Activities and Attributes of Nurse Practitioner Leaders: Lessons from a Primary Care System Change
Bibliographic record
Abstract
Nurse practitioners (NPs) are being encouraged to practice to the full extent of their skills, and they have a critical role to play in leading health system reform. The evidence in support of NP-led initiatives is growing; however, in spite of the positive outcomes associated with these initiatives, considerable opposition to and debate about the potential for NPs to lead health system change and interprofessional teams continues. To date, we know very little about NP leadership activities, particularly those activities that contribute to primary care system change, and there are very few examples of this type of leadership. The qualitative descriptive study here was part of a larger case study that examined stakeholder participation in a system change led by NPs. The change involved the introduction of a new NP-led model of team-based primary care delivery in Ontario, Canada. Data from participant interviews and public documents were analyzed to describe the activities and attributes (perseverance, risk-taking and effective communication) of two NP leaders who were the drivers of this change. Knowledge of these activities and attributes has the potential to inform NP leadership roles in health system policy planning and implementation. However, to be able to provide effective leadership in system change, NPs need access to educational content about public policy and opportunities to develop and practice the skills required to work with multiple stakeholders, including those who oppose change.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".