Moving Knowledge to Action: A Qualitative Study of the Registered Nurses' Association of Ontario Advanced Clinical Practice Fellowship Program
Bibliographic record
Abstract
UNLABELLED: With funding from the Ontario Ministry of Health and Long-Term Care, the Registered Nurses' Association of Ontario (RNAO) established the Advanced Clinical Practice Fellowship (ACPF) program in 2000 to improve patient care and outcomes through advanced nursing knowledge and skills. This paper describes the perceptions of ACPF fellows regarding their influence on quality of care and patient outcomes, specifically, the types of practice change activities initiated, successful implementation and influence on outcomes, barriers encountered and strategies used to address them and influence change. METHODS: Thirty telephone interviews were conducted with ACPF fellows after completing their fellowship. Interviews were analyzed using descriptive content analysis. RESULTS: Fifty-one practice change activities were identified. Ratings for successful implementation (1 = not successful, 10 = extremely successful) were 7.2/10; ratings for successful influence on outcomes were 7.4/10. Barriers identified were (a) resistant attitudes, (b) time and workload, (c) lack of administrative support and (d) lack of mentor's involvement. Strategies proposed were (a) building a knowledge base, (b) negotiation and dialogue and (c) self-reliance and persistence. IMPLICATIONS: The ACPF program is an innovative and highly utilized initiative. While this program supports strategic directions of government and nursing professional groups, further research will validate and expand on the specific ways in which the initiative influences professional development, healthcare delivery and patient outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".