title: A historical overview of the development of advanced practice nursing roles in Canada.
abstract: Advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide. To understand the development and current status of advanced practice nursing within a Canadian context, it is important to explore its historical roots and influences. The purpose of this paper is to provide a historical overview of the major influences on the development of advanced practice nursing roles that exist in Canada today, those roles being the nurse practitioner and the clinical nurse specialist. Using a scoping review and qualitative interviews, data were summarized according to three distinct time periods related to the development of advanced practice nursing. They are the early beginnings; the first formal wave, between the mid 1960s and mid 1980s; and the second wave, beginning in the late 1980s and continuing to the present. This paper highlights how advanced practice nursing roles have evolved over the years to meet emerging needs within the Canadian healthcare system. A number of influential factors have both facilitated and hindered the development of the roles, despite strong evidence to support their effectiveness. Given the progress over the past few decades, the future of advanced practice nursing within the Canadian healthcare system is promising.
authors.affiliation: Affiliate Faculty, School of Nursing, McMaster University, Career Scientist, Ontario Ministry of Health and Long-Term Care, Hamilton, ON.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.forename: Patricia
authors.initials: P
authors.lastname: Harbman
authors.forename: Denise
authors.initials: D
authors.lastname: Bryant-Lukosius
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
mesh_terms: D057179:Advanced Practice Nursing / Q000266:history / Q000379:methods*; D002170:Canada; D003695:Delivery of Health Care / Q000266:history / Q000458:organization & administration*; D006291:Health Policy / Q000266:history* / Q000639:trends; D006301:Health Services Needs and Demand; D006676:History of Nursing; D049673:History, 20th Century; D006801:Humans; D009720:Nurse Clinicians; D024802:Nurse's Role / Q000266:history*; D036301:Qualitative Research; D000078329:Workforce