Clinical Practice Development Using Novice to Expert Theory Book

	Contributors	xi
	Foreword	xv
	Acknowledgments	xix
	Introduction	xxi
Chapter 1	Vision to Reality: A Historical Perspective	1
	From Career Ladder to a Clinical Development Model	2
	Reflecting on the Past	2
	The Peer Review Process	7
	A Language Needed for Practice	8
	The Effects of Culture on Care	9
	Doing Versus Being	10
	Shifting the Paradigm: Implementation of a New Governance Model	11
	Next Steps	16
Chapter 2	The Clinical Practice Development Model: Making the Clinical Judgment, Caring, and Collaborative Work of Nurses Visible	17
	Using Clinical Narratives to Reflect on Practice--Growing and Extending Excellent Practice	31
	Reading and Reflecting on Narratives	35
	The Distinctions, Dis-junctures, and Risks in Using Narratives as Research Data and Using Narratives as Evaluation Tools	39
	References	41
Chapter 3	Developing the Clinical Practice Development Model at St. Luke's Medical Center	43
	The Emergence of a New Model	43
	Getting Started	44
	Narrative Workgroup Selection	45
	Consultation Support	47
	First Steps in Design	47
	Development of Practice Domains	48
	First Communications with the Entire Nursing Body	52
	Next Steps	53
	Validation	53
	Creating an Understanding of the New Model	53
	Promoting Leadership Proficiency	64
	Implementation	64
Chapter 4	Use of a Steering Committee to Guide Implementation	65
	Decision to Use Narratives to Measure Practice	68
	Separating Clinical Advancement from Annual Review	69
	CPDM Implementation Workgroup	70
	Learning About the Concerns of Staff	72
	Developing New Understanding	74
	Champions for Change	76
	Model Education	77
	Transition Celebration	80
	Completion of Transition	82
	Evaluating the Process	83
	Summarizing the Transition	84
	Suggested Reading	85
Chapter 5	Determining Staff Nurses' Developmental Stages Using a Peer Review Process	87
	A Historical Look at Peer Review	88
	Structuring the Process at St. Luke's	91
	First Panel Members	92
	Validation Process	93
	Creation of House-Wide and Unit-Based Panels	102
	Panel Facilitator Role	102
	Coordination of the Paneling Process	107
	Panel Narrative Packet	108
	Applicant's Interview	111
	Applicant and Panel Members' Responses	113
	Supporting Panel Members	114
	References	116
Chapter 6	Coaching: An Integral Component	117
	Learning Relationships	117
	Leadership's Role	119
	Enhancing Professional Growth through Focused Practice Dialogue	120
	Learning the Coaching Role	122
	Coaching Guidelines	127
	Essential Elements	130
	Fostering Professional Development and Lifelong Learning	133
	References	135
Chapter 7	Staff Nurses' Experiences During Transition and Beyond	137
	Study Purpose and Methodology	139
	Results of the Study	144
	Summary and Recommendations	150
	References	151
	Suggested Readings	151
Chapter 8	The Manager's Experience	153
	Management Council Accountabilities	153
	Removing System Barriers to Practice	160
	Posttransition: Using Knowledge of Staff's Developmental Stages to Achieve Organizational Goals	161
	A Practical Approach to Achieving Desired Outcomes	162
	Summary	163
	Reference	164
Chapter 9	Moving Beyond Transition: Enhancing the Process Through Performance Improvement Activities	165
	Transition Process Enhancements	167
	The Starting Point: Applicant Accountabilities	168
	Monitoring the Quality of the Peer Review Panel Process	168
	Monitoring Panel Outcomes	171
	Appeals	171
	Panel of Nonconsensus	172
	Ongoing Monitoring of the Process	173
Chapter 10	Metro Clinical Practice Development Model: Redesign for the Region	175
	History	176
	The Design Team	178
	Design Team Charter	179
	Clinical Focus Determined	180
	Benner's Novice to Expert Model is Chosen	184
	Creating the Metro Clinical Practice Development Model (MCPDM)	188
	Implementation	192
Chapter 11	Future Trends: Advancing Professional Practice in an Interdisciplinary Model	195
	Interdisciplinary professional Practice Model	197
	Interdisciplinary Collaborative Governance Structure	200
	Professional Development Committee	203
	Articulating Themes of Practice through Clinical Narratives	204
	Review Process for Themes of Practice	206
	Clinical Narratives as Tools to Enhance Professional Development	213
	Continuing Steps	213
	Summary	215
	References	215
Chapter 12	Defining the Essence of Health Care Practice through Novice to Expert Models: Research-Basis and Future Opportunities	217
	Are Novice to Expert Models Valid and Reliable?	218
	Internal Validity, Credibility, and Authenticity	218
	External Validity, Transferability, and Fittingness	220
	Reliability, Dependability, and Audibility	221
	Summary of Validity and Reliability Issues	225
	Future Directions for Research	225
	Conclusion	226
	References	227
Chapter 13.	The Role of the Chief Nurse Executive in Fostering Excellence in the Professional Practice Environment	229
	A New Context for Organizations	229
	The Role of the Chief Nurse Executive	230
	The Role of the Professional Nurse	231
	The Role of Professionals in Organizations	232
	Nursing as a Profession	234
	Nursing Shared Governance	235
	Peer Review and Professional Practice	236
	Building for Excellence in Patient Care	238
	References	239
Appendix A	From Career Ladder to Clinical Practice Development Model (CPDM): A Timeline at a Glance	241
Appendix B	Professional Nursing Assembly Diagram and Bylaws	245
Appendix C	Clinical Practice Development Model	253
Appendix D	Staging/Advancement Policy for the Clinical Practice Development Model	263
Appendix E	CPDM Applicant Feedback Form	275
Appendix F	CPDM Coach Feedback Form	279
	Index	281
	About the Contributors	291