References

Cheshire and Merseyside governance framework for advanced clinical practice: paediatrics and neonates. 2019a. https://tinyurl.com/bdhn53v9 (accessed 4 April 2022)

Cheshire and Merseyside governance framework for advanced clinical practice: paediatrics and neonates. 2019b. https://tinyurl.com/5fpzsp9h (accessed 4 April 2022)

Bates R. A critical analysis of evaluation practice: the Kirkpatrick model and the principle of beneficence. Evaluation and Program Planning. 2004; 27:(3)341-347 https://doi.org/10.1016/j.evalprogplan.2004.04.011

Bell J, Waters S. Doing your research project: a guide for first-time researchers, 6th edn. Maidenhead: Open University Press/McGraw-Hill Education; 2014

Benner P. From novice to expert, excellence and power in clinical nursing practice.Menlo Park, CA: Addison-Wesley Publishing Company; 1984

Bertheloot K, Deraeve P, Vermandere M How do general practitioners use ‘safety netting’ in acutely ill children?. Eur J Gen Pract. 2016; 22:(1)3-8 https://doi.org/10.3109/13814788.2015.1092516

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101 https://doi.org/10.1191/1478088706qp063oa

British Educational Research Association. Ethical guidelines for educational research. 2018. https://tinyurl.com/yvmb3hrd (accessed 4 April 2022)

Bryant-Lukosius D, DiCenso A. A framework for the introduction and evaluation of advanced practice nursing roles. J Adv Nurs. 2004; 48:(5)530-540 https://doi.org/10.1111/j.1365-2648.2004.03235.x

Bryant-Lukosius D, Spichiger E, Martin J Framework for evaluating the impact of advanced practice nursing roles. J Nurs Scholarsh. 2016; 48:(2)201-209 https://doi.org/10.1111/jnu.12199

Casey M, O'Connor L, Cashin A An overview of the outcomes and impact of specialist and advanced nursing and midwifery practice, on quality of care, cost and access to services: A narrative review. Nurse Educ Today. 2017; 56:35-40 https://doi.org/10.1016/j.nedt.2017.06.004

Chien LY. Evidence-based practice and nursing research. J Nurs Res. 2019; 27:(4) https://doi.org/10.1097/jnr.0000000000000346

Cohen L, Manion L, Morrison K. Research methods in education, 7th edn. London: Routledge; 2011

Dreyfus SE. The five-stage model of adult skill acquisition. Bull Sci Technol Soc. 2004; 24:(3)177-181 https://doi.org/10.1177/0270467604264992

Dunn K, Nicklin W. The status of advanced nursing roles in Canadian teaching hospitals. Canadian journal of Nursing Administration. 1995; 111-135

Evans JR, Mathur A. The value of online surveys. Internet Res. 2005; 15:(2)195-219 https://doi.org/10.1108/10662240510590360

Fitzpatrick S, Gripshover J. Expert nurse to novice nurse practitioner: the journey and how to improve the process. J Nurse Pract. 2016; 12:(10)e419-e421 https://doi.org/10.1016/j.nurpra.2016.05.012

Goldsberry JW. Advanced practice nurses leading the way: interprofessional collaboration. Nurse Educ Today. 2018; 65:1-3 https://doi.org/10.1016/j.nedt.2018.02.024

Gray A. Advanced or advancing nursing practice: what is the future direction for nursing?. Br J Nurs. 2016; 25:(1)8-13 https://doi.org/10.12968/bjon.2016.25.1.8

Green BN, Johnson CD. Interprofessional collaboration in research, education, and clinical practice: working together for a better future. J Chiropr Educ. 2015; 29:(1)1-10 https://doi.org/10.7899/JCE-14-36

Hanson J. Educational developers as researchers: the contribution of insider research enhancing understanding of role, identity and practice. Innovations in Education and Teaching International. 2013; 50:(4)388-398 https://doi.org/10.1080/14703297.2013.806220

Hart AM, Macnee CL. How well are nurse practitioners prepared for practice: results of a 2004 questionnaire study. J Am Acad Nurse Pract. 2007; 19:(1)35-42 https://doi.org/0.1111/j.1745-7599.2006.00191.x

Health Education England. Multi-professional framework for advanced clinical practice in England. 2017. https://tinyurl.com/yeyzzmtb (accessed 22 March 2022)

Hill LA, Sawatzky JA. Transitioning into the nurse practitioner role through mentorship. J Prof Nurs. 2011; 27:(3)161-167 https://doi.org/10.1016/j.profnurs.2011.02.004

Hulse AL. A multidisciplinary learning approach: a narrative review. Br J Nurs. 2022; 31:(7)364-370

Illingworth A, Aranda KF, De Goeas SM, Lindley PJ. Changing the way that I am: students experience of educational preparation for advanced nursing roles in the community. Nurse Educ Pract. 2013; 13:(5)338-343 https://doi.org/10.1016/j.nepr.2012.09.009

Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice: 2016. 2016. https://tinyurl.com/bdem9yws (accessed 22 March 2022)

Jain B. The key role of differential diagnosis in diagnosis. Diagnosis (Berl). 2017; 4:(4)239-240 https://doi.org/10.1515/dx-2017-0005

Keifenheim KE, Teufel M, Ip J Teaching history taking to medical students: a systematic review. BMC Med Educ. 2015; 15:(1) https://doi.org/10.1186/s12909-015-0443-x

King R, Tod A, Sanders T. Development and regulation of advanced nurse practitioners in the UK and internationally. Nurs Stand. 2017; 32:(14)43-50 https://doi.org/10.7748/ns.2017.e10858

Kirkpatrick DL, Kirkpatrick JD. Evaluating training programs: the four levels, 3rd edn. San Francisco, CA: Berrett-Koehler; 2006

