From competence to capability: A study of nurse practitioners in clinical practice

Cabrini-Deakin Centre for Nursing Research, Deakin University, Burwood, Victoria, Australia.
Journal of Clinical Nursing (Impact Factor: 1.26). 02/2008; 17(2):250-8. DOI: 10.1111/j.1365-2702.2006.01880.x
Source: PubMed


This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework.
The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence.
A secondary analysis of data obtained from interviews with nurse practitioners working in Australia and New Zealand was undertaken. These data had previously been obtained in a study to identify nurse practitioner competencies. The analysis described in this paper investigated whether or not the components of capability would adequately explain the characteristics of the nurse practitioner.
Fifteen nurse practitioners were interviewed from Australia and New Zealand. A secondary (deductive) analysis of interview data using capability as a theoretical framework was conducted.
The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams.
This study suggests that both competence and capability need to be considered in understanding the complex role of the nurse practitioner.
The dimensions of capability need to be considered in the education and evaluation of nurse practitioners.

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    • "Experiential learning has long been recognized among the most effective means of developing the ability to adapt to change, to generate new knowledge, and to solve problems in collaboration with a diverse set of stakeholders [Gardner et al., 2008]. Experiential learning is well accepted and widely adopted in management education at all levels and in all functional areas. "
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    ABSTRACT: Business and IS pedagogy emphasizes developing competence in a fixed set of skills. Given the rapid pace of change in today’s business world, we advocate developing students’ capabilities in dealing with ambiguity, giving and receiving feedback, and reflecting on lessons learned as well. Experiential learning can help to bridge competence and capability paradigms in higher education. In this article, we describe an experiential-learning approach for developing business students’ management capabilities in which they work in teams with external stakeholders to design, implement, and assess the effectiveness of an online advertising campaign. The project not only builds competence but also enhances students’ capability in a wide range of business subject areas including information systems management. This article shares lessons learned from its implementation in information systems and marketing courses.
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    • "Reflective journaling and constructive feedback during post clinical discussions also enable the building of personal resilience and clinical competence (Jackson et al., 2007; Gillespie et al., 2007). The use of adult learning principles and collaborative experiential learning is important given that context, social interaction and a clear rationale are vital components of adult education (Gardner et al., 2007). "
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    • "It is interesting that the use of ANPs has been largely confined to specialist areas , as the reduction in junior doctors hours in the UK affected all areas of patient care including general in - patient wards . It is argued that ANPs have not just filled the gap left by a reduction in junior doctors ' hours , but also use their expertise to identify and fill gaps in service provision ( Ball & Cox 2004 , Gardner et al 2008 , Laurent 2009 ) . "
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