In the last of four articles based on her study tour of the United States, Nursing Standard Editor Norah Casey considers the lessons which nurses in the UK can learn from the American experience of mandatory continuing education. The Credit Accumulation and Transfer Scheme seems to offer a suitable system of academic currency, but the problem of establishing the impact of continuing education on practice still has to be solved

There are many lessons to be iearned from the US experience of mandatory continuing education (CE). There are also significant differences in the US system which must betaken into account.