Transitioning from an advanced clinical practitioner (ACP) role into one in higher education presents a unique set of challenges. ACPs, who typically have extensive clinical experience and work at a high level of autonomy, are expected to engage across four pillars of practice: clinical practice, leadership, research, and education (Health Education England (HEE), 2017). However, moving into academia often requires a shift in professional identity and the development of new skills, particularly within teaching and research.
These transitions can be complex and involve navigating new institutional cultures, role expectations and a redefinition of their professional self.
Identity shift and professional role
Advanced practice is defined as a level of practice – it is not a job title – and it applies across multiple health professions. It is characterised by high levels of autonomy, complex decision-making, leadership and applying evidence to practice. As professionals working at this level move into academic roles many experience a significant shift in their sense of identity.
Although direct research on ACPs transitioning into academia is limited, related studies highlight key challenges. Murray et al (2014) have described a staged identity shift from clinician to academic, involving early vulnerability, adaptation to unfamiliar expectations and eventual development of a new academic identity. Others have similarly reported that many of those moving across to academia describe themselves as ‘clinically confident but academically uncertain’ (Barken and Robstad, 2024), reflecting ongoing identity negotiations.
Hill (2017) highlighted that advanced practice roles already involve complex and sometimes ambiguous professional identities. These tensions may intensify during transition into academic roles, where clinical expertise is not always clearly recognised or valued.
This identity shift can be viewed through Wenger's (1998) concept of identity as socially constructed and formed through participation in professional communities. It may also be understood as a liminal space, neither fully clinical nor fully academic, – where identity is in flux (Turner, 1969) – or as a transformative learning experience triggered by disorienting dilemmas (Mezirow, 1991).
Consequently, supporting ACPs in these transitions involves more than skills development, they need to be allowed space for reflection, mentorship and validation of their evolving professional identity.
Skill adaptation
ACPs bring a wealth of clinical knowledge and expertise to their teaching roles, however the skills required for effective teaching and academic work differ from those used in clinical practice. Effective teaching involves understanding educational theories, curriculum development, assessment methods and student engagement techniques (Ireland and Majewska, 2024).
Developing these new skills requires time and effort. ACPs may need to undertake formal training in educational methods, seek mentorship from experienced educators, and engage in continuous professional development to hone their teaching abilities. Balancing this skill development with ongoing clinical responsibilities can be challenging, especially for those who continue to practise part time while teaching.
Institutional dynamics
Higher education institutions operate under different structures and cultures compared with healthcare settings. Understanding and navigating these dynamics is essential for ACPs transitioning into academic roles. Academic institutions have specific policies, procedures and hierarchies that can be unfamiliar to those coming from a clinical background.
For instance, the expectations around research productivity, securing funding and publishing in peer-reviewed journals can be overwhelming for new academic staff. Additionally, the collegial and often competitive nature of academic environments can be a stark contrast to the collaborative and team-oriented culture of clinical practice.
Building networks and relationships within the academic community is crucial. Mentorship from experienced academics offers essential guidance and support during the transition to academic roles (McIntosh, 2024). In addition, engaging in faculty development programmes and contributing to academic committees can support ACPs in becoming familiar with the expectations of higher education and navigating institutional culture more effectively.
Balancing act
One of the most significant challenges for ACPs in higher education is balancing the demands of teaching, research and any ongoing clinical practice. Academic roles typically require a combination of teaching, conducting research and contributing to administrative duties. Managing these responsibilities simultaneously can be overwhelming.
Time management and prioritisation become critical skills in this context. ACPs must learn to allocate their time effectively, ensuring that they meet their teaching commitments, pursue their research interests and, if applicable, maintain their clinical practice. This balancing act often requires excellent organisational skills and the ability to set clear boundaries to prevent burnout.
Emotional and psychological adjustments
The transition from clinical practice to academia can also involve significant emotional and psychological adjustments. ACPs may experience feelings of imposter syndrome, doubting their ability to succeed in an academic role despite their clinical expertise. The pressure to publish, secure research funding, and meet academic expectations can contribute to stress and anxiety (Ross et al, 2024).
Support systems and self-care strategies are essential in managing these challenges. Institutions can play a role by providing mental health resources, peer support groups, and professional development opportunities focused on building resilience and coping strategies. ACPs themselves should also prioritise self-care, seeking balance and maintaining a healthy work-life integration.
Opportunities
Despite the challenges, transitioning from an ACP role into higher education also presents numerous opportunities for growth and development. Academia offers a platform to influence the next generation of health professionals, contribute to the advancement of knowledge through research and engage in interdisciplinary collaboration.
ACPs bring a unique perspective to academia, grounded in practical, real-world experience. This can enrich the educational experience for students, by bridging the gap between theory and practice. Moreover, engaging in research allows ACPs to explore areas of interest, contribute to evidence-based practice and influence healthcare policy and practice on a broader scale.
Conclusion
Transitioning from an ACP role into higher education is a complex and multifaceted process, marked by significant challenges and opportunities. ACPs must navigate identity shifts, develop new skills, understand institutional dynamics, balance multiple responsibilities, and manage emotional and psychological adjustments.
However, with the right support and resources, they can successfully make the transition and thrive in their new roles, ultimately contributing to the betterment of healthcare education and practice.