{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:03:39Z","timestamp":1790381019725,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>The mixed\u2010method review aimed to synthesize research on how clinical nurse specialists' expertise develops from novice to expert and how this progression can be supported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodological Design and Justification<\/jats:title>\n                    <jats:p>The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) and was registered on PROSPERO. A mixed\u2010methods approach was used to combine qualitative and quantitative data and enhance the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Methods<\/jats:title>\n                    <jats:p>Literature search was conducted in CINAHL, PubMed and Scopus in September 2024. The selection and quality assessment of the studies were performed using JBI critical appraisal tools. The synthesis was based on qualitative and quantitative studies, using Benner's \u2018From Novice to Expert\u2019 model as a framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical Issues and Approval<\/jats:title>\n                    <jats:p>Ethical approval was not required for this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures<\/jats:title>\n                    <jats:p>The main outcomes were stages of expertise development and factors supporting progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven articles were included for review. Becoming a clinical nurse specialist requires a basic nursing degree, clinical experience and a higher education degree. According to the results, expertise was seen to develop through three stages: novice, competent and expert, with the support of organizations, mentors, colleagues and multi\u2010professional collaboration. Pursuing continuing education while gaining experience is essential to carry on the journey towards expertise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Limitations<\/jats:title>\n                    <jats:p>The study screening process may have introduced selection bias, potentially leading to the omission of relevant articles. Additionally, selected articles on other interventions, such as service development, were excluded. However, they could have provided further insights into development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review shows that developing CNS expertise from novice to expert requires education, clinical experience, and continuous professional support. Strengthening structures and collaboration enhances patient care, while further research on support strategies and competencies is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70300","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:55:08Z","timestamp":1784094908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Nurse Specialists' Journey From Novice to Expert\u2014A Systematic Mixed\u2010Method Review"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1886-0554","authenticated-orcid":false,"given":"Sanna Marika","family":"Imel\u00e4inen","sequence":"first","affiliation":[{"name":"Department of Nursing Science University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5974-8732","authenticated-orcid":false,"given":"Tarja Anneli","family":"Kvist","sequence":"additional","affiliation":[{"name":"Department of Nursing Science University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7669-6249","authenticated-orcid":false,"given":"Mea Mirella Marjatta","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Nursing Science University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista Susanna","family":"Jokiniemi","sequence":"additional","affiliation":[{"name":"Department of Nursing Science University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Guidelines on Advanced Practice Nursing 2020","author":"International Council of Nurses [ICN]","year":"2020"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.22605\/RRH4260"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15587"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000373"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16032"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000424"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NUR.0000299619.28851.69"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000684"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000442"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13183"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0b013e3182a0ba68"},{"issue":"8","key":"e_1_2_12_13_1","first-page":"775","article-title":"The Development of an Oncology Clinical Nurse Specialist Fellowship Program","volume":"10","author":"De Villiers A.","year":"2019","journal-title":"Journal of the Advanced Practitioner in Oncology"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3928\/01484834-20220303-05"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1130-8621(18)30055-X"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2019.102685"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2019.102796"},{"key":"e_1_2_12_18_1","unstructured":"World Health Organization [WHO] \u201cStronger Collaboration Better Health \u2013 Global Action Plan for Healthy Lives and Well\u2010Being for All \u201dhttps:\/\/www.who.int\/initiatives\/sdg3\u2010global\u2010action\u2010plan."},{"key":"e_1_2_12_19_1","unstructured":"World Health Organization [WHO] \u201cWorking for Health and Growth: Investing in the Health Workforce \u201d Report of the High\u2010Level Commission on Health Employment and Economic Growth https:\/\/www.who.int\/publications\/i\/item\/9789241511308."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12753"},{"issue":"5","key":"e_1_2_12_21_1","first-page":"339","article-title":"Generic Competence of Social and Health Care Professionals \u2013 A Survey Study of Nurses and Public Health Nurses","volume":"40","author":"Soini H.","year":"2021","journal-title":"Hallinnon Tutkimus (Journal of Administrative Studies)"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCC.0000000000000342"},{"key":"e_1_2_12_23_1","first-page":"1","volume-title":"From Novice to Expert. Excellence and Power in Clinical Nursing Practice","author":"Benner P.","year":"2000"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0270467604265061"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11577\u2010017\u20100454\u20101"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-D-19-00169"},{"key":"e_1_2_12_27_1","article-title":"Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses: The PRISMA Statement","volume":"6","author":"Moher D.","year":"2009","journal-title":"Annals of Internal Medicine"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2018.345"},{"key":"e_1_2_12_30_1","unstructured":"Covidence \u201cBetter Systematic Review Management \u201dhttps:\/\/www.covidence.org\/."},{"key":"e_1_2_12_31_1","unstructured":"IDoStatistics \u201cCohen's Kappa Free Calculator \u201dhttps:\/\/idostatistics.com\/cohen\u2010kappa\u2010free\u2010calculator\/#calculator."},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010016\u20100449\u20104"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000531"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000078"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000415"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2019.03.001"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000825"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000278"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000394"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.4215"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2013.03.005"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2012.04.007"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000703"},{"key":"e_1_2_12_44_1","volume-title":"Pan\u2010Canadian Core Competencies for the Clinical Nurse Specialist","author":"Canadian Nurses Association","year":"2014"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-97103-2_2"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15095"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-05536-2_1"},{"key":"e_1_2_12_48_1","volume-title":"Clinical Nurse Specialists","author":"Canadian Nurses Association","year":"2023"},{"issue":"2","key":"e_1_2_12_49_1","article-title":"Challenges in Clinical Nurse Specialist Education and Practice","volume":"19","author":"Foster J.","year":"2014","journal-title":"Online Journal of Issues in Nursing"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000357"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0b013e3182011eda"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0000000000000201"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2011.12.004"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1590\/0034-7167-2021-0573"},{"key":"e_1_2_12_55_1","volume-title":"Consolidated telemedicine implementation guide","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_56_1","volume-title":"Competence Structure 2035. Sectoral Competence Needs of the Future and Challenges of Developing Education and Training \u2013 Results of the National Forum for Skills Anticipation's Work","author":"Leve\u00e4lahti S.","year":"2019"}],"container-title":["Scandinavian Journal of Caring Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scs.70300","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/scs.70300","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scs.70300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:52:22Z","timestamp":1790380342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/scs.70300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":55,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/scs.70300"],"URL":"https:\/\/doi.org\/10.1111\/scs.70300","archive":["Portico"],"relation":{},"ISSN":["0283-9318","1471-6712"],"issn-type":[{"value":"0283-9318","type":"print"},{"value":"1471-6712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"2024-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70300"}}