一项质性研究，探索英国英格兰西南部急诊护理高级临床从业者培训的经历。

A qualitative study exploring the experiences of advanced clinical practitioner training in emergency care in the South West of England, United Kingdom.

作者信息

Ablard Suzanne, Kuczawski Maxine, O'Keeffe Colin, Sampson Fiona C, Mould Jedidah, Mason Suzanne M

机构信息

The School of Medicine and Population Health, The University of Sheffield, Sheffield, UK

The School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.

出版信息

Emerg Med J. 2025 Feb 21;42(3):193-199. doi: 10.1136/emermed-2024-214016.

DOI:10.1136/emermed-2024-214016

PMID:39406466

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11874414/

Abstract

BACKGROUND

Attempting to improve emergency care (EC) advanced clinical practitioner (ACP) training, Health Education England (HEE) South West (SW) implemented a pilot, whereby emergency departments (ED) were provided with enhanced funding and support to help ED consultants deliver teaching and supervision to EC ACPs to ensure more timely completion of EC ACP training compared with previous cohorts training in the region.We explored the experiences of trainee EC ACPs and consultant EC ACP leads working in EDs, which had implemented the new regional pilot.

METHODS

We used a qualitative design to conduct semi-structured interviews with trainee EC ACPs and consultant EC ACP leads across five EDs that had implemented the HEE SW pilot. Interview data were analysed thematically.

RESULTS

Twenty-five people were interviewed. We identified four themes: (1) the master's in advanced practice could be better aligned with the Royal College of Emergency Medicine credentialling e-portfolio; (2) EC ACP training needs some flexibility to reflect the individual-'one size does not fit all'; (3) supervision and teaching were recognised as important but requires significant staff capacity that is impacted by external pressures and (4) unclear role expectations and responsibilities hinder role transition and impact role identity.It was notable that EC ACPs primarily spoke about the development of their clinical skills both academically and within the workplace, despite there being other skills mentioned in the multiprofessional framework for advanced practice (leadership and management, education and research).

CONCLUSION

A clear supervision structure with protected time allocated for teaching and assessment of clinical skills within the ED is essential to facilitate trainee EC ACP progression. However, increasing demands on EDs make this a challenging goal to achieve. Role identity issues continue to persist despite the introduction of new guidance designed to provide more clarity around the ACP role.

摘要

背景

为改进急诊护理（EC）高级临床从业者（ACP）培训，英国健康教育署（HEE）西南部（SW）开展了一项试点项目，为急诊科（ED）提供额外资金和支持，以帮助急诊科顾问为急诊护理高级临床从业者提供教学和监督，确保与该地区以往同期培训相比，急诊护理高级临床从业者培训能更及时完成。我们探讨了在实施新区域试点项目的急诊科工作的实习急诊护理高级临床从业者和急诊护理高级临床从业者顾问负责人的经验。

方法

我们采用定性设计，对五个实施了英国健康教育署西南部试点项目的急诊科的实习急诊护理高级临床从业者和急诊护理高级临床从业者顾问负责人进行半结构化访谈。对访谈数据进行主题分析。

结果

共访谈了25人。我们确定了四个主题：（1）高级实践硕士学位可以更好地与皇家急诊医学院的认证电子档案相匹配；（2）急诊护理高级临床从业者培训需要一定灵活性，以体现因人而异——“一刀切并不适用所有人”；（3）监督和教学被认为很重要，但需要大量员工，而这受到外部压力的影响；（4）角色期望和职责不明确阻碍了角色转变，并影响角色认同。值得注意的是，尽管高级实践多专业框架中提到了其他技能（领导力和管理、教育和研究），但急诊护理高级临床从业者主要谈到了他们在学术和工作场所临床技能的发展。