The State of the Art of Clinical Master’s Degrees in Nursing and Health Professions in Italy: A Systematic Narrative Review

Abstract

Background: The evolution of healthcare needs in Italy, including population ageing, chronic disease burden, technological innovation, workforce shortages and the transition from hospital-centred to community-based care, has renewed the debate on advanced clinical education for nurses and other health professionals. Traditionally, Italian Master’s degrees in the health professions have been mainly oriented toward management, education and research. In 2026, the reform of the LM/SNT1 class introduced a new clinical direction for nursing, creating specialist Master’s degree pathways in primary care and family and community nursing, neonatal and paediatric care, and intensive and emergency care.
Aim: This systematic narrative review aims to synthesize the state of the art of clinical Master’s degrees in nursing and health professions in Italy, analysing regulatory evolution, educational models, clinical competencies, implementation challenges and future perspectives.
Methods: A systematic narrative search was conducted in June 2026 using PubMed/MEDLINE, Google Scholar, official Italian legislative sources, Ministry of University and Research documents, professional federation documents and international policy sources. Search terms included “clinical Master’s degree”, “advanced practice nursing”, “health professions”, “Italy”, “LM/SNT”, “nursing specialist”, “advanced clinical competencies”, “professional development”, “healthcare professions reform”, and “clinical specialization”. Sources included peer-reviewed articles, reviews, international guidelines, Italian legal acts and institutional policy documents. Due to the heterogeneity of evidence and the predominance of regulatory and policy sources, findings were synthesized narratively.
Results: The review identified five major themes: (1) the historical structure of Italian Master’s degrees in the health professions; (2) the emergence of clinical specialization in nursing through the 2026 reform of LM/SNT1; (3) the relationship between clinical Master’s degrees and international advanced practice nursing frameworks; (4) the still incomplete development of equivalent clinical Master’s pathways for rehabilitation, technical and prevention professions; and (5) implementation barriers related to regulation, workforce planning, academic capacity, interprofessional governance, contractual recognition and outcome evaluation.
Conclusions: Italy is entering a transitional phase in which advanced clinical education is becoming formally recognized, especially in nursing. The 2026 reform represents a turning point because it moves part of postgraduate nursing education from a mainly managerial and educational orientation toward advanced clinical practice. However, the model remains incomplete unless similar pathways are developed for other health professions and unless clinical competencies are translated into regulated roles, organizational positions, appropriate remuneration, and measurable outcomes.