One of the major changes envisaged in the Five Year view was the changing roles of Nurses, Midwives and Allied health professionals, essentially taking on roles that previously were the domain of medical staff. This has actually 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 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, with a Post graduate Diploma being generally accepted as the minimum requirement for practice. 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. Scotland and Wales each have a single framework for advanced Practice, and Northern Ireland is following suit.
There is no fully defined curriculum for MSc ACP, however both the East and West Midlands have agreed a standardised programme in liaison with local clinical stakeholders and the Association of Advanced Practice Educators. Our Course is based along similar lines. We seek to develop practitioners who are:
“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:
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.
If you don’t want to do the full MSc and have a primary care employment, then you might also consider the PGDip Advanced Practice in Urgent / Primary Care.
Structure and assessment
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.
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.
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.
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
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
Health and Life Sciences facilities
Investment of £12 million in Health and Life Sciences has developed our first-class teaching and learning facilities to help you develop your practical experience and theoretical knowledge beyond the classroom.
The 19th century Hawthorn Building has facilities designed to replicate current practice in health and life sciences, including contemporary analytical chemistry and formulation laboratories, audiology booths and nursing and midwifery clinical skills suites.
Purpose-built clinical skills areas allow you to apply theory to practice in a safe environment. You will receive guidance and support from staff, to ensure that your practical ability in the clinical skills suites is accurate.
The main Kimberlin Library is open 24 hours a day, 365 days a year (other than in exceptional circumstances) and offers a huge range of online resources, all of which can be remotely accessed from anywhere you choose.
The library is run by dedicated staff who offer additional support to students, including help with academic writing, research strategies, literature searching and reference management and assistive technology, and mathematical skills for non-maths students. There is also a Just Ask service for help and advice, available via email or telephone.
Our Learning Zones and the The Greenhouse also provide space for group or individual work and study.
There are 1,600 study places across all library locations, more than 700 computer stations, laptops to borrow, free wi-fi and desktop power outlets.
You can also book rooms with plasma screens, laptops and DVD facilities for group work and presentations, secure an individual study room with adjustable lighting or make use of our assistive technology.
Opportunities and careers
On completion of this course, students will fulfil the academic requirements in order to practice as an Advanced Clinical Practitioner. This anticipates possible future NMC regulation, and complies with standards across all the different nations of the UK.