For many years, nurses have sought to define advanced practice (AP). There is now a developing consensus that it should be broadly defined in ways which include and embrace not only clinical practice, but also other domains such as education, management and leadership. This broad definition is congruent with Benner's notion of the novice to expert trajectory and lends support to the view that the risks around AP are minimal, since advanced practitioners by definition have expertise. The broad model of AP, however, ignores one distinct subset of advanced practice nurses who we term nurse practitioners (NPs). NPs are distinct because of their hybrid, quasi-medical practice, which crucially involves autonomous medical diagnosis and treatment. The risks in this area of practice are substantial, and consequently require nothing less than a nationally-regulated set of benchmarks. These must address the training, assessment and registration of NPs for the primary purpose of public protection.
The current political healthcare economy is blurring traditional professional boundaries, and national agendas are requiring nurses to take on more roles and tasks previously undertaken by doctors. The emergency nurse practitioner's expanding scope of practice has moved beyond managing the care of patients with minor injuries, to include those with 'minor' illnesses and indeed beyond that to the management and care of those with increasingly complex, acute and chronic conditions. The process of conjugation between the two disciplines has been driven by the demands and pressures on the health economy. Given the unprecedented and increasing overlap in practice between the domains of medicine and nursing, it is time to re-examine differences between them and clarify the issues which divide them. There is a need to benchmark infrastructure and standardize the education and development of nurses undertaking advanced practice roles. There is also a need for continued debate on the future of the health care workforce, informed by research, to facilitate correct and cost effective decision making.
The objective of this study is to identify the factors which have a significant impact on the performance of students on an undergraduate accounting degree course. Previous research in this area has taken place over many years and has considered a number of factors which might influence performance such as: prior academic achievement, gender, age and numeracy. The findings of these studies have been quite mixed, perhaps reflecting differences in the institutions being considered, the courses analysed and the research methods adopted. This study follows a cohort of students who commenced an undergraduate accounting degree course at a UK University through to their graduation. It unites and tests all the key findings of the other previous studies in this area to determine the key factors affecting student performance. The results can inform universities in terms of their policies on admissions, teaching and retention and also inform students in deciding whether to apply for or continue with an accounting course. The results will also be of interest to academics delivering accounting courses and those with an interest in accounting education.
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