ObjectivesIn response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.DesignA scoping review was undertaken following JBI methodological guidance.Methods13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.Results191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.ConclusionThis review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.

IntroductionA global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.Methods and analysisThis scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).DisseminationThe review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.

ObjectiveWe aimed to support service transformation by developing a core capabilities framework for first contact practitioners working with people who have musculoskeletal conditions.MethodsWe conducted a modified three-round Delphi study with a multi-professional panel of 41 experts nominated through 18 national professional and patient organizations. Qualitative data from an open-ended question in round one were analysed using a thematic approach and combined with existing literature to shape a draft framework. Participants rated their agreement with each of the proposed 142 outcomes within 14 capabilities on a 10-point Likert scale in round two. The final round combined round two results with a wider online survey.ResultsRounds two and three of the Delphi survey were completed by 37 and 27 participants, respectively. Ninety practitioners responded to the wider online survey. The final framework contains 105 outcomes within 14 capabilities, separated into four domains (person-centred approaches; assessment, investigation and diagnosis; condition management, intervention and prevention; and service and professional development). The median agreement for all 105 outcomes was at least nine on the 10-point Likert scale in the final round.ConclusionThe framework outlines the core capabilities required for practitioners working as the first point of contact for people with musculoskeletal conditions. It provides a standard structure and language across professions, with greater consistency and portability of musculoskeletal core capabilities. Agreement on each of the 105 outcomes was universally high amongst the expert panel, and the framework is now being disseminated by Health Education England, NHS England and Skills for Health.

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In response to poor student attainment rates, the teaching, learning and assessment strategy of a Level 1 circuit theory unit has been revised to emphasise the importance of regular attendance at teaching sessions, and also to provide regular formative feedback. As part of the assessment scheme a tutorial workbook has been used for both formative and summative assessment. The workbook is assessed regularly during scheduled teaching sessions. The use of objective questions has reduced the time taken to assess the work, while the regular assessments help with student motivation, provide formative feedback, and help students to structure and pace their learning. Keywords circuit theory; formative assessment; objective tests; student motivation and attainment rates Southampton Institute offers a range of courses at undergraduate and Higher National level that include the study of electrical and electronic engineering. Many of these programmes are offered in full-time and part-time study modes. Consequently students have a wide range of prior skills, experiences and learning styles. Students enrolling on the various programmes also have a wide range of educational qualifications, including 'A'-levels, BTEC National Diplomas/ Certificates and various international qualifications. Students also join their course after completing a Foundation or Access programme, either at Southampton Institute or elsewhere. Teaching staff have therefore sought to develop appropriate teaching, learning and assessment strategies, while making efficient use of resources, particularly staff time, and meeting institutional and external demands for outcomes-based programmes. This paper describes our approach to the delivery and assessment of a Level 1 circuit theory unit presented to a group of 40-60 students each year. The cohort includes full-and part-time students, where part-time students normally attend for one full day per week. The unit is presented in one semester of 15 weeks, comprising 12 teaching weeks, 1 'revision' week and 2 weeks allocated for end-of-unit assessments. Some students do not have good time-management skills or may initially underestimate the commitment necessary to complete their course successfully. Providing timely formative feedback is therefore vital for students and teaching staff. A 12-week teaching period does not allow much time for remedial action by either student or teacher. Our experience has been that students who attend regularly and diligently complete all work set generally complete their course successfully.