Last week in #advancedpractice

There was significantly less controversy and  activity in #advancedpractice since the last installment. The most discussed and retweeted topic was a survey/research project by @alisonleary1 (Professor of Healthcare and Workforce Modelling), Health Education England (HEE), Jessica Lawler and colleagues .  Thanks to @stuart_maddock for the retweeting:

This research project aims to gain insight into the Advanced Clinical Practitioner (ACP) role from different professional backgrounds through an online survey. Its quick to complete (took me 10 minutes) and allows you to opt into a semi-structured interview which can be completed over the phone. It appears to be promoted mainly through social media by those that complete it. This is commonly referred to as snowball sampling (or chain sampling/ referral sampling) (Greenhalgh, 2014).

But whats already known about this topic and is it vital to complete this survey in order to advance the ACP profession? A simple literature search should suffice!

The Literature Search.

As with all literature searches, inclusion and exclusion criteria are vital in order to both streamline and capture as much literature as possible (Aveyard, 2014). The table below sets out the inclusion and exclusion used for this simple literature search:


Papers from 2017 onwards
Papers from before 2017
Primary research or systematic review
Editorials, opinion and non-peer reviewed research
Full Text
Papers exploring advanced nurse practitioners, physician associates or nurse practitioners 

Peer reviewed
Papers not from the UK.

Papers were excluded that explored ACP's before 2017, this is because the ACP multi professional framework was released in 2017 (HEE, 2017). Editorials, opinion and non-peer reviewed research was excluded as reliable primary research investigations were most appropriate. Likewise, papers exploring advanced nurse practitioners, physician associates or nurse practitioners were excluded as ACP's are of interest for this literature search. Finally, papers not from the UK were also excluded.

Academic search premier, CINAHL complete and MEDLINE were searched through EBSCO service from 2017 onwards with the keywords "Advanced Clinical Practitioner*". The PRISMA diagram below demonstrates this search in detail:

One article was retrieved at full text: 

Moran and Nairn (2017) present an interesting qualitative synthesis of 11 articles from 1997 to 2016 surrounding the development of ACPs across a spectrum of specialties. This review identifies that the following themes are key to ACP development in clinical practice:

1. Orientation
2. Mentorship
3. Clinical development
4. Clinical supervision
5. Education provision.

Ultimately, these topics are later highlighted as areas that more research is required and the implications of the HEE (2017) framework is not explored due to the nature of the review. Fianlly, this review does not specifically explore each professional group and its activity at advanced practice level. However, the key themes are important to those seeking to develop the ACP role within their specialty.


Moran and Nairn (2017) identify five key areas which require further research. We argue that the project undertaken by @alisonleary1, HEE and colleagues is essential to the ACP profession. There has been no national survey has been conducted prior to this work and this work will allow the ACP community to appreciate how different professional backgrounds practice at an advanced level. As argued by Moran and Nairn (2017) advanced level practice is not completely defined nationally. We hope that the work by @alisonleary1, HEE and colleagues will provide a foundation for future work to begin.

I have completed the survey and I am working actively to promote the survey due to its snowball sampling methodology. I ask that we all consider those practitioners who may not be on Twitter or social media - we may have to use traditional 'word of mouth' to further promote this vital research.


Aveyard, H. (2014) Doing a literature review in health and social care: A practical guide, 3rd edition. Berkshire: Open University Press.

Greenhalgh, T. (2014) How to read a paper: The basics of evidence-based medicine, 5th edition. West Sussex: John Wiley & Sons Ltd.

Health Education England (2017) Multi-professional framework for advanced clinical practice in england. England: Health Education England.

Moran, G. M. & Nairn, S. (2017) How does role transition affect the experience of trainee advanced clinical practitioners: Qualitative evidence synthesis. 74 (2), 251-262.


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