Models of initial training and pathways to registration: a selective review of policy in professional regulation.

Aim To provide a synthesis of literature on international policy concerning pro-fessional regulation in nursing and midwifery, with reference to routes of entry intotraining and pathways to licensure.Background Internationally, there is evidence of multiple points of entry into initialtraining, multiple divisions of the professional register and multiple pathways tolicensure.Evaluation Policy documents and commentary articles concerned with models ofinitial training and pathways to licensure were reviewed. Item selection, qualityappraisal and data extraction were undertaken and documentary analysis wasperformed on all retrieved texts.Key issues Case studies of five Western countries indicate no single uniform systemof routes of entry into initial training and no overall consensus regarding theoptimal model of initial training.Conclusions Multiple regulatory systems, with multiple routes of entry into initialtraining and multiple pathways to licensure pose challenges, in terms of achievingcommonly-agreed understandings of practice competence.Implications for nursing management The variety of models of initial trainingpresent nursing managers with challenges in the recruitment and deployment ofpersonnel trained in many different jurisdictions. Nursing managers need to con-sider the potential for considerable variation in competency repertoires amongnurses trained in generic and specialist initial training models.Keywords