The design and delivery of Canadian nursing regulators’ continuing competence programs: An environmental scan

Background The development, maintenance, and enforcement of Continuing Competence Programs (CCPs) is a core function of nursing regulators in Canada. Although regulators invest significant resources into these programs, there is limited evidence about how they impact workforce and patient safety outcomes. Furthermore, nursing regulators across Canada operate within their unique jurisdictional and professional contexts and have varied regulatory approaches. Purpose This study aimed to identify the similarities and differences in CCP features across Canadian nursing regulators to inform the development of targeted research questions and thus advance theory-informed CCPs. Methods Between January and March 2025, we conducted an environmental scan of 22 nursing regulators across Canada using publicly available information posted on regulators' websites. Data were extracted using a structured extraction form and analyzed using directed content analysis to compare program structures and features. Results All 22 nursing regulators in Canada require registrants to participate in annual CCPs as a regulatory requirement. While the core features of completing a self-assessment, learning plan, learning activities, and evaluation are consistent, differences exist in the level of guidance offered, the prescriptiveness of requirements, and audit practices. Conclusions Additional research is needed to inform the design of CCPs for optimal impact. There is no one-size-fits-all approach, and adopting a realist approach to future research can drive the development of theory-informed programs and strategies to understand which strategies work, for whom, and when. Evidence generation can help regulators move toward rigorous and responsive regulation.