The ConceptThe Conceptof Advanced Practiceof Advanced Practice

Foundations of Advanced PracticeFoundations of Advanced Practice

APH4000APH4000

November 2008November 2008

ConceptsConcepts

A mental image of a phenomenon, idea or a A mental image of a phenomenon, idea or a construct in the mind about a thing or actionconstruct in the mind about a thing or action Kaplan, 1964Kaplan, 1964

‘…‘…Categorising all the things that are alike about Categorising all the things that are alike about them…’them…’

Walker L & Avant K (2005) Strategies for Theory Construction in Walker L & Avant K (2005) Strategies for Theory Construction in NursingNursing

Pearson/Prentice Hall New JerseyPearson/Prentice Hall New Jersey

Concept analysisConcept analysis

Language we use to communicate AP to other Language we use to communicate AP to other peoplepeople

Words and terms used to describe APWords and terms used to describe AP Attribute meaningAttribute meaning Be able to debate APBe able to debate AP Reduce ambiguityReduce ambiguity

Determines the attributes and characteristics that Determines the attributes and characteristics that make AP unique from other concepts (nurse make AP unique from other concepts (nurse practitioner, specialist, extended scope, doctor)practitioner, specialist, extended scope, doctor)

Careful examination of AP literatureCareful examination of AP literature

Explanation of what is an AP and how it is Explanation of what is an AP and how it is not like ?not like ?

Gives us an operational definitionGives us an operational definition

Clarifies vaguenessClarifies vagueness

Standard languageStandard language

What is our concept?What is our concept?

Advanced PracticeAdvanced Practice

Identify when and how its used in literatureIdentify when and how its used in literature

What are the characteristics of AP?What are the characteristics of AP?

Model AP caseModel AP case

Has all defining attributesHas all defining attributes

Well if that’s not AP I don’t know what is?Well if that’s not AP I don’t know what is?

What things are different?What things are different?

Is there anything missing?Is there anything missing?

GMSHA (NHSNW)GMSHA (NHSNW)

An Advanced Practitioner is an An Advanced Practitioner is an Experienced non-medical registered professional who Experienced non-medical registered professional who has developed his or her knowledge to a very has developed his or her knowledge to a very high high standard in a specific and often high level of practice. standard in a specific and often high level of practice. This high standard is such that not only is the This high standard is such that not only is the individual the expert in the base domain:- but can also individual the expert in the base domain:- but can also accept the full responsibilities for providing those accept the full responsibilities for providing those services hitherto supplied by doctors,services hitherto supplied by doctors, in defined in defined circumstances.circumstances.

J. Sargent 2003J. Sargent 2003

ProcessProcess

1.1. Select a concept Select a concept

2.2. Determine the aims/purpose of analysisDetermine the aims/purpose of analysis

3.3. Identify all the uses of the concept you canIdentify all the uses of the concept you can

4.4. Determine the defining attributesDetermine the defining attributes

5.5. Identify a model caseIdentify a model case

6.6. Identify borderline, related, contrary, invented Identify borderline, related, contrary, invented and illegitimate casesand illegitimate cases

7.7. Identify antecedents and consequencesIdentify antecedents and consequences

GMSHA GMSHA Advanced Level of PracticeAdvanced Level of PracticeExpert practitionerExpert practitionerTransformational leadershipTransformational leadershipA high level of communication & influencing A high level of communication & influencing

skills, deals with complexityskills, deals with complexityDevelops policy, does not work through Develops policy, does not work through

protocolsprotocolsHigh level decision-makingHigh level decision-makingUtilisation & application of research & evidence Utilisation & application of research & evidence

based practice & knowledgebased practice & knowledgeA Progressive, critical thinker / challengerA Progressive, critical thinker / challengerChange agentChange agent

What?What?

Concept – Advanced PractitionerConcept – Advanced Practitioner

Capture the critical elements at this moment in Capture the critical elements at this moment in time from your own experiencestime from your own experiencesAllows differentiation ie like and also unlikeAllows differentiation ie like and also unlikeEnable you to communicate your role to Enable you to communicate your role to colleagues/other professionalscolleagues/other professionalsNegotiate responsibilities etcNegotiate responsibilities etc

Why?Why?

Discriminate between AP and other Discriminate between AP and other roles/titlesroles/titles

Where?Where?

Consider all uses of the term / USA/other Consider all uses of the term / USA/other countries identify literaturecountries identify literature

Professional groupsProfessional groups

Cluster of defining attributesCluster of defining attributes

Identify the cluster of attributes that are the most Identify the cluster of attributes that are the most frequently associated with the conceptfrequently associated with the conceptIterative – ie the ones that appear over and over Iterative – ie the ones that appear over and over againagainThis list will become the defining characteristicsThis list will become the defining characteristicsMay change over timeMay change over time

Additional casesAdditional cases

Identify cases that are not exactly same but Identify cases that are not exactly same but similar/contrarysimilar/contrary

A bit fuzzy at the edgesA bit fuzzy at the edges

Some defining characteristicsSome defining characteristics

Borderline casesBorderline cases

Contain most of the attributes but not allContain most of the attributes but not all

May differ significantly in just 1 characteristicMay differ significantly in just 1 characteristic

Related casesRelated cases

Related to the concept but do not contain all Related to the concept but do not contain all the defining attributesthe defining attributes

Very similar ideas but differ under closer Very similar ideas but differ under closer examination examination

Contrary casesContrary cases

Definitely NOT an APDefinitely NOT an AP

Antecedents/context to APAntecedents/context to AP

Antecedents are those events that must occur Antecedents are those events that must occur prior to the AP roleprior to the AP role

ConsequencesConsequences

Events that occur as a consequence of APEvents that occur as a consequence of AP

OutcomesOutcomes

How to measure APHow to measure AP

Concept analysis processConcept analysis process

1.1. Select a conceptSelect a concept

2.2. Determine aims of analysisDetermine aims of analysis

3.3. Identify all uses of the conceptIdentify all uses of the concept

4.4. Determine defining attributesDetermine defining attributes

5.5. Identify a model caseIdentify a model case

6.6. Identify borderline, related and contrary casesIdentify borderline, related and contrary cases

7.7. Identify antecedents and consequencesIdentify antecedents and consequences

8.8. Define empirical referentsDefine empirical referents