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An Advanced Nurse Practitioner course for Educators – opportunities and future challenges, an experience from the Nordplus network

TEXT: Daniel Nenonen RN, MSc and Rika Levy-Malmberg RN, PhD

The Advanced Nurse Practitioner (ANP) course for educators was organized by Turku University of Applied Sciences under the Nordplus network during 29.05.23 – 2.06.23.  Countries from the Nordic and Baltic states participated, from Finland three universities of Applied Sciences took part in the course: Turku University of Applied Sciences who have had the ANP program for several years and who also acted as the coordinator of the Nordplus network; Jyväskylä University of applied Sciences that will start an ANP program in English in August 2023 and have a well-established program for ANP in Finnish; and Novia University of Applied Sciences which was the pioneer university in the Nordic countries and in Finland to start the education in 2007. Two lecturers teaching in the ANP program at Novia took part in this inspiring course.

ANPs are highly trained and educated nurses who have completed an advanced level of education, usually a Masters degree or Doctors degree. They possess the expertise to diagnose and treat various medical conditions, in several countries. They can also prescribe medication and interpret diagnostic tests and provide comprehensive care to patients.  Countries in the Nordic and Baltic states have a variety of roles for the ANP. ANPs play a crucial role in health care, particularly in underserved areas as rural areas, and collaborating with other healthcare providers to enhance patients’ outcomes.

The participants shared concerns and visions concerning the legislation in each country and the content formulating the curriculum. We had the opportunity to share our experiences and gain new understandings from our Nordic and Baltic colleagues. For example, a unique role for Clinical Nurse Specialist (CNS) programs on a Master level and the legislation in Iceland, gave some new visions for future development. Teachers from more established ANP programs shared their concerns about the need for more educated nurses to meet the demand of a growing elderly population in their countries or the lack of physicians, which creates a path for career development for nurses. In all the Baltic and Nordic states, the education for ANP is organized on Master level but the legislation for ANP varies between countries.



New experience and ideas

The course included a variety of lectures, workshops and group discussions. The host university also put an emphasis on connecting and networking between the participants. This was especially important because the ANP role is relatively new in the majority of the countries or even in its infancy for example in Sweden and in the Baltic states.

It became clear that despite the differences between countries and educational institutions the same competencies were required to complete ANP’s programs. Competencies like advanced clinical skills, comprehensive assessment, diagnostics, the ability to process information and generate recommendations based on evidence were emphasized. The challenges to teach ANPs and ideas for courses to increase clinical competences were discussed during several group discussions.  

Focus was also put on the ways educators evaluate student's skills and knowledge within the ANP education. In most cases the Objective Structured Clinical Exam (OSCE) was the preferable tool for evaluation. OSCE is a widely used assessment method in medical and healthcare education. It’s designed to evaluate clinical skills competency and performance of students in a standardized setting. During the OSCE, participants rotate through a series of stations, where they are required to interact with standardized patients, usually an actor. The international community of ANPs has recognized the OSCE method, therefore, in Novia, we have been using this method since 2009. During the group discussions we shared our experiences about OSCE and discussed the different applications of this exam also in BsN level. We were inspired by the application in Turku were the OSCE was including peer learning and the evaluators included also one student in each station. 

Common challenges

Three main challenges all programs shared. The first was how to raise awareness about ANP and the possibility for programs improvement. ANP was understood as the opportunity for nurses’ career development path and at the same time to create an advanced role that will benefit the health care system in each country. The second challenge relates to the legislation and registration for ANP’s that needs to be developed in each county. It is important to add that in Finland a group of educators are meeting regularly toward achieving a registration for ANP in Valvira. The third is the deliberate need to integrate practice courses in the curriculum. This issue is important in order to meet the recommendation of the International Council of Nurses (ICN). However, in Finland in all Universities of Applied Sciences this significant subject has not been addressed yet and has to be considered and discussed in the future.

The future

The need for ANP will intensify in the future due to a growing need for nurses with advanced clinical and expert knowledge.  The number of programs for ANP will grow in all countries and bring new opportunities and challenges. The opportunity to share knowledge, experiences and concerns is a productive way of cooperation and it is understood as a part of lifelong learning for us. We are looking forwards to more cooperation between the universities in the near future.

Svängrum-e Utges av Svenska Österbottens förbund för utbildning och kultur skn (Söfuk)

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Redaktionsråd: Maria Nystrand, Carola Harmaakivi, Simon Ventus, Caroline Lång 
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