1. The Concept of Advanced Practice Foundations of Advanced Practice APH4000 November 2008

2. 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

3. Concept analysis Language we use to communicate AP to other people Language we use to communicate AP to other people Words and terms used to describe AP Words and terms used to describe AP Attribute meaning Attribute meaning Be able to debate AP Be able to debate AP Reduce ambiguity Reduce ambiguity Determines the attributes and characteristics that make AP unique from other concepts (nurse practitioner, specialist, extended scope, doctor) Determines the attributes and characteristics that make AP unique from other concepts (nurse practitioner, specialist, extended scope, doctor)

4. 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

5. What is our concept? Advanced Practice Identify when and how its used in literature What are the characteristics of AP?

6. 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?

7. 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 J. Sargent 2003

8. Process 1. Select a concept 2. Determine the aims/purpose of analysis 3. Identify all the uses of the concept you can 4. Determine the defining attributes 5. Identify a model case 6. Identify borderline, related, contrary, invented and illegitimate cases 7. Identify antecedents and consequences

9. 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

10. What? Concept – Advanced Practitioner Capture the critical elements at this moment in time from your own experiences Capture the critical elements at this moment in time from your own experiences Allows differentiation ie like and also unlike Allows differentiation ie like and also unlike Enable you to communicate your role to colleagues/other professionals Enable you to communicate your role to colleagues/other professionals Negotiate responsibilities etc Negotiate responsibilities etc

11. Why? Discriminate between AP and other roles/titles

12. Where? Where? Consider all uses of the term / USA/other countries identify literature Professional groups

13. Cluster of defining attributes Identify the cluster of attributes that are the most frequently associated with the concept Identify the cluster of attributes that are the most frequently associated with the concept Iterative – ie the ones that appear over and over again Iterative – ie the ones that appear over and over again This list will become the defining characteristics This list will become the defining characteristics May change over time May change over time

14. Additional cases Identify cases that are not exactly same but similar/contrary A bit fuzzy at the edges Some defining characteristics

15. Borderline cases Contain most of the attributes but not all May differ significantly in just 1 characteristic

16. Related cases Related to the concept but do not contain all the defining attributes Very similar ideas but differ under closer examination

17. Contrary cases Definitely NOT an AP

18. Antecedents/context to AP Antecedents are those events that must occur prior to the AP role

19. Consequences Events that occur as a consequence of AP Outcomes

20. How to measure AP

21. Concept analysis process 1. Select a concept 2. Determine aims of analysis 3. Identify all uses of the concept 4. Determine defining attributes 5. Identify a model case 6. Identify borderline, related and contrary cases 7. Identify antecedents and consequences 8. Define empirical referents