What makes continuing professional development clinically useful for nurses? A qualitative study across primary and hospital care in Spain

Continuing professional development is essential for maintaining nursing competence, but completing accredited education does not necessarily ensure clinically relevant or transferable learning. This study explored the characteristics nurses consider necessary for continuing professional development to be clinically relevant, credible, accessible, and applicable, and examined similarities and differences between primary and hospital care, using diabetes and ostomy care as clinical reference contexts. A qualitative descriptive–interpretive study was conducted with 28 nurses from nine Spanish autonomous communities: 11 worked in primary care and 17 in hospital settings. Data were collected through individual semi-structured interviews between January and June 2024. Purposive maximum-variation sampling included different age groups, professional experience levels, care settings, and generalist or expert profiles. Data were examined using thematic and comparative analyses. Five interrelated themes were identified: continuing professional development as a negotiated professional responsibility; the disconnect between credentialing and clinically meaningful learning; contextual alignment; credibility; and adaptive educational architecture. Nurses across settings valued current evidence, nursing-relevant content, competent educators, practical learning, accessibility, and organizational support. Primary care nurses prioritized broad, concise, and immediately retrievable resources, whereas hospital nurses emphasized specialized knowledge, procedures, devices, simulation, and supervised practice. Online education increased flexibility and geographic access but could facilitate superficial completion when poorly designed. Blended education was valued for connecting theoretical preparation with experiential learning. Clinically useful continuing professional development depends less on accreditation or modality alone than on the alignment of content with clinical needs, care context, credible evidence, educational design, and organizational conditions. Programs should be differentiated by setting and professional trajectory, include meaningful competency assessment, and be supported through protected learning time and opportunities to apply learning in practice.