Exploring nursing expertise: nurses talk nursingIt has become increasingly important for practitioners to articulate their expertise in modern healthcare settings that demand high levels of accountability and evidence‐based practice. The material presented within this article has been interpreted drawing from discourse analysis1to help explore the discourses that shape and influence understandings of nursing practice. What we present are extracts from four of the 35 participant nurses who applied to take part in the Royal College of Nursing Institute's Expertise in Practice (...) (pilot) Project (EPP). The material presented is used to provide a starting point for exploring how nurses talk about and construct expertise in nursing practice. The four nurse participants’ clinical practice areas cover palliative care, mental health, intensive care and fertility care. The material reveals high levels of intensity in the nurse–patient relationship, ‘maverick’ nursing practices and ongoing reflexivity. All of these aspects appear to capitalize on expertise as a ‘catalyst’ that alters treatment pathways and maximizes patient‐centred outcomes. Exploring a discourse of nursing expertise exposes the tacit situated nature of professional practice that is heterogeneous and most difficult to articulate and explain. It is proposed that expertise tends to be understood from traditional and dominant discourses of medicine, management and technology. Explaining expertise in practice exposes non‐conventional practice that in itself can be isolating and challenging to the status quo of contemporary health‐care. (shrink)

Abstract The strength of a discipline is reflected in the development of a set of concepts relevant to its practice domain. As an evolving professional discipline, nursing requires further development in this respect. Over the past two decades in North America there have emerged three different approaches to concept analysis in nursing scholarship: Wilsonian-derived, evolutionary, and pragmatic utility. The present paper compares and contrasts these three methods of concept in terms of purpose, procedures, philosophical underpinnings, limitations, guidance for researchers, and (...) ability to contribute to nursing knowledge and disciplinary advancement. This work extends prior criticisms of concept analysis methods, especially as formulated by Morse and colleagues, by promoting further critical discussion regarding the direction and effectiveness of nursing efforts to meet the basic needs of disciplinary development. Its central thesis is that nursing concept analysis must advance beyond the Wilsonian-derived methods of Walker and Avant by devoting greater attention to understanding the domain of concepts to be analysed and deriving features from these contexts. (shrink)

This paper is a review of the experiences gained whilst working with the ‘expertise in practice project’. The project was concerned with understanding the complex phenomenon of practitioners investigating and evaluating their own practice. The research intention was focused on making a difference to how those nurses practised, through introducing systematic practice‐based inquiry processes that could enable nurses to think more critically about their work and how their practice affects others. Particular attention is paid to the process of engaging people (...) who use healthcare services, as research participants in the evaluation of nursing practice expertise. We outline how the project incorporated practitioners’ concerns about asking people who use health care services opinions on nursing practice expertise and how a process of discovery emerged that enabled transformation of practice and consideration of the patient‐participants’ role as a sophisticated evaluator of health‐care. As a result, we present a case for transformational qualitative research. Such research is values‐driven and uses inclusive, collaborative and facilitative processes. It contributes to human flourishing, not only through its ‘ends’ (i.e. research products) but also, intentionally, through its ‘means’ (e.g. research processes and stakeholder involvement). Thus, transformational research is complex and requires that researchers engage in reflexivity (deep self‐reflection) to examine and critique their personal values. (shrink)

‘Interactional expertise’ is developed through linguistic interaction without full scale practical immersion in a culture. Interactional expertise is the medium of communication in peer review in science, in review committees, and in interdisciplinary projects. It is also the medium of specialist journalists and of interpretative methods in the social sciences. We describe imitation game experiments designed to make concrete the idea of interactional expertise. The experiments show that the linguistic performance of those well socialized in the language of a specialist (...) group is indistinguishable from those with full blown practical socialization but distinguishable from those who are not well socialized. The imitation game can also be used to indicate whether an individual can enter an esoteric domain and master the interactional expertise, a skill required by interpretative sociologists of science, anthropologists, ethnographers, and the like.Keywords: Expertise; Interactional expertise; Imitation game; Turing test; Colour blindness; Interpretative methods. (shrink)

The strength of a discipline is reflected in the development of a set of concepts relevant to its practice domain. As an evolving professional discipline, nursing requires further development in this respect. Over the past two decades in North America there have emerged three different approaches to concept analysis in nursing scholarship: Wilsonian‐derived, evolutionary, and pragmatic utility. The present paper compares and contrasts these three methods of concept in terms of purpose, procedures, philosophical underpinnings, limitations, guidance for researchers, and ability (...) to contribute to nursing knowledge and disciplinary advancement. This work extends prior criticisms of concept analysis methods, especially as formulated by Morse and colleagues, by promoting further critical discussion regarding the direction and effectiveness of nursing efforts to meet the basic needs of disciplinary development. Its central thesis is that nursing concept analysis must advance beyond the Wilsonian‐derived methods of Walker and Avant by devoting greater attention to understanding the domain of concepts to be analysed and deriving features from these contexts. (shrink)