Kolb DA. Experiential learning: experience as the source of learning and development.Englewood Cliffs, NJ: Prentice-Hall; 1984

Korstjens I, Moser A. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. Eur J Gen Pract. 2018; 24:(1)120-124 https://doi.org/10.1080/13814788.2017.1375092

Imposter syndrome: how it makes NHS managers doubt their abilities. 2015. https://tinyurl.com/mk9p49xj (accessed 5 April 2022)

Lyneham J, Parkinson C, Denholm C. Explicating Benner's concept of expert practice: intuition in emergency nursing. J Adv Nurs. 2008; 64:(4)380-387 https://doi.org/10.1111/j.1365-2648.2008.04799.x

Moore J. A personal insight into researcher positionality. Nurse Res. 2012; 19:(4)11-14 https://doi.org/10.7748/nr2012.07.19.4.11.c9218

Morgan C, Barry C, Barnes K. Master's programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics. Adv Med Educ Pract. 2012; 3:129-137 https://doi.org/10.2147/AMEP.S29270

Nadaf C. Perspectives: reflections on a debate: when does advanced clinical practice stop being nursing?. J Res Nurs. 2018; 23:(1)91-97 https://doi.org/10.1177/1744987117751456

NHS England/NHS Improvement. NHS long term plan. 2019. https://www.longtermplan.nhs.uk/ (accessed 22 March 2022)

NHS Leadership Academy. Leadership framework: a summary. 2011. https://tinyurl.com/3bmbj4zx (accessed 22 March 2022)

Parker JM, Hill MN. A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China. Int J Nurs Sci. 2017; 4:(2)196-204 https://doi.org/10.1016/j.ijnss.2017.01.002

Robeano K, Delong D, Taylor HA. Optimizing transitional support for novice nurse practitioners. Nurse Lead. 2019; 17:303-307 https://doi.org/10.1016/j.mnl.2019.03.020

Royal College of Nursing. RCN standards for advanced level nursing practice. 2018. https://tinyurl.com/47tzmkvn

Spitzer WO. Evidence that justifies the introduction of new health professionals. In: Slayton P, Trebilcock MJ (eds). Toronto: University of Toronto Press; 1978

Stasa H, Cashin A, Buckley T, Donoghue J. Advancing advanced practice—clarifying the conceptual confusion. Nurse Educ Today. 2014; 34:(3)356-361 https://doi.org/10.1016/j.nedt.2013.07.012

Towards a new model of leadership for the NHS. 2013. https://tinyurl.com/2p8t7jh6 (accessed 22 March 2022)

van der Vleuten CPM, Schuwirth LWT. Assessing professional competence: from methods to programmes. Med Educ. 2005; 39:(3)309-317 https://doi.org/10.1111/j.1365-2929.2005.02094.x

Assessing and evaluating adult learning in career and technical education. In: Wang VX (ed). : IGI Global (ebook); 2011 https://doi.org/10.4018/978-1-61520-745-9

Woo BFY, Lee JXY, Tam WWS. The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Hum Resour Health. 2017; 15:(1) https://doi.org/10.1186/s12960-017-0237-9

World Health Organization. Framework for action on interprofessional education and collaborative practice. 2010. https://tinyurl.com/ycy9kpbe (accessed 12 April 2022)

A multidisciplinary learning approach: training, preparation and role transition

21 April 2022
25 min read
Volume 31 · Issue 8

Abstract

The review in part 1 identified that, although studies address global differences in advanced practice roles, there is limited literature regarding training preparation and role transition, highlighting a gap in educational research.

Aim:

To explore trainee and qualified advanced practitioner learning experiences, how training has prepared learners for clinical practice and role transition. Evaluation of a multidisciplinary learning approach was sought, identifying its impact on developing collaborative learning and working partnerships.

Design and methods:

A small-scale, mixed-methods cross-sectional study was used to gather descriptive data. Convenience sampling was used with two groups: trainees and qualified advanced (paediatric) nurse practitioners/advanced clinical practitioners (ANPs/ACPs). All participants had completed or were undertaking master's level training. An anonymous, voluntary online survey was used to gather quantitative and qualitative data reflecting participant learning experiences. Evaluation research methodologies and their application were examined through exploration of three advanced practice frameworks and a well-established framework for evaluation of training.

Findings:

Overall, responses indicate positive learning experiences, and that current and previous ANP/ACP training in the UK does adequately prepare trainees for practice. However, further improvements in curriculum content are suggested. Consistent with the literature, collaborative multidisciplinary teaching, learning and mentorship were identified as key elements in the learning process and role transition.

A generic narrative review was undertaken in the first part of this discussion (Hulse, 2022), exploring the global development of advanced practice. The review concluded that there are vast global differences in advanced practice definition and roles, with a lack of standardised curriculum structure and limited literature surrounding advanced clinical practitioner (ACP), including advanced nurse practitioner (ANP), training preparation and role transition. The review did, however, highlight the importance of interprofessional education and interprofessional collaboration through teaching and clinical mentorship during and after training. With advanced clinical practice firmly embedded across multiple disciplines in health care, promotion of ongoing multidisciplinary collaborative working partnerships is central to improving healthcare services and to meet ongoing complex healthcare demands worldwide (Interprofessional Education Collaborative (IPEC), 2016; Health Education England (HEE), 2017).

There are a number of well-established learning theories and educational frameworks that relate to practitioner development of knowledge and skill acquisition. Benner's (1984) widely used novice-to-expert theory describes a five-stage learning journey and is arguably the best description of role transition for emerging novice ACP/ANPs (Lyneham et al, 2008). Benner's model applies the Dreyfus (1984) model of skill acquisition, which differentiates between ‘experienced’ and ‘novice nurse’. The Dreyfus (1984) model describes a five-stage process of the learning journey:

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content