Exploring advanced clinical practitioner perspectives on training, role identity and competence: a qualitative study

Area of Science:

• Healthcare Workforce Development
• Advanced Practice Nursing
• Medical Education

Background:

• Advanced Clinical Practitioners (ACPs) are integral to addressing NHS service pressures.
• ACPs possess capabilities comparable to mid-grade medical staff, enhancing patient care and service outcomes.
• A lack of standardized UK training leads to variability in ACPs' skills and experiences.

Purpose of the Study:

• To explore the training experiences of Advanced Clinical Practitioners (ACPs).
• To understand ACPs' perspectives on role identity.
• To gather insights into the future development of the ACP role.

Main Methods:

• Five online focus groups conducted with trainee and qualified ACPs in the North of England (March-May 2021).
• Exploration of supervision, competence acquisition, role identity, and career progression in ACP training.
• Thematic analysis of focus group transcripts guided by grounded theory principles.

Main Results:

• Training effectiveness was hindered by internal/external role perceptions and structural factors.
• Key themes included a lack of structured training, inconsistent support, and variable confidence levels.
• Poor understanding of the ACP role and responsibilities by both practitioners and the wider medical profession was evident.

Conclusions:

• Structured training and robust support are essential for ACPs' transition to advanced practice.
• Clear role definition, adequate learning time, accreditation, and supervision are vital for role sustainability.
• Structural changes and knowledge brokering are necessary to enhance role clarity and responsibilities.