The Concept
of Advanced Practice
Foundations of Advanced Practice
APH4000
November 2008
Concepts
A mental image of a phenomenon, idea or a
construct in the mind about a thing or action
Kaplan, 1964
‘…Categorising all the things that are alike about
them…’
Walker L & Avant K (2005) Strategies for Theory Construction in
Nursing
Pearson/Prentice Hall New Jersey
Concept analysis
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Language we use to communicate AP to other
people
Words and terms used to describe AP
Attribute meaning
Be able to debate AP
Reduce ambiguity
Determines the attributes and characteristics that
make AP unique from other concepts (nurse
practitioner, specialist, extended scope, doctor)
Careful examination of AP literature
Explanation of what is an AP and how it is
not like ?
Gives us an operational definition
Clarifies vagueness
Standard language
What is our concept?
Advanced Practice
Identify when and how its used in literature
What are the characteristics of AP?
Model AP case
Has all defining attributes
Well if that’s not AP I don’t know what is?
What things are different?
Is there anything missing?
GMSHA (NHSNW)
An Advanced Practitioner is an
Experienced non-medical registered professional who
has developed his or her knowledge to a very high
standard in a specific and often high level of practice.
This high standard is such that not only is the
individual the expert in the base domain:- but can also
accept the full responsibilities for providing those
services hitherto supplied by doctors, in defined
circumstances.
J. Sargent 2003
Process
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Select a concept
Determine the aims/purpose of analysis
Identify all the uses of the concept you can
Determine the defining attributes
Identify a model case
Identify borderline, related, contrary, invented
and illegitimate cases
Identify antecedents and consequences
GMSHA
Advanced Level of Practice
Expert practitioner
Transformational leadership
A high level of communication & influencing
skills, deals with complexity
Develops policy, does not work through
protocols
High level decision-making
Utilisation & application of research &
evidence based practice & knowledge
A Progressive, critical thinker / challenger
Change agent
What?
Concept – Advanced Practitioner
Capture the critical elements at this moment in
time from your own experiences
Allows differentiation ie like and also unlike
Enable you to communicate your role to
colleagues/other professionals
Negotiate responsibilities etc
Why?
Discriminate between AP and other
roles/titles
Where?
Consider all uses of the term / USA/other
countries identify literature
Professional groups
Cluster of defining attributes
Identify the cluster of attributes that are the most
frequently associated with the concept
Iterative – ie the ones that appear over and over
again
This list will become the defining characteristics
May change over time
Additional cases
Identify cases that are not exactly same but
similar/contrary
A bit fuzzy at the edges
Some defining characteristics
Borderline cases
Contain most of the attributes but not all
May differ significantly in just 1 characteristic
Related cases
Related to the concept but do not contain all
the defining attributes
Very similar ideas but differ under closer
examination
Contrary cases
Definitely NOT an AP
Antecedents/context to AP
Antecedents are those events that must occur
prior to the AP role
Consequences
Events that occur as a consequence of AP
Outcomes
How to measure AP
Concept analysis process
1.
2.
3.
4.
5.
6.
7.
8.
Select a concept
Determine aims of analysis
Identify all uses of the concept
Determine defining attributes
Identify a model case
Identify borderline, related and contrary cases
Identify antecedents and consequences
Define empirical referents