Graduate education and competency development in advanced practice provider roles: A scoping review

The evidence base supporting the relationship between graduate education and the quality of advanced practice (AP) in healthcare remains limited and often fragmented across professional contexts. This project sought to understand more fully what evidence can provide insight to guide AP education and training in radiation therapy and other professions.

The protocol was registered with the Open Science Framework, https://doi.org/10.17605/OSF.IO/37J4S. Professions such as nursing, radiation therapy, medical imaging, and physician assistants were included. The review focused on graduate-level education, with the outcome assessed in terms of competency development, scope of practice, or professional role advancement. Multiple databases in OvidSP and Clarivate were searched from 2005 onwards, and records were imported into Covidence. Multiple reviewers reviewed the title and abstract and then the full-text records, and performed templated data extraction. Charted data included profession, type of study, study comparator and outcome.

Duplicates were removed from the 11,346 initially identified, leaving 6417 unique records. Based on initial screening, 111 were advanced to full-text review. Eleven articles were subsequently included, and three more were identified through manual reference searching, for a total of 14 articles from multiple countries. All were in the context of nursing, and 12 (85.7%) relied on survey data. Ten (71.4%) articles demonstrated significant benefit in graduate-level preparation for AP, though four of these were explicitly focused on doctoral-level education. None demonstrated a negative impact of a graduate degree.

The majority of the evidence assessed is at least weakly supportive of the role of graduate education in building necessary advanced competence. Such evidence is important to inform policy and standards and to avoid unjustified credential creep. There is more work needed to strengthen evidence, especially outside of nursing in aligned professions with advanced classes of practice.

Advanced practice roles in healthcare often require higher levels of education, but their benefits are not always clearly understood. This study reviewed research studies to understand how graduate education supports advanced practice roles. This study found that most evidence shows benefits in building skills and career development, mainly in nursing, with no negative effects reported. This matters because better evidence can help guide training, policy, and fair use of qualifications in healthcare.