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Clinical Nurse Specialists' Journey From Novice to Expert-A Systematic Mixed-Method Review.
Sanna Marika Imeläinen1, Tarja Anneli Kvist1, Mea Mirella Marjatta Wright1
1Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Scandinavian Journal of Caring Sciences
|July 15, 2026
Summary
Clinical nurse specialist (CNS) expertise develops through novice, competent, and expert stages, requiring education, experience, and support. Continuous learning and collaboration are key to advancing CNS roles and improving patient care.
Area of Science:
- Nursing Science
- Healthcare Professional Development
- Clinical Expertise
Background:
- Understanding the developmental trajectory of clinical nurse specialists (CNS) from novice to expert is crucial for effective professional support.
- Existing literature synthesis is needed to identify key factors influencing CNS expertise progression and inform educational strategies.
Purpose of the Study:
- To synthesize research on the development of clinical nurse specialist expertise.
- To identify factors that support the progression of CNS expertise from novice to expert.
- To provide evidence-based recommendations for fostering CNS professional growth.
Main Methods:
- A mixed-method systematic review was conducted, adhering to PRISMA guidelines and registered on PROSPERO.
- Literature searches were performed in CINAHL, PubMed, and Scopus.
- Benner's 'From Novice to Expert' model served as the framework for synthesizing qualitative and quantitative data using JBI critical appraisal tools.
Main Results:
- Eleven articles were included, indicating that becoming a CNS requires a basic nursing degree, clinical experience, and higher education.
- Expertise development progresses through novice, competent, and expert stages, facilitated by organizational support, mentorship, collegial relationships, and interprofessional collaboration.
- Continuous education alongside experience is vital for advancing along the expertise continuum.
Conclusions:
- Developing CNS expertise necessitates a combination of formal education, practical experience, and ongoing professional support.
- Enhanced organizational structures and collaborative practices are essential for improving patient care outcomes.
- Further research is warranted to explore optimal support strategies and core competencies for CNS development.
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