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Trainee ANPs' experiences of having a clinical practice facilitator introduced into a Hospital at Night team

23 May 2024
Volume 33 · Issue 10



The role of the advanced nurse practitioner (ANP) within Hospital at Night (H@N) teams has emerged in line with the demands of the service and the needs of patients in the out-of-hours period. The majority of ANPs with H@N teams are recruited as trainees. There is a high volume of trainees needing support against a low number of experienced ANPs. Introduction of the clinical practice facilitator (CPF) role is one way of addressing these issues. Within this evaluative study of one H@N service, the CPFs are experienced ANPs who have received additional training in the delivery of practice assessment and learner feedback.


To explore the experiences and perceptions of those trainee ANPs who have had or are currently receiving support and supervision from the CPFs in an H@N service in one Scottish NHS health board.


The CPFs undertook a service evaluation following introduction of the role. Purposive sampling was undertaken whereby a descriptive questionnaire was sent to 22 eligible participants.


16 questionnaires were returned. Qualitative data from the questionnaire generated several themes from the participants' responses: validation of competencies, supporting wellbeing, accessibility of support, designated prescribing practitioner role and support post-qualification.


CPFs are ideally placed to meet the required needs of trainees. Organisational commitment is key to ensuring ANPs are in optimal positions to provide support and supervision for the next generation of trainees.

In Scotland, the majority of trainee advanced nurse practitioners (ANPs) are registered nurses undertaking postgraduate education through a collaborative pathway between employer and a higher education institute. Core modules undertaken often include advanced patient history taking and clinical examinations, work-based learning and independent non-medical prescribing to achieve a minimum requirement of a Postgraduate Diploma in Advanced Practice. Some are working towards a Master's in Advanced Practice. The majority of the nursing team in Hospital at Night (H@N) services are recruited as trainees in the first instance, and the service will support them to the role of ANP.

Montgomery et al (2021) acknowledged the challenges of supporting staff to undertake training in the out-of-hours period. Despite a real willingness to learn, Haslam (2021) argued that lack of access to clinical support and supervision remains the most significant barrier. Similar to the findings from other clinical environments, it would appear that the majority of clinical supervision for advanced practice comes from medical colleagues (Guevara et al, 2020; Mundy and Pow, 2021; Lee et al, 2023). This model for supervision is particularly problematic for trainee ANPs in a H@N context for a number of reasons. These include the high volume of trainees needing support against a low number of experienced ANPs; rotating medical colleagues meaning supervision is often ad hoc with little consistency; and medical consultants working during the ‘in hours’ period. This results in ANP trainees doing much of the necessary learning in their own time, outside working hours.

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