. Table 1 presents detailed demographic characteristics.

Section B responses revealed that nurses possess key self-directed learning attributes, although expression varies contextually. Across all 17 items, 67.7%–79.8% of responses selected ‘I sometimes feel this way’, with mean scores ranging from 3.2 to 3.8 on the five-point scale. Items indicating the strongest self-directed tendencies included:

Items indicating occasional dependency or challenges included:

The predominance of ‘sometimes’ responses suggests that while nurses possess self-directed learning dispositions, contextual factors influence whether these capacities manifest consistently in practice. Overall, the pattern reflects latent self-directed capacity constrained by contextual variability rather than absence of readiness.

Section C responses demonstrated strong endorsement of core professional learning values, although tempered by workplace realities. Across all eight items, 56.3%–63.9% selected ‘Neutral’, with combined positive responses (agree or strongly agree) ranging from 34.2% to 40.5%. Items with the strongest positive endorsement included:

Disagreement was minimal across all items (0.6%–4.4%), indicating underlying positive learning orientations even among neutral respondents. The neutral response dominance suggests nurses conceptually value learning, but practical enthusiasm is tempered by contextual constraints.

An overwhelming majority (94.3%, n = 149) reported that their workplace had provided learning opportunities post-qualification. However, among those with available opportunities, only 51.0% (n = 78) actually participated, while 47.7% (n = 73) did not participate despite availability. This reveals a critical availability–accessibility gap: opportunities exist, but substantial barriers prevent nurses from accessing them.

Among the 73 nurses who did not participate despite available opportunities, content analysis revealed significant barriers, as presented in Table 2.

Staff shortage emerged as the predominant constraint (41.1%), preventing nurses from attending even when motivated and when opportunities existed. This finding is critical: the primary barrier is structural/systemic rather than individual.

Figure 1 illustrates the dramatic gap between availability of opportunities, interest in learning and actual participation – demonstrating the motivation-barrier paradox central to this study’s findings.

This visualisation demonstrates that the problem is not a lack of motivation (98.7% interested) or a lack of organisational provision (94.3% have opportunities), but rather systemic barriers that prevent nurses from accessing available opportunities.

Future learning interest was nearly universal (98.7%, n = 153), with only two nurses expressing disinterest – both because of systemic barriers (selection inequity and approaching retirement) rather than a genuine lack of interest. This confirms exceptionally high motivation despite participation barriers.

Learning frequency preferences strongly favoured monthly opportunities (90.4%) over weekly (9.6%), likely reflecting workload realities. Format preferences were predominantly blended learning combining face-to-face and online (82.5%), with only 14.3% preferring face-to-face exclusively and 2.6% online exclusively.

Topics of interest revealed extraordinary diversity (over 100 distinct topics mentioned), with highest frequencies for:

This diversity indicates that CPD models must accommodate varied interests across clinical specialties, management, public health, and emerging technologies rather than standardised programming.

Despite 82.5% preferring blended learning formats, significant technology infrastructure deficits were evident, as presented in Table 3.

This technology gap creates a critical mismatch between preferred learning formats (82.5% want blended learning) and available infrastructure (84% lack workplace internet/computers), potentially shifting costs to individual nurses and creating socioeconomic inequities.

A substantial 62.2% (n = 97) had participated in learning opportunities outside the workplace, indicating nurses actively seek CPD beyond employer-provided programmes. This demonstrates not only strong intrinsic motivation but also highlights potential inequities favouring nurses with financial and temporal resources to pursue external learning.

Staff shortage emerged as the dominant barrier (41.1% as shown in Table 2), far exceeding other constraints. This finding aligns with documented nurse–patient ratio challenges in South African public healthcare (Armstrong & Rispel 2015) but empirically quantifies its specific impact on CPD participation. The prevalence of this barrier reveals that adequate staffing is not merely a workforce management issue but a foundational prerequisite for professional development. When releasing nurses for training compromises patient care, organisations face impossible choices between immediate service delivery and long-term workforce competence.

