Keywords
Professional Identity
Advanced Practice Nursing
Specialist Nursing
Scientific Societies
Competency-Based Education
Health Policy
Workforce Planning
Abstract
Introduction. The publication in the Italian Official Gazette (12 May 2026) of the decree activating second-cycle clinical Master’s tracks (primary care; intensive and emergency care; pediatric) has reopened a long-standing question about how specialist practice and advanced practice can be combined in concrete professional exercise. Nursing scientific societies have a stake in this transition as cultural infrastructures that connect education, regulation, the labor market, and health-service implementation.
Objective. To develop a shared, policy-oriented position on how nursing scientific societies can contribute to the architecture of professional identity in Italy, using the roundtable discussion held at The Nursing Forum 2026 as the primary deliberative material.
Methods. Documentary qualitative analysis of the full roundtable transcript (eight societies plus the chair) combined with reflexive thematic analysis and exploratory lexicometric analysis (word and n-gram frequencies, keyword-in-context, term co-occurrence). The position-development process was iterative, with checkpoint-based validation by the writing group.
Findings and position statements. Seven themes were identified, from which nine numbered position statements were derived, addressing professional identity as social mandate; the distinction and connection between specialist and advanced practice; competency frameworks as shared language; validation of specialist education; alignment of the new Master’s degrees with workforce planning, accreditation and contracts; explicit workforce numbers; safe attribution and visibility in information systems; outcomes as the ultimate criterion; and scientific societies as cultural infrastructure.
Conclusions. Professional identity should be anchored in nursing’s social mandate and made visible, accountable, and measurable. Scientific societies can connect education, competencies, accreditation, and policy, provided that workforce numbers and contractual recognition are addressed in parallel. This document is a position paper informed by a roundtable discussion; formal multi-society consensus would require the documented endorsement process described herein.
References
Acocella, I., & Cataldi, S. (2021). Using focus groups: Theory, methodology, practice. SAGE Publications. https://doi.org/10.4135/9781529739794
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.
Braun, V., & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE.
Breyer, L., & Schemmann, M. (2018). Comparing national adult education policies on a global level: An exploration of patterns of difference and similarity in international policy contexts by method of lexicometric analysis. International Journal of Lifelong Education, 37(6), 749–762. https://doi.org/10.1080/02601370.2018.1553211
Caruso, R., & Stievano, A. (2026). The missing retention agenda: A commentary on the EU-funded Nursing Action Initiative. Journal of Nursing Scholarship, 58(2), e70066. https://doi.org/10.1111/jnu.70066
Casey, M., & O'Connor, L. (2022). Advanced practice nursing: Should research be the icing on the cake? Nursing Open, 9(1), 8–10. https://doi.org/10.1002/nop2.1122
Consociazione Nazionale Associazioni Infermiere/i, & Network delle Organizzazioni Infermieristiche Italiane. (2023). Assistenza infermieristica: Quadro definitorio italiano. https://www.cnai.pro/post/assistenza-infermieristica-presentato-il-quadro-definitorio
Cumming, A. (2010). The Bologna process, medical education and integrated learning. Medical Teacher, 32(4), 316–318. https://doi.org/10.3109/01421590903447716
Davies, H. (2017). Competence-based curricula in the context of Bologna and EU higher education policy. Pharmacy, 5(2), Article 17. https://doi.org/10.3390/pharmacy5020017
De Caro, W. (2022). Advanced nursing practice and the wave of the future. Professioni Infermieristiche, 75(1), 1–2. https://doi.org/10.7429/pi.2022.751001
European Centre for Disease Prevention and Control. (2013). Core competencies for infection control and hospital hygiene professionals in the European Union. https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/infection-control-core-competencies.pdf
