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AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa. BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue. SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects. DISCUSSION: Four African countries have formally adopted the advanced practice nurse practitioner role, with significant interest from countries throughout Africa, and ever-increasing requests for assistance regarding initiation, development and integration of advanced practice roles. Initiatives to advance the roles have been supported by the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network and Global Academy of Research and Enterprise. Next steps and projects for future role development are discussed. CONCLUSIONS: There is a progression towards the adoption of the advanced practice nurse practitioner role in Africa, and further mechanisms are suggested to allow full uptake and utilization. IMPLICATIONS FOR NURSING PRACTICE: Prioritization and investment in initiatives implementing nurse practitioner/advanced practice nurse roles in Africa allows nurses to pursue further education, advanced role and leadership opportunities consistent with Nursing Now goals. IMPLICATIONS FOR HEALTH POLICY: Implementation of nurse practitioner/advanced practice nurse roles increases the primary care workforce, consistent with recommendations and priorities in the World Health Organization Global Strategic Directions for Nursing and Midwifery 2021-2025 helping countries ensure that nurses optimally contribute to achieving universal health coverage and other population health goals.
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AIM: To examine the diagnostic reasoning skills of two nurse practitioner student cohorts. INTRODUCTION: Nurse practitioners continue to play a pivotal role in health care provision. Diagnostic reasoning is a core skill of advanced practice. A comparative diagnostic reasoning study between two student cohorts was undertaken between 2018 and 2019. METHODS: A validated diagnostic reasoning scale was completed by nurse practitioner students in the United Kingdom and the United States of America at the beginning and end of their clinical placements. The study utilized descriptive quantitative statistics from the data submitted by 22 survey respondents from an online survey. RESULTS: Analysis of the diagnostic reasoning skills suggested there was a difference in the structural memory scores when compared with the beginning of their clinical placements and the final semester of their clinical placements. CONCLUSION: Diagnostic reasoning skills are a core skill of advanced practice. As students progress through their training, these skills improve. Despite the statistical difference in diagnostic reasoning scores, caution should be made in determining any larger implications due to the small number of participants in this study. Further study is needed in this area.