The effectiveness of flexible modes of learning in postregistration nursing, midwifery, and health visiting education and practice in England was examined through three surveys and case studies. Of the 874 questionnaires mailed to institutions (colleges of nursing, colleges of higher education, National Health Service (NHS) trusts, hospices, and private-sector institutions), 263 were returned (overall response rate, approximately 30%). The second survey was sent to 31 colleges of nursing and elicited a 100% response. The third survey was sent to 477 representatives of the same institutions the 90th percentile of their high school classes. Postests, administered since 1983, show continuing education for nurses/midwives has had mixed consequences, including the following: the modular nature of programs sometimes leads to a lack of cohesion, reduced sense of organizational unity, marginalization of educators' and organizations' needs, increased stress on teachers, greater consideration of prior experiential learning, reinforcement of the view that the nursing knowledge held by practitioners is important. Appended are the following: questionnaires; performance indicators; interview schedules; dimensions of flexible learning in postregistration nurse education; and list of members of the expert group. Contains 58 references. (MN)