Exploring the Professional Identity of Advanced Clinical Practitioners: Constructivist ethnographic qualitative research study

Published: 10 August 2023| Version 2 | DOI: 10.17632/cd5pwwc2sx.2
Anouar Amine, Christopher Mannion


Background: The Advanced clinical practitioner, is a healthcare professional who has undertaken additional years of Master's level training, acquired new skills and capabilities and developed as an autonomous practitioner. Purpose: Whilst several studies have appraised and analysed this professional role, there are limited empirical studies that have explored professional identity formation within this group. This paper explores this evolution. Method: Through a constructivist ethnographic approach, we conducted semi-structured interviews with seven qualified Advanced clinical practitioners within a secondary care setting. We identified key issues regarding professional identity formation. Results: Our research highlights the lack of role recognition which acts as a barrier to Advanced clinical practitioner professional identity formation and further development. Conclusion: Professional identity is an intertwined concept and without enhancing all the components involved in identity formation, the solo individual component cannot enact the formation of a new identity if this is not legitimated by the other components too, including personal, socio-cultural, educational and institutional.


Steps to reproduce

The semi-structured questions are shown in (Appendix 2). These were deductively developed to include domains conceptualised as relevant in professional identity formation through the current literature. Data were analysed using thematic analysis, specifically employing Framework Analysis and encompassing the five stages: familiarisation, identifying themes, indexing, charting and summarizing. MAXQDA 2022 plus software was used to import vocal recordings. Identifying themes and subthemes and subsequent manual qualitative coding then took place. During the stage of interpreting and mapping, emerging themes were explored and categorised and linked to overarching narratives, with researchers undertaking analytics and subsequent critical analysis. A research diary with reflexive notes was kept throughout the study and critical reflection was periodically undertaken to reduce biases. This method was also used to document early impressions, ideas and theories. A participation letter inviting interested colleagues to volunteer for this study was sent to the hospital's current qualified ACPs workforce via the hospital's internal email system. Eight participants were chosen to take part. The study applied a purposive sampling strategy, which is used to maximize sample variation and data diversity. The participants’ professional background, gender, speciality and department with their years of clinical experience were documented. Before commencing the study, information was provided to allow appropriate consent (Appendix 1). All participants were invited to attend recorded individual semi-structured interviews in October 2021. These were undertaken by the same researcher (lead author, Amine) and lasted up to 1 hour. The interviews were based on the domains of professional identity formation as defined by current literature research.


University of Leeds Leeds Institute of Medical Research, Leeds General Infirmary


Professional Education, Professionalism, Clinical Practice, Advanced Nursing Practice, Healthcare Practitioner