One of the major changes envisaged in the NHS’s Five Year Forward View and further developed in the Long Term Plan is the changing roles of nurses, midwives and allied health professionals, essentially taking on roles that previously were the domain of medical staff. This has been happening for many years but numbers have increased significantly over recent times and with it a burgeoning desire to see standards set and the role clearly defined.

There is unfortunately still no clear definition of what ‘advanced practice’ is and therefore the education and roles that the practitioner might be required to perform or undertake is also open to question. There is however clear support from all parties involved (across the UK) that the educational provision should be at Masters level; and ideally a full MSc. The Department of Health (DoH) and HEE have published curriculum guidelines pertaining to the content of ACP courses in an attempt to introduce some standardisation. The full MSc enhances the practitioner’s ability to appraise research, think critically, and prepares them to develop further beyond simply the role of an expert clinician.

Our MSc Advanced Clinical Practice programme is designed to match the DoH and HEE guidelines, and future proof graduates in regards to possible credentialing or voluntary registration schemes in the future. This programme has also taken into account the needs of local stakeholders and the views of past and current students. We seek to develop:

“Registered practitioners with an expert knowledge base, complex decision-making skills and clinical competencies for expanded autonomous scope of practice, the characteristics of which are shaped by the context in which the individual practices. Demonstrable at Masters level and meets the education, training and CPD requirements for Advanced Clinical Practice” (HEEM, 2014)

The advanced practitioner is characterised by high levels of skill, competence and autonomous decision making, at a perhaps higher level than the specialist, though of course a practitioner may well specialise at an advanced level. A more simplistic explanation might be that the specialist operates at a high level in their specialism, but returns to novice when outside it; the advanced practitioner operates at a higher level in their speciality, but can also bring advanced practice to other areas as well. The department of Health (2010) suggested that it was a level of practice, rather than specific role.

Nationally, due to the extremely varied nature of ACP roles, it has proved impossible to define a set list of ‘competencies’, beyond very broad strictures such as the ability to physically examine a patient. There is however broad agreement

on some aspects that should be common to all. Those have been identified as the ‘four pillars’ of advanced practice:

• Clinical
• Education
• Research
• Leadership

The MSc ACP at De Montfort University draws these together and produces an able graduate who is highly employable. This course will not make you competent – no course will – but it will give you the educational grounding in order to develop competence and in turn become expert, with a strong clinical focus.

The curriculum has been designed with expert advice from clinicians, academics and local strategic partners to address both the academic and clinical demands of the role. Regular meetings are held between faculty and clinical staff to ensure good exchange of information. Student opinion and feedback is also incorporated.

Structure and assessment

Course modules

Students must complete either:

MPHE 5208 (45 credits) or MPHE 5801 (30 credits). These are the physical examination / history taking modules. Both incorporate elements of pathophysiology and diagnostic reasoning, with MPHE 5208 having a more general medical slant and including more pathophysiology. The modules are delivered together, with MPHE 5208 having a further 4 days once MPHE 5801 finishes. Both are assessed with a combination of OSCEs, case study and practice portfolio.

If you do not work in an environment where you will have the opportunity to see / examine all systems, then you will need to be able to take time to access such an environment.

These modules will enable the student to critically appraise the underlying principles of consultation and physical examination. The module will enable the student to make informed judgements, problem solve and identify complex health needs and issues specific to an advanced clinical role.

Allied issues such as requesting investigations, inter-professional team working, patient referral mechanisms and professional accountability in an advanced role are also addressed. It is aimed at those health care practitioners who will be professionally supported in this active interventionist role.  It is relevant to Registered Paramedics, Nurses and Allied Health Professionals working within a variety of primary and secondary care settings.

Prescribing.

If the student is from a profession that is legislatively able to prescribe, then they MUST undertake the non-medical prescribing course (PG cert) as part of this programme. Please see the non-medical prescribing course web page for further information. This is 60 credits (45 for pharmacists).

This course cannot be undertaken until the successful completion of a physical examination course.

If the student is not legislatively able to prescribe currently (e.g. paramedics) then they must make up the 60 credits from the wider DMU M level portfolio, using modules with a clinical / advanced practice focus.

Research Module

Students can chose from a variety of research modules, the completion of any one of which is compulsory. The choice will depend on the student’s requirements in terms of number of credits, and their potential research interests. See individual module webpages for more information:

HEST 5001 research designs in health (30) – this module has a more qualitative focus.

SPEC 5602 Using evidence to develop service and advance nursing practice (15) A generalist perspective.

HEST 5016 Making sense of quantitative and qualitative data (30) If you want to know more about quantitative this is a good choice.

Dissertation:

All students must complete the dissertation (MPHE 5007). This is a 60 credit 20,000 word assignment, which can take many forms including empirical research, audit, literature review or service development; or a combination of these.

To summarise, most students must undertake:

A clinical examination module

A research module

The prescribing course

The dissertation

It is possible to exit the course without doing the dissertation (if the other modules are completed) and gain the award of PG Dip in Advanced clinical practice. A PG cert is also available if a student completes a physical examination module and a research module, but please note; this is NOT a PG cert Advanced Clinical Practice.

Facilities and features