The term 'practice development' is widely but inconsistently used in British nursing, addressing a broad range of educational, research, and audit activity, but there appears to be little consensus as to what practice development actually involves. Such lack of clarity means that the increasing number of nurses whose work involves addressing practice development issues can have difficulty in focusing their efforts. To try to clarify the concept of practice development and to describe the focuses of practice development work and the approaches used, a concept analysis was conducted. Both primary and secondary data were gathered and analysed in the study. One hundred and seventy seven items of published literature were gathered and analysed. Focus group interviews were carried out involving 60 practice developers. In addition, 25 clinical nurses were interviewed about their experiences of being involved in practice development. This paper describes the identified purposes, attributes and outcomes of practice development. Practice development activities are described as addressing the effectiveness of care through the transformation of care practices and cultures. Practice development is described as a systematic, rigorous activity underpinned by facilitation processes. The outcomes of practice development can be described in terms of changes in the behaviours, values and beliefs of staff involved. Parallels between practice development and current policy imperatives are outlined.

This paper identifies current UK policy for exploring both competence and expertise. It is argued that the purpose of assessing competence and expertise is relevant in deciding the approaches used. Different perspectives about competence, specifically those that have arisen in the United States and the United Kingdom, are considered in relation to how competencies may be developed and assessed. The different terms used in discussion about competency are also discussed. From the literature, criteria for selecting experts in nursing, the attributes of expertise and enabling factors are presented in relation to how expertise in practice may be judged. The pilot recognition process and development of evidence for the Royal College of Nursing's Expert Practice Project, together with its facilitation through critical companionship, are described. It is concluded that the processes necessary for demonstrating expertise in practice are consistent with the recognition that the attributes of expertise are interdependent, complex and situational. Critical companionship provides a mechanism which is primarily developmental and supportive, but focuses on practice development and practitioners' effectiveness and can result in the development of evidence for a range of different purposes such as demonstrating expertise, as well as practice development, service development and career progression.

Practice development is a widely used term within British nursing. However, there is a lack of consistency and clarity in the way that the term is used. A small-scale qualitative telephone interview study was therefore conceived to explore practitioners' views of practice development. Qualitative telephone interviews were carried out with 26 nurses working in a range of settings and roles around the UK. Informants reported varying degrees of awareness of practice development roles and activities ranging from little awareness to being closely involved. Most informants seemed to place more emphasis on issues of personal development and educational aspects of practice development than is found in the literature. Practice development staff were seen as having a range of functions ranging from working with individual practitioners to the co-ordination of education and training within an organization. The credibility of practice development staff was closely related to their clinical experience and ability.

There is a growing interest in practice development as a systematic process for the development of quality patient care. Whilst there is a range of accounts of practice development in the literature, little work has been undertaken to develop an understanding of the systems and processes involved and there is even less on the roles involved in practice development. This paper explores in particular the characteristics, qualities and skills of practice developers, i.e. professionals who have formal responsibility for developing practice in organizations. The paper represents part of a larger study exploring the conceptual basis of the term 'practice development'. Data for this part of the project were collected through literature analysis, seven focus groups involving 60 practice developers and telephone interviews with 25 practising nurses with experience of working with practice developers. The data were analysed using cognitive mapping processes. Four role functions are presented in the paper, as well as qualities and skills needed to operationalize the identified role functions. A clear picture of the skills and qualities required by practice developers emerges from the data.

It 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 analysis1 to 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.