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Change on the horizon: issues and concerns of neophyte advanced healthcare practitioners


  • Graham R Williamson BA, MA, PhD, RGN, PGDipEd,

  • Christine Webb MSc, PhD, RN, RSCN, RNT, FRCN,

  • Nadine Abelson-Mitchell BSc, PhD, RN, RM, RT,

  • Simon Cooper BA, MEd, PhD, RN

Graham R Williamson
Senior Lecturer
Adult Nursing
Faculty of Health and Social Work
University of Plymouth
Exeter Centre
Exeter, Devon EX2 6AS
Telephone: 01392 475150


Aims and objectives.  The aim was to interview new entrants to a Master's level programme of educational preparation for advanced healthcare practice roles. The objectives were to gain an understanding of their issues and concerns as they looked ahead to their future development and to illuminate issues concerning their experiences as students and as employees.

Background.  As advanced practice roles become more widespread in the United Kingdom and abroad, nurses and other healthcare professionals are becoming more involved in innovation and service development and experiencing greater autonomy in many areas, particularly in regard to clinical examination and diagnosis.

Design.  A qualitative design was employed to illuminate issues and concerns of new students on a Master's degree programme of educational preparation for advanced healthcare practitioners.

Methods.  Two focus group interviews were conducted in 2004. Sixteen students from two programme cohorts participated in the two groups.

Findings.  Two main themes were outlined. These were: ‘opportunities for development’ and ‘time pressures’. Subcategories within these two themes are also discussed.

Conclusions.  Students undertaking Master's level preparation for advanced healthcare practitioner roles perceive personal and professional benefits and opportunities to develop innovative services to improve patient care as accruing from the programme. These opportunities and benefits were related to the United Kingdom national health policy agenda. Some role difficulties were experienced. The additional burdens that the programme of study provided were an issue for some, but these were perceived as a temporary problem, worth undergoing for the likely long-term benefits.

Relevance to clinical practice.  Students undertaking educational preparation for advanced practice roles see themselves as innovators, specifically aiming to develop and improve aspects of service provision. Education for advanced practice roles should not be undertaken lightly, but can equip students with various skills, particularly regarding clinical assessment, and these skills should underpin practitioners’ autonomy.