Abstract

Background:
In professional healthcare fields, such as nursing, there has been a notable evolution of advanced roles, including non-medical prescribing (NMP) and advanced clinical practice (ACP). Within higher education institutions (HEIs), the curricula supporting these roles emphasise theoretical foundations related to conducting comprehensive patient assessments, with the primary aim of ensuring patient safety. Consultation models in healthcare refer to structured frameworks or approaches that guide healthcare professionals through patient interactions. These models outline the process of conducting patient consultations, ensuring that key elements, such as gathering information, building rapport, diagnosing conditions, formulating management plans, and engaging in shared decision-making, are systematically addressed.

Historically, the instruction of theoretical concepts associated with the medical consultation was primarily tailored to medical students prior to the establishment of advanced practice courses. Consequently, consultation models traditionally developed and utilised were created with physicians as the intended users, rather than nurses or other allied health professionals. This raises critical questions about the extent to which these models can be effectively adapted and applied to non-medical practitioners and advanced clinical practitioners practice, proposing an area of scholarly investigation.

Aim:
To explore the experiences of newly qualified non-medical prescribers and advanced clinical practitioners in utilising consultation model theory, within the clinical environment.

Methods:
This study employed a qualitative research design informed by the principles of grounded theory. Seventeen participants from diverse healthcare settings were included, all of whom had recently completed non-medical prescribing or advanced practice courses and were actively engaged in patient assessment and diagnosis within clinical environments. Data collection occurred in two phases: phase one involved gathering data through free-writing contributions, followed by phase two, which consisted of semi-structured interviews. Data analysis was conducted iteratively, with ongoing analysis throughout the data collection process, allowing emerging themes to guide subsequent inquiry, consistent with the constructivist grounded theory approach.

Findings:
Participants highlighted the benefits and challenges of learning consultation models and applying them in practice for patient assessment. They also discussed how these models supported their transition into roles with increased responsibilities. The emergent theory was: Using consultation models facilitated my transition towards working as an autonomous practitioner with additional responsibilities and an extended scope of practice.

Conclusions:
This is the first qualitative in-depth study to explore the experiences of non-medical prescribing and advanced practice graduates in learning and subsequently applying theory into practice associated with the use of consultation models. Learning consultation models facilitated the transition for graduates into roles with added levels of responsibility. These findings can inform and improve the teaching of patient assessments within HEIs.