European Federation of Nurses Associations. (2024). EFN workforce matrix on the three categories of nursing care and key principles for the development of HCAs (Rev. ed.; original work published 2016). https://efn.eu/wp-content/uploads/2024/01/EFN-Workforce-Matrix-31-Final-Oct.2016-REV-January-2024.pdf
European Operating Room Nurses Association. (2019). EORNA common core curriculum for perioperative nursing (3rd ed.). https://eorna.eu/wp-content/uploads/2020/09/EORNA-Common-Core-Curriculum-for-Perioperative-Nursing-Third-Edition-2019.pdf
European Specialist Nurses Organisations. (2015). Competences of the nurse specialist (NS): Common plinth of competences for a common training framework of each specialty (Version 2). https://www.esno.org/assets/files/Harmonise-Common_Training_Framework.pdf
Federazione Nazionale degli Ordini delle Professioni Infermieristiche. (2023). Consensus conference: Documento di consenso. https://www.fnopi.it/wp-content/uploads/2023/02/FNOPI_Consensus-2023.pdf
Fielding, N. G. (2012). Triangulation and mixed methods designs: Data integration with new research technologies. Journal of Mixed Methods Research, 6(2), 124–136. https://doi.org/10.1177/1558689812437101
Fosah, R., & Llahana, S. (2025). Barriers and enablers to leadership in advanced practice nursing: A systematic review. International Nursing Review, 72(2), e70034. https://doi.org/10.1111/inr.70034
Gobbi, M., & Kaunonen, M. (Eds.). (2018). Tuning educational structures in Europe: Guidelines and reference points for the design and delivery of degree programmes in nursing (Edition 2018). University of Groningen. https://ec.europa.eu/programmes/erasmus-plus/project-result-content/f868119c-e75a-472d-95ee-d8b8dd28c5af/WP_4_-_Del._1.4_Guidelines_and_Reference_Points_for_the_Design_and_Delivery_of_Degree_Programmes_in_Nursing_-_FINAL.pdf
Guetterman, T. C., Fetters, M. D., & Creswell, J. W. (2015). Integrating quantitative and qualitative results in health science mixed methods research through joint displays. Annals of Family Medicine, 13(6), 554–561. https://doi.org/10.1370/afm.1865
Italian law: Disposizioni in materia di professioni sanitarie (Legge 26 febbraio 1999, n. 42). (1999). Gazzetta Ufficiale della Repubblica Italiana, Serie Generale, n. 50. https://www.gazzettaufficiale.it/eli/id/1999/03/02/099G0092/sg
International Council of Nurses. (2020). Guidelines on advanced practice nursing 2020. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf
International Council of Nurses. (2021). Guidelines on prescriptive authority for nurses 2021. https://www.icn.ch/sites/default/files/2023-04/ICN_Nurse_prescribing_guidelines_EN.pdf
International Council of Nurses. (2025a). International Nurses Day 2025 report: Caring for nurses strengthens economies. https://www.icn.ch/sites/default/files/2025-04/ICN_IND2025_report_EN_A4_FINAL_0.pdf
Kilpatrick, K., Savard, I., Audet, L. A., et al. (2024). A global perspective of advanced practice nursing research: A review of systematic reviews. PLOS ONE, 19(7), e0305008. https://doi.org/10.1371/journal.pone.0305008
Ministero della Salute. (2020). Piano nazionale della prevenzione 2020–2025. https://www.salute.gov.it/imgs/C_17_notizie_5029_0_file.pdf
Ministero della Salute. (2022). Piano nazionale di contrasto all'antibiotico-resistenza (PNCAR) 2022–2025. https://www.aifa.gov.it/documents/20142/1807239/PNCAR_2022-2025.pdf
Ministero dell'Università e della Ricerca. (2026). Revisione della classe di laurea magistrale infermieristica e istituzione dei profili infermieristici specialistici. Gazzetta Ufficiale della Repubblica Italiana, Serie Generale, 108. https://www.gazzettaufficiale.it/eli/id/2026/05/12/26A02397/sg
Morin Galfout, S., Schwingrouber, J., & Colson, S. (2025). Advanced practice nursing in the European Union: A scoping review. Nursing Outlook, 73(6), 102588. https://doi.org/10.1016/j.outlook.2025.102588
Nania, T., Barello, S., Caruso, R., et al. (2021). The state of the evidence about the Synergy Model for patient care. International Nursing Review, 68(1), 78–89. https://doi.org/10.1111/inr.12629
Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., et al. (2020). Guidelines on advanced practice nursing 2020. International Council of Nurses. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Rosario Caruso, Francesca Angelelli, Paola Arcadi, Elena Barnabei, Gianluca Castiello, Bruno Cavaliere, Walter De Caro, Stefano Mancin, Giancarlo Mercurio, Eustachio Parente, Stefano Sironi, Bernardino Tomei, Antonio Vitiello