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Perceptions of advanced practice nurses’ role expansion among graduate students in advanced practice nursing programs: a qualitative study using SWOT-TOWS analysis
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Eun Sook Kim, Hui Jin Lim, Boram Sagong, Jinhu Seok, Su Jung Choi
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Received April 3, 2026 Accepted September 19, 2026 Published online October 8, 2026
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DOI: https://doi.org/10.4040/jkan.26050
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 Abstract
 ePub
- Purpose
This study aimed to explore graduate nursing students’ perceptions of advanced practice nurse (APN) role expansion and identify strategic directions for APN role development using strengths, weaknesses, opportunities, and threats (SWOT) analysis and a threats, opportunities, weaknesses, and strengths (TOWS) matrix.
Methods
A qualitative descriptive design was used. Participants were 24 nurses enrolled in graduate APN programs who had experience relevant to APN roles and practice. Focus group interview data underwent inductive content analysis and were organized into SWOT domains, with the APN system as the unit of analysis. A TOWS matrix was used to derive strategies.
Results
Strengths included clinical expertise, patient-centered care, continuity of care, and multidisciplinary coordination. Weaknesses included role ambiguity and interprofessional conflict arising from unclear role boundaries, as well as insufficient shared understanding and clarification of APN roles within the system. Opportunities arose from policy and organizational changes that facilitated formalization of APN roles. Threats included structural undervaluation of APN expertise and the risk of burnout arising from insufficient support for expanded roles and responsibilities. Four TOWS strategies were derived: (1) institutionalizing and expanding APN roles by drawing on clinical expertise and organizational opportunities; (2) clarifying roles and establishing standardized systems for education and competency development; (3) making clinical contributions more visible to strengthen recognition of APN expertise and roles; and (4) preventing burnout through clearer responsibilities and appropriate workload and compensation systems.
Conclusion
Participants’ perceptions suggest that expanding APN roles may require a structural approach that integrates role clarification, competency development, organizational support, and policy and institutional frameworks, rather than extending tasks alone. Further validation involving diverse stakeholders is warranted.
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