This finding has profound implications for CPD policy. Traditional approaches emphasising training programme development or individual motivation enhancement are insufficient when the healthcare system’s fundamental staffing crisis prevents participation. Effective CPD facilitation requires integrated workforce planning addressing both adequate staffing levels and protected learning time, challenging the siloed approach in which staffing and professional development are managed separately.

The predominance of ‘sometimes’ responses (67.7%–79.8%) across self-directed learning items reveals that readiness is not a stable trait but a context-dependent capacity. Nurses possess self-directed learning dispositions – evidenced by strong endorsement of intrinsic motivation (22.2%–23.4% frequent), responsibility-taking (20.3%) and theory-practice integration (23.4%) – but express these behaviours variably depending on organisational conditions. This pattern aligns with situational learning theory (Lave & Wenger 1991), suggesting self-directed learning emerges from interactions between individual capacity and environmental affordances.

This finding challenges individualistic CPD interventions focused solely on enhancing nurse readiness. While nurses demonstrate foundational readiness, translating this into consistent learning behaviour requires organisational enablers: manageable workloads, accessible resources, protected time and supportive cultures. The concept of readiness must be reconceptualised not as an individual attribute to be developed but as a contextually enacted capacity requiring supportive conditions.

The gap between learning format preferences (82.5% want blended learning, as shown in Table 3) and infrastructure availability (84% lack workplace internet and/or computers) represents a critical contemporary challenge. As CPD increasingly incorporates online components (Rouleau et al. 2019; Shen et al. 2021), technology infrastructure becomes foundational rather than supplementary. The current deficit creates inequitable access where online learning depends on personal resources – devices, home internet, data costs – thereby disadvantaging nurses with limited financial means.

This finding extends beyond infrastructure provision to raise fundamental equity concerns. When contemporary CPD assumes access to technology, structural inequities in South African society (income disparities, geographic digital divides, differential home connectivity) directly translate into professional development inequities. Organisations must either provide workplace technology infrastructure enabling equitable access or risk entrenching socioeconomic disadvantages into professional advancement opportunities.

Findings reveal that organisational support extends beyond opportunity provision to encompass multiple enabling dimensions, as evidenced in Table 2:

Current organisational support is incomplete: opportunities exist (94.3%), but enabling conditions often do not. This incompleteness explains the participation gap illustrated in Figure 1. Comprehensive organisational support requires simultaneous attention to all dimensions rather than piecemeal interventions.

The finding that 62.2% pursue external learning demonstrates nurses’ commitment to professional growth despite workplace barriers. However, this self-directed compensation strategy raises equity concerns. Nurses with financial resources, supportive families, and flexible personal circumstances can supplement inadequate workplace CPD through external courses, conferences or online programmes. Those lacking these resources experience compounded disadvantage: workplace barriers prevent access to organisational CPD, while personal constraints prevent access to external alternatives. This dynamic may contribute to competency gaps that correlate with socioeconomic factors rather than professional commitment.

These findings necessitate reconceptualising CPD facilitation from individual-focused interventions towards multi-level ecological models addressing four interconnected levels:

Effective CPD facilitation requires simultaneous intervention across all levels. Individual motivation enhancement without organisational enablement merely widens the motivation–participation gap, while organisational programming without addressing systemic workforce challenges creates opportunities nurses cannot access.

Study strengths include validated instruments with excellent reliability (α = 0.92–0.95), a diverse sample across hospital types and career stages (Table 1) and integration of psychometric measurement with contextual barrier analysis. The 58.5% response rate, while lower than anticipated, provided adequate statistical power for descriptive and exploratory analyses.

Limitations include a cross-sectional design precluding causal inference, reliance on self-reported data susceptible to social desirability bias (although frequency framing may have mitigated this), ethnic homogeneity (94.9% black African, as shown in Table 1) constraining diversity analysis and a Gauteng-specific context potentially limiting transferability. In addition, the study measured readiness and motivation but not actual learning outcomes or competency improvements, leaving the relationship between CPD participation and professional competence unexamined.