The current confusion surrounding the definition and role function of the nurse practitioner (NP) has created a situation in which advanced clinical practice is delivered in a variety of ways and at many levels. Not surprisingly, this has led to difficulties in regulating educational provision for NPs. This study reports a survey of the perceptions of the role definitions and training needs of all nurses working at advanced clinical levels within an acute sector Trust. Although this concept is not a novel one in advanced nursing practice, the procedure adopted differed from previous studies in two fundamental ways: firstly, a unique training needs assessment instrument was used, which because of its validity and opacity, was capable of yielding a highly reliable data-base, comprising a prioritized profile of real training needs as opposed to the standard wish-list typically elicited. Secondly, it did not rely simply on the self-reported needs of the nurse sample, but also included the perceptions of the sample's immediate medical and managerial colleagues. In this way, a triangulation paradigm was adopted. The results indicated that overall, there was high agreement between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat different opinions being offered by the medical staff. When the raw scores were standardized to correct for response bias, the data provided an operational definition of the role of the NP and a prioritized profile of training needs for nurses who wished to train to this level.
