Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study)
Article first published online: 29 AUG 2012
© 2012 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 69, Issue 6, pages 1323–1337, June 2013
How to Cite
2013). Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of Advanced Nursing 69(6),1323–1337. doi: 10.1111/j.1365-2648.2012.06124.x, , , , & (
- Issue published online: 10 APR 2013
- Article first published online: 29 AUG 2012
- Manuscript Accepted: 21 JUL 2012
- National Council for the Professional Development of Nursing and Midwifery
- advanced practitioner;
- clinical specialist;
- expert practice;
- mixed methods;
To report a study designed comparing the roles, responsibilities, and perceived outcomes of Clinical Nurse Specialists, Clinical Midwife Specialists, and Advanced Nurse Practitioners in Ireland.
A clinical career pathway that encompasses progression from staff nurse or midwife through clinical specialist to advanced practitioner level was introduced in Ireland in 2000. Such roles are common internationally, but little evaluation has been conducted and few comparisons have been made between roles.
A mixed-method case-study design was used.
Following Research Ethics Committee Approval, data were collected in 2009–2010, using non-participant observation (92 hours) of 23 Clinical Specialists and Advanced Practitioners, interviews with 21 clinicians and 13 Directors of Nursing or Midwifery. A survey was completed by 154 service-users.
A clear difference was seen between Clinical Specialist and Advanced Practitioners, with advanced practice roles providing improved service delivery, greater clinical and professional leadership, increased research, and a clear governance and accreditation structure. Clinical Midwife Specialists were rated at a similar level to Advanced Nurse Practitioners for certain aspects and rated more highly for ‘continuity of care and carer’.
Advanced Practitioners do give a higher level of care, particularly at a strategic level. Existing Clinical Specialists should therefore be encouraged to develop their skills and education to achieve advanced practice level and more specialist and advanced practice posts should be instituted.