Exploring nurse practitioners' views on the key elements shaping their professional identities within interspecialty...

Nurse practitioners (NPs) with their boundary-spanning roles bridging gaps between nurses' and physicians' practices are equipped to address emerging demands for team-based care. Despite their significance, the different perspectives reflecting their understanding of what it takes to practice within this tactical yet highly contented 'third space' are missing. This study addresses how NPs think about their profession and the elements that define their professional identities.

Using Q methodology, which synthesizes quantitative and qualitative insights to investigate subjectivity, 41 NPs from diverse specialties were purposively recruited from five hospitals in Taiwan. Participants ranked 61 statements, representing elements of advanced nursing practice identity, into a fixed quasi-normal distribution grid (Q grid). The outcomes of their ranking (Q sorts) were analysed using R software to identify shared patterns of sorting (viewpoints). Viewpoint arrays were then constructed to reflect the archetypal respondents who load into a particular viewpoint. Interpretation synthesized distinguishing statements and post-sorting qualitative data to provide the rationale behind the identified viewpoints.

Thirty-six of 41 NPs loaded significantly into four distinct viewpoints: team-based care and specialty-specific competence (1), role acknowledgment and fair compensation (2), fulfilment and legislative recognition (3) and patient-focused collaboration with physicians (4). Each of the viewpoints highlights the interplay between internal perceptions of who NPs believe they are and external perceptions of how they think others perceive them.

The findings highlight the multifaceted nature of NPs' professional identity construction and development. Educationally, training that supports multiple ways of becoming an NP is needed. Using the four viewpoints as a framework, curricula should be designed to emphasize the acquisition of sub-specialty knowledge, promote institutional and professional recognition, foster emotional resilience and collaborative competencies. Making these elements explicit in curricula can better prepare NPs for the evolving realities of practice, enabling them to develop a sense of belonging and positive professional identities.