Letter in response to 'The conceptual model of advanced practice does include research'.

This letter refutes the suggestion made the authors of other letters to the Editor that the proposed model of the characteristics of advanced practitioners excludes research.

Re:

We are pleased that the paper on the ‘Conceptualisation of the Characteristics of Advanced Practitioners …’1 has generated such interest; however, as indicated in our previous letter to the editor,2 research is explicitly included in the model, not omitted as has been suggested.3 In fact, the word ‘research’ is used in 25 instances in the article, all with positive intent. This count is not itself a true indication of the degree to which we value research as part of advanced practitioners’ roles but rather makes the point that research has not been omitted. Instead, it is integrated across the various essential characteristics, emphasising the principal clinical role of advanced practitioners.1

The opinion that research has been omitted because it is not one of the seven essential characteristics is to take a somewhat superficial view of the article and of the model itself. We agree with the authors of the two recent letters4, 5 that research must be highly valued in any profession. We admire the progress made on the development of radiation therapist advanced practitioner roles in Canada.3 Their research output is excellent but our paper makes it clear that advanced practitioner performance should be measured by, among many other performance indicators, their ‘research track record’, ‘conference publications’ and ‘peer‐reviewed publications’, under the characteristic of ‘Evidence‐Based Practice’ in Table 1.1

The same authors are critical of the use of the CanMeds model in the development of our model;4 however, it is obvious by making a comparison between the two models that we have not simply replicated CanMeds but used it, together with other models referred in the article, to inform the model of medical radiation advanced practitioner characteristics. It is true that the medical radiation professions have a markedly different history to medicine, but if advanced practitioners in our professions are to perform clinical roles traditionally performed by specialist medical practitioners, surely they must possess comparable essential characteristics. We argue that advanced practitioner performance in the medical radiation professions must be benchmarked against that of radiologists and oncologists.

The other letter contains misinformation in saying that in our model ‘emphasis was placed on separating clinical practitioners from conducting research’.5 At no point in the article did we profess or countenance such an opinion. Indeed, even in the abstract it is stated that advanced practitioners will use ‘evidence‐based practice, with judgements made on the basis of research findings, including research by the advanced practitioner’.1

In that same letter it is suggested that the level of research knowledge and skills we have advocated is no better than that of a new graduate practitioner.5 Undergraduates do not produce a Masters level research thesis. At best, they would have an introductory knowledge of research principles, not the ability to ‘understand and articulate research design and methodologies’, let alone interpret, translate and apply research findings in clinical practice, as well as promoting ‘a research culture in the clinical environment’ by educating and mentoring others.1 The letter's author displays a simplistic view of research, which, when performed well, is exceptionally time consuming and requires the utmost dedication. If it was a mandatory essential characteristic of advanced practitioners to be active researchers, it would be expected to take them away from what we consider their essential, frontline, core clinical service role.1 Although, again, we do not exclude research from the comprehensive knowledge, skills and abilities that advanced practitioners must possess in the medical radiation professions.