Nursing expertise: a course of ambiguity and evolution in a concept.
In this article, we clarify and describe the nature of nursing expertise and provide a framework to guide its identification and further development. To have utility and rigour, concept-driven research and theories of practice require underlying concepts that are robust, valid and reliable. Advancing understanding of a concept requires careful attention to explicating its knowledge, metaphors and conceptual meaning. Examining the concepts and metaphors of nursing expertise, and how they have been interpreted into the nursing discourse, we aimed to synthesise definitions and similarities between concepts and elicit the defining characteristics and properties of nursing expertise. In clarifying the concept, we sought to move beyond the ambiguity that currently surrounds expertise in nursing and unravel it to make explicit the characteristics of nursing expertise from published peer-reviewed studies and structured literature synthesis. Findings indicate a lack of clarity surrounding the use of the term expertise. Traditional reliance upon intuition as a way of explaining expert performance is slowly evolving. Emerging from the analysis is a picture of expertise as the relationship between networks of contextual reasoning, understanding and practice. Striking absences in the discourse include limited explication of ethical reasoning and theorising a broader interpretation of expertise reflective of contemporary forms of nursing.
Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.|School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia.
Marie
M
Hutchinson
Independent Researcher, Sydney, NSW, Australia.
Mary
M
Higson
Mental Health Nursing, School of Health Sciences, University of Tasmania, Sydney, NSW, Australia.
Michelle
M
Cleary
Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.|Oxford Institute of Nursing & Allied Health Research (OxINAHR), Oxford, UK.|Oxford University Hospitals NHS Foundation Trust, Oxford, UK.|University of New England, Armidale, NSW, Australia.
Debra
D
Jackson
D002983:Clinical Competence / Q000592:standards*; D006280:Health Workforce; D006801:Humans; D019545:Intuition; D024802:Nurse's Role; D009736:Nursing Process; D011361:Professional Competence; D013850:Thinking; D035501:Uncertainty
concept analysis; expert practice; expertise; nursing; nursing workforce; professional competence