Article Text

Download PDFPDF

The factors influencing the effective early career and rapid transition to a nursing specialty in differing contexts of practice: a modified Delphi consensus study
  1. Diane Chamberlain1,
  2. Desley Hegney2,3,
  3. Clare Harvey4,
  4. Bruce Knight5,
  5. Anne Garrahy6,
  6. Lily Pei-San Tsai7
  1. 1College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  2. 2Research Division, Central Queensland University, Brisbane, Queensland, Australia
  3. 3School of Nursing, University of Adelaide, Adelaide, South Australia, Australia
  4. 4School of Nursing, Midwifery and Social Sciences, Central Queensland University, Mackay, Queensland, Australia
  5. 5School of Education and the Arts, Central Queensland University, Townsville, Queensland, Australia
  6. 6Department of Health, Queensland Government, Brisbane, Queensland, Australia
  7. 7School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
  1. Correspondence to Professor Diane Chamberlain; di.chamberlain{at}


Objectives This study aimed to test and further develop the ‘Early Career and Rapid Transition to a Nursing Specialty’ (TRANSPEC) model to a nursing specialty developed from a systematic review. Semi-structured interviews of specialist clinically based nurses and a consensus Delphi study with an expert panel were used to expand and achieve consensus, agreement, reliability and stability of the model.

Design A modified Delphi, two rounds (64 and 52 Likert items) of reiterative online questionnaires and one round as a nominal group technique, was informed by qualitative thematic analysis of semi-structured interviews.

Setting and participants Interviews with 14 specialists clinical practicing registered nurses and a panel of 25 national experts participated in the Delphi study.

Results The interview participants experienced 14 rapid transitions and three were early career transition. The overarching themes from the preliminary model were confirmed and further expanded. These were the self (personal and professional); the transition processes (final and informal); a sense of belonging; and the overarching context of practice over a time continuum. In the Delphi, the highest rating item was ‘Specialty work colleagues respect, include, support, and accept specialist nurse on completion of transition processes’. Pre-entry was highlighted as an important time point prior to transition. All items reaching consensus were included in the final model. Cronbach α increased from 0.725 to 0.875 for the final model.

Conclusions The TRANSPEC model is a valid and reliable evidence-based tool for use in the career pathway and development of nursing specialists. Using the Benner model ‘Novice to Expert’ after the novice incomer phase is achieved, further lifelong learning development will transform the novice specialist over time continuum.

  • nursing
  • TRANSPEC model
  • medical education training
  • health safety
  • quality inhealthcare

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributorship statement DH conceived and designed the study with the support of all authors. DH and LP-ST undertook the interviews and data analysis of the interviews. DC conducted the Delphi study and drafted the manuscript and incorporated the revisions between authors (DH, CH, BK, AG, LP-ST). DC and LP-ST edited all versions prior to final versions. DC designed the model artwork. All authors (DC, DH, CH, BK, AG, LP-ST) read and approved the final manuscript.

  • Funding The study was funded by the Office of the Chief Nurse and Midwifery Officer, Queensland Health, Brisbane, Australia, grant number RSH/4665.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Central Queensland University Human Research Ethics Committee (0000020980).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.