Currently in health and social care the titles expert, specialist and advanced are used interchangeably resulting in a lack of consistency and potential confusion. Many organisations, professions and academics have sought to define advanced practice. While all approach from different angles; there are similarities in the concepts and skills such a:
- Breadth and depth of practice.
- Leadership, innovation and creativity.
- Service improvement/service development.
- Education and development of others.
- Improve outcomes for service users.
It is clear that it is the how rather than what that is the main factor in determining level of practice. As in addition professional definitions tend to include aspects of development of the profession such as through advocacy for the profession, dissemination of good practice (publishing and presenting), influencing at a national and international level, active engagement with professional body and mentoring and development of other dietitians.
Rolfe et al, after Schon (Rolfe, 2001), describes advanced practitioners as working in the swampy marshland where the messy, confusing problems are. This ‘marshland’ has no guide book and the advanced practitioner has to integrate knowledge and skills and reflect on their experience and practice to develop and apply the solutions.
There is, therefore, general agreement that while advanced practice tends to need some years of experience to develop, years of experience do not automatically result in advanced practice; and advanced practice is more than being an excellent practitioner.
The BDA Postgraduate Professional Development Framework is due to be launched early 2019 and therefore the Advanced Practitioner supporting documents are currently under review.