![]() In our framework the individual characteristics of the nurse, such as education level and years of experience, influence an individual nurse's clinical expertise. A contextual approach is particularly useful for understanding organizational phenomena where individuals are nested within larger systems such as nurses within hospitals. The organizational context includes the educational and experiential composition of the staff and the nurse practice environment. Through this framework, derived from the sociology of organizations ( Blau, 1960 Shortell & Getzen, 1979), we suggest that the organization provides a context that influences individual outcomes. 1) to describe how clinical expertise develops through both individual and organizational factors. We developed a multi-level framework ( Fig. We then outline the relationships between expertise and the three principal concepts examined in this study-experience, education, and the nurse practice environment. Our study contributes evidence about the theoretical relationships between individual and contextual factors and expertise that may guide efforts to improve nurses' expertise.Īs background for the study, in this manuscript we first outline the theoretical framework used to structure this investigation and then review the literature related to expertise in nursing. We hypothesized that contextual factors affect expertise above and beyond individual factors. We capitalized on a large multi-level secondary data set of nurses in hospitals to examine individual nurses and their contexts. ![]() These contextual factors include the educational and experience levels of a nurse's coworkers as well as the nursing practice environment. A notable gap in this debate that we examine is the influence of hospital contextual factors on an individual nurse's expertise. Debate continues about the respective contributions of experience and education to expertise. ![]() Research on the foundations of expertise has focused on individual characteris tics-particularly a nurse's years of experience and level of education. ![]() Clinical nursing expertise is fundamental to quality of care. ![]()
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