A qualitative exploration of evolving needs to support Continuing Professional Development: Perspective of Advanced Clinical Practitioner nurses in primary care in the UK

Abstract

Worldwide, the Nurse Practitioner (NP) role has become well-established, particularly in countries experiencing falling GP recruitment and healthcare inequalities. Despite the increased responsibility the role has brought to Nurse Practitioners, post-graduation education and mentoring have been patchy, creating difficulties in meeting the role requirements and generating stress and anxiety among Nurse Practitioners. Although previous studies around UK Nurse Practitioners have concentrated on regulation, undergraduate education, acceptance, and identity, there is less information on post-graduate learning and support, and no studies that I could find that have explored this issue from the perspective of Nurse Practitioners. This study aims to examine the provision of post-graduate education and mentoring for NPs in primary care. A qualitative approach was taken to explore the perceptions of Nurse Practitioners in Primary Care, allowing for an in-depth understanding of personal experiences, contextual influences, and nuanced professional perspectives. This approach facilitates the exploration of subjective realities and captures the complexity of the NP role within the primary care setting, including interpersonal dynamics, professional identity, and perceived challenges.

The research sample was chosen from Nurse Practitioners in primary care, as this role manages care, across the whole spectrum of patient care including but not confined to, chronic disease management, End of Life Crae, frail elderly, on the acute care, home visits, and patent care planning, creating a broad, generalised remit of practice. A sample of seven Nurse Practitioners working across the Southwest areas participated in semi-structured interviews. Interviews were analysed using Braun and Clarke's (2023) Reflexive Thematic Analysis, which allowed analyses of the data to identify common themes and differences while preserving contributors’ voices.
The findings suggest that, while at the forefront of care delivery, participants’ roles existed within an employer led dynamic, which often lacked insight into the Nurse Practitioner role, leading Nurse Practitioners to establish their own communities of practice (Lave and Wenger 2000). Peer mentoring was perceived to be a resource for professional growth, education, clinical practice, and support for new colleagues. Finally, participants suggested the development of a clinical facilitator role for Nurse Practitioners, incorporating education, mentoring, and negotiation with practices for career development pathways that benefit both the practice and the Nurse Practitioner, ensuring Nurse Practitioners can meet the future demands of an increasingly medicalised role.
This study provides an original contribution to knowledge by exploring the development of education, mentoring, and role development from the perception of the participants, highlighting the self-motivated development of informal communities of practice among primary care Nurse Practitioners, using shared knowledge and peer mentoring.
Potential implications from this study include development of the Nurse Practitioners in other non-patient facing areas, such as a facilitator role to mitigate the four pillars of practice, mentoring, role development by facilitating learning opportunities and acting as a resource for access to education courses and funding. Additionally, the specialization of NPs in specific areas negotiated with their practice can help build a range of expert nurses who provide resource resources for both nursing and medical staff.

Date of Award	25 Jun 2025
Original language	English
Awarding Institution	University of Bath
Supervisor	Shona McIntosh (Supervisor)