Competency and Role Development in Advanced Nursing Practice Following a Swiss Master's Cohort Through Education and Early Clinical Practice: Protocol for a Longitudinal Convergent Mixed Methods Study.

Background: Master's degree programs in advanced nursing practice have been established in Switzerland for approximately 2 decades, and the role of advanced practice nurses (APNs) is increasingly embedded within the Swiss health care system. Despite their growing presence, there remains a lack of clarity and consistency regarding this progress; persistent ambiguity in role definitions, expectations, and competencies continues to hinder consistent implementation and contributes to uncertainty for both APNs and employers. Existing research has not sufficiently examined how APN competencies and role perceptions develop during graduate education and the early transition to practice. This substudy of the EDUCate research initiative, EDUCate-Competence and Role Development (EDUCate C-ARE), focuses exclusively on a defined cohort of master's students and follows their competence and role development longitudinally. Objective: The EDUCate C-ARE substudy aims to provide a comprehensive understanding of how APN competencies and role perceptions change during a master's program and in the first year following graduation (research question [RQ] 1), identify factors that facilitate or hinder their development (RQ 2), and explore challenges that APNs report during this process (RQ 3). Methods: A longitudinal convergent mixed methods design will be applied. Quantitative data on APN competencies are collected using the Advanced Practice Nursing Competency Assessment Instrument at 4 time points (T0-T3), and qualitative data are generated through semistructured interviews at 3 time points (I1-I3). The quantitative and qualitative strands are analyzed independently and subsequently integrated using joint displays and narrative weaving to highlight convergence, complementarity, or divergence. Data collection spans 4 years, beginning in September 2023. Results: Baseline (T0) and midprogram (T1) quantitative data have been collected, with 141 students responding at T0 (full time: n=25, 17.7%; part time: n=56, 39.7%) and T1 (full time: n=17, 12.1%; part time: n=43, 30.5%). Data collection at T2 is ongoing. Initial analyses have been completed for T0 and T1. Qualitative interviews at I1 have been conducted and preliminarily analyzed (full time: n=6; part time: n=20). Data collection for full-time students is expected to conclude by May 2026, with preliminary findings anticipated by August 2026; for part-time students, data collection will continue until August 2027, with initial findings expected by October 2027. Integrated study results are anticipated by late 2026, with final analyses following completion of all data collection phases. Conclusions: This study will generate longitudinal evidence on APN competence and role development in a Swiss master's cohort. By developing a conceptual, explanatory model of competence acquisition, role perception, and influencing factors, the study is expected to inform curriculum development, strengthen role clarity, and support the evidence-based implementation of APN roles in the Swiss health care system. Findings will contribute to national and international discussions on APN competency frameworks and professional role development.