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Developing advanced nursing practice: a European perspective

Carol E Marrow
Senior Lecturer
Coordinator MSc Advanced Nursing Practice (European Dimension)
School of Nursing and Midwifery
St Martin’s College
E: [email protected]

The development of the MSc Advanced Nursing Practice (European Dimension) will aid the achievement of the aims of the 1999 Bologna agreement ( bologna). A key goal is establishing a European higher education arena by 2010, which will help to develop a competitive and dynamic knowledge-based economy in Europe that will provide the basis for better jobs and improved social cohesion.

The MSc is an innovative project based on two years’ funding (October 2005 to September 2007) from the EU’s Socrates Erasmus curriculum development initiative. The initial discussions and formation of ideas began with committed members of the Thematic European Nursing Network (TENN) and specifically builds on the work of two TENN subgroups: Nurse Practitioner and Leadership. Consequently, the MSc focuses on those two pathways.

One definition of advanced nursing practice agreed by the working group is: the Advanced Nurse Practitioner (ANP) demonstrates highly developed healthcare knowledge and skills, and engages in the critical appraisal, evaluation and synthesis of theory and practice. Furthermore, the ANP inspires and guides change in advanced nursing practice to meet global health challenges of the 21st century across cultural interfaces.

It is a collaborative initiative across a number of European countries. Many of the institutions that are involved would like to develop the nursing profession, but not all have the expertise to teach in the proposed areas of nurse practitioner and leadership. The advantage of this work is the availability of experts who will teach modules in different institutions, while the students will also be able to study at different institutions. Ireland, Spain, Sweden, Finland, Greece, Portugal, Slovenia and Italy are the countries that have chosen to work on the programme to ensure that their nurses are equipped for employment in advanced roles, and that they are also equipped for putting themselves in a competitive position with the rest of the world.

The programme
The programme joins different professionals (eg, academics or staff working in patient care) from nursing and other professions allied to health in an integrated, multidisciplinary teaching mode. At the European level, these values and principles entail looking ahead and respecting the diversity of our institutions. This understanding will provide us with an education that satisfies multiple needs and will enable us to carry out varied types of research, as well as providing a service to society in different environments that will attract a higher number of students.

The work is an important initiative for the nursing profession. It has developed considerably over the last few decades from an apprentice-style education to an academic-based curriculum that produces articulate, critically thinking nurses at the point of registration.(1,2) This programme is novel in all countries within Europe and timely because of the rapid changes in global nursing care. The nursing profession is shifting its boundaries and nurses are functioning in extended and higher roles in order to develop practice and improve patient care.(3,4) Nurses are therefore advancing their knowledge and clinical skills beyond the initial qualification to fulfil many needs shaped by the changing healthcare demands of society, the development of sophisticated technology and the changes in medical roles.

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The students on the programme will need to successfully complete six modules and one research project equivalent to three modules in order to obtain the MSc Advanced Nursing Practice (Leadership or L) or MSc Advanced Nursing Practice (Nurse Practitioner or NP) award. The programme can be delivered fulltime over one year and two years part-time (minimum) in a variety of learning modes (Figure 1).


The MSc will be validated in each institution to enable the flexibility of the programme being delivered at each institution. The project members will work with the local institutions delivering the programme to ensure that all quality assurance and strategic mechanisms are in place, including support for the students. There will be common quality assurance mechanisms and a common assessment and examination framework that is in line with national agency policies and the principles established by the “Tuning Educational Structures in Europe” project.

Currently, the MSc development team have met on two occasions and have identified the programme’s philosophy, aims, content, teaching, learning and assessment modes. It is now working on quality assurance and validation mechanisms.

Apart from the collective initiative of developing the curriculum for educating and advancing nurses in practice, an action research project has been implemented to help individuals reflect on their learning and development as educators throughout the life of the project.

The future
Once the MSc is set up, the development team will apply for further EC funding to establish the course firmly in the European higher education arena. This will award scholarships for non-EU students to attend these courses and enable Europe to become a strong competitor in the world higher education market.


  1. Marrow CE. Clinical supervision in action: problems and dilemmas. Unpublished M Phil thesis. Lancaster: Lancaster University; 1995.
  2. Morton-Cooper A, Palmer A. Mentoring, preceptorship and clinical supervision: a guide to support roles in clinical practice. 2nd ed. London: Blackwell Science; 2000.
  3. McGee P, Castledine G. Advanced nursing practice. 2nd ed. London: Blackwell Science; 2003.
  4. Hamric AB, Spross JA, Hanson CM. Advanced nursing practice: an integrative approach. 2nd ed. Philadelphia: WB Saunders; 2000.

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