title: Learning transitions-a descriptive study of nurses' experiences during advanced level nursing education.
abstract: BACKGROUND
  Building capacity in a changing health care system is a challenge for advanced nursing education programs. Master-level nursing education is increasingly becoming the required education level for specialist nurses, and additional studies are needed to learn more about students' experiences and learning transitions while undertaking such education. This study aimed to explore nursing students' experience of their learning transitions while undertaking advanced nursing education and to describe how they translated the new knowledge and competence they gained into clinical practice.
  
  
  METHODS
  We used a qualitative research design with narrative self-reported reflections. 34 nurses (95 % women) from both urban and rural areas working with children, with adults in outpatient and inpatient endocrinology clinics in hospitals or with adults, including older people, attending primary health care services participated in the study. We collected data at two time points 15 months apart. Time one was the first week of the advanced nursing education, and time two was the completion of the education program. We used Malterud's modification of Giorgi's phenomenological analysis, otherwise known as systematic text condensation, to analyze the data.
  
  
  RESULTS
  Two core themes captured the participants' experiences. The first theme was "assessing the situation of people with diabetes from a different perspective", with the subthemes "an expanded perspective of practice and higher level of reflection", "applying critical thinking in practice" and "changing patient-nurse relationships in diabetes care". The second core theme was "a change in participants' perception of their professional position", with the subthemes "a greater knowledge base enhancing professional confidence" and "a more equal position within the professional team".
  
  
  CONCLUSIONS
  The study provides in-depth information about transition into advanced nursing education and can inform curriculum developers, nurse educators, policy-makers and nursing managers about how nursing education broadened participants' perspectives of nursing and enhanced their confidence and professional position.
authors.affiliation: Faculty of Health and Social Sciences, Centre for Evidence-Based Practice, Bergen University College, 7030, , 5020 Bergen, Norway ; Faculty of Health and Social Sciences, Institute of Nursing, Bergen University College, Bergen, Norway ; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Graue
authors.affiliation: School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia.
authors.forename: Bodil
authors.initials: B
authors.lastname: Rasmussen
authors.affiliation: Faculty of Health and Social Sciences, Institute of Nursing, Bergen University College, Bergen, Norway.
authors.forename: Anne S
authors.initials: AS
authors.lastname: Iversen
authors.affiliation: Centre for Nursing and Allied Health Research, Deakin University and Barwon Health, Geelong, Australia.
authors.forename: Trisha
authors.initials: T
authors.lastname: Dunning
keywords: Diabetes nursing; Learning transitions; Nursing education; Qualitative research