Paying Peter and Paul: reconciling concepts of expertise with competency for a clinical career structure

This paper identifies current UK policy for exploring both competence and e xpertise. It is argued that the purpose of assessing competence and expertise is rele vant in deciding the approaches used. Different perspectives about competence, specifically those that have arise n in the United States and the United Kingdom, are considered in relation t o how competencies may be developed and assessed. The different terms used in discussion about competency are also discussed. From the literature, criteria for selecting experts in nursing, the attribu tes of expertise and enabling factors are presented in relation to how expe rtise in practice may be judged. The pilot recognition process and development of evidence for the Royal Col lege of Nursing's Expert Practice Project, together with its facilitation t hrough critical companionship, are described. It is concluded that the processes necessary for demonstrating expertise in practice are consistent with the recognition that the attributes of expert ise are interdependent, complex and situational. Critical companionship pro vides a mechanism which is primarily developmental and supportive, but focu ses on practice development and practitioners' effectiveness and can result in the development of evidence for a range of different purposes such as d emonstrating expertise, as well as practice development, service developmen t and career progression.