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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.
Aims And Objectives:
The mixed-method review aimed to synthesize research on how clinical nurse specialists' expertise develops from novice to expert and how this progression can be supported.
Methodological Design And Justification:
The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered on PROSPERO. A mixed-methods approach was used to combine qualitative and quantitative data and enhance the robustness of the findings.
Research Methods:
Literature search was conducted in CINAHL, PubMed and Scopus in September 2024. The selection and quality assessment of the studies were performed using JBI critical appraisal tools. The synthesis was based on qualitative and quantitative studies, using Benner's 'From Novice to Expert' model as a framework.
Ethical Issues And Approval:
Ethical approval was not required for this study.
Outcome Measures:
The main outcomes were stages of expertise development and factors supporting progression.
Results:
Eleven articles were included for review. Becoming a clinical nurse specialist requires a basic nursing degree, clinical experience and a higher education degree. According to the results, expertise was seen to develop through three stages: novice, competent and expert, with the support of organizations, mentors, colleagues and multi-professional collaboration. Pursuing continuing education while gaining experience is essential to carry on the journey towards expertise.
Study Limitations:
The study screening process may have introduced selection bias, potentially leading to the omission of relevant articles. Additionally, selected articles on other interventions, such as service development, were excluded. However, they could have provided further insights into development.
Conclusions:
This review shows that developing CNS expertise from novice to expert requires education, clinical experience, and continuous professional support. Strengthening structures and collaboration enhances patient care, while further research on support strategies and competencies is needed.
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