In order to identify and prioritize the development needs of medical and surgical nurses, their possible approaches to learning, and the contextual factors influencing their professional development, a Delphi survey was carried out using a panel of 28 participants. Current development needs included skills in essential clinical care, specialist nursing, changing roles, patient care management, research and practice development. Although there was ambivalence about changing nurses' clinical roles, participants expected roles to diversify in the future. The need for responsiveness to change was emphasized, as was the need to maintain current areas of expertise. Professional development activity could take many forms, but fostering an organizational climate in which development was inherent in everyday working practices was felt to be as valuable as formal course attendance. Restricting factors included lack of time, resources, support and recognition. The survey has enabled professional and practice development activities to be prioritized locally, and the method used could be readily applied to other settings.