How to Write a Concept Analysis Paper (Walker & Avant Model)

What Is a Concept Analysis Paper — And Why You Need One

A concept analysis paper is an academic assignment used in nursing theory courses to clarify the meaning of a specific concept (like “caring,” “resilience,” or “patient safety”) by examining how it’s used across literature, identifying its defining characteristics, constructing real-world case examples, and finding measurable indicators that prove it exists in practice.

Instructors assign it because nursing uses a lot of words that sound the same but mean different things. “Caring” might mean holding a patient’s hand at one hospital and following a strict protocol at another. A concept analysis pinpoints exactly what your concept means, so researchers, educators, and clinicians all talk about the same thing.

If you’re looking at this assignment for the first time, here’s the truth: the Walker & Avant method is the most commonly taught approach in nursing education, and your instructor probably expects you to follow their 8-step framework. This guide walks you through every step with published examples from real peer-reviewed papers so you can see exactly how successful concept analyses are structured.

Key Takeaways

• Walker & Avant uses 8 specific steps — selecting a concept, defining attributes, constructing cases, and defining empirical referents.
• Most online guides get the order wrong. Antecedents and consequences are Step 7, not Step 3. Attributes (Step 4) come before antecedents.
• Published examples help. Real concept analyses from PMC (PubMed Central) show exactly how model, borderline, and contrary cases are constructed with full narratives.
• Topic selection matters. “Caring” and “resilience” are oversaturated. Newer concepts like “exnovation” (phasing out outdated practices) are emerging and less competitive.
• Word counts vary by level: BSN 1,500–2,500 words, MSN 2,500–4,000 words, DNP 3,500–7,500+ words.
• Empirical referents are often missed. Students define the concept but forget to identify measurable indicators — a common reason for lower grades.

Step 1: Select a Concept

Choose a single term relevant to nursing that needs clarification. The concept should be specific enough for focused analysis — not a broad, compound phrase.

What to look for:

• A term used frequently in nursing literature but with unclear or inconsistent meaning
• A concept that appears across multiple disciplines (nursing, psychology, sociology) with different definitions
• A term your instructor has assigned or one you propose that fills a definitional gap

What to avoid:

• Compound/broad concepts like “nursing leadership and innovation” (pick one term)
• Concepts already thoroughly defined with established operational definitions
• Personal opinions disguised as concepts

Worked Example — Exnovation (Nashwan 2026):

Nashwan and colleagues selected “exnovation” — the deliberate removal of outdated practices or technologies to make room for innovation. This is an onomasiological concept (a new term entering the field) rather than a dictionary word, making it ideal for concept analysis because its meaning is still forming.

Your approach: Pick a term your instructor hasn’t already overused. If your program focuses on patient outcomes, consider “patient safety culture.” If leadership is your focus, “shared governance” is a strong candidate.

Step 2: Determine the Purpose/Aims

State clearly why you are analyzing this concept. Your purpose section should answer:

• Why does this concept need clarification?
• What will clarifying it accomplish?
• Who benefits (educators, clinicians, researchers)?

Good purpose statements:

• “To clarify the meaning of ‘motivation’ in nursing practice and develop an operational definition useful for both educators and clinicians”
• “To identify the defining attributes of ‘patient-centered care’ and determine how it differs from related concepts like ‘holistic care'”

Worked Example — Motivation in Nursing (Amoah & Adeola, 2026):

Amoah and Adeola’s purpose was to clarify “motivation in nursing” and understand what drives nurses to persist despite high-stress environments. Their aim was twofold: develop an operational definition and identify how motivation varies across nursing specialties (ICU, ED, pediatrics).

Step 3: Identify All Uses of the Concept

Search for the concept’s definition across all disciplines, not just nursing. The Walker & Avant method explicitly requires you to look at dictionary definitions, general usage, and multidisciplinary literature (psychology, sociology, education, etc.).

Search strategy:

1. Dictionary definitions (Merriam-Webster, Oxford English Dictionary)
2. General keyword search across PubMed, Scopus, and CINAHL
3. Review interdisciplinary journals (psychology, education, sociology)
4. Include nursing journals specific to your field

Worked Example — Positive Nursing Practice Environment (Pereira et al., 2024):

Pereira and colleagues examined “nursing practice environment” across nursing, organizational behavior, and health policy literature. They traced the concept from early organizational theory (1960s-70s) through modern healthcare settings, identifying how the same term meant different things depending on whether the source was a nursing journal or a management study.

📖 Read the full example: Positive Nursing Practice Environment concept analysis — Pereira et al., 2024

Step 4: Determine the Defining Attributes

This is the heart of your analysis. Defining attributes are the characteristics that appear most frequently across your literature review and distinguish your concept from similar ideas. Think of these as the “non-negotiable” features — if your concept doesn’t have them, it’s not the same concept.

How to find attributes:

• Read at least 10-15 peer-reviewed articles using your concept
• Look for recurring descriptions, characteristics, or behaviors
• Use the cluster analysis method: group related characteristics and identify the most common cluster
• Ensure each attribute appears in multiple sources (not just one author’s opinion)

Number of attributes: Most published concept analyses identify 3 to 10 attributes. Fewer than 3 makes the concept too broad; more than 10 suggests you may have selected a compound concept.

Worked Example — Exnovation (Nashwan et al., 2026):

Worked Example — Poor Care (Khalili & Heydari, 2022):

Khalili and Heydari identified 3 defining attributes: (1) Poor evaluation of the patient’s condition; (2) Inadequate or inappropriate patient management; (3) Delay in diagnosis, treatment, or referral.

📖 Read the full example: Poor Care concept analysis — Khalili & Heydari, 2022

Step 5: Identify a Model Case

A model case is a realistic clinical scenario that contains ALL of your defining attributes. It should read like a real patient case or clinical event — concrete, specific, and detailed enough that a reader can recognize every attribute in action.

How to construct a model case:

• Include a specific patient or setting (age, condition, location)
• Show each defining attribute explicitly (reference them in your narrative)
• Make it plausible — based on real clinical possibilities, not fantasy
• Keep it concise (150-250 words) — one paragraph with a clear beginning, middle, and end

Worked Example — Poor Care Model Case (Khalili & Heydari, 2022):

A 60-year-old diabetic patient with respiratory distress is admitted to the wrong ward. The nurse fails to report abnormal vitals. The doctor delays examining the chest X-ray. Over 4 hours, the patient deteriorates without intervention.

Every attribute appears: poor evaluation (wrong ward, abnormal vitals not reported), inadequate management (doctor delays examination), and delay (4 hours without intervention).

Worked Example — Motivation in Nursing (Amoah & Adeola, 2026):

Sarah, 28, is an ICU nurse motivated by her grandmother’s positive healthcare experience. She pursues critical care certification, works in a supportive environment with adequate staffing, demonstrates resilience through reflection and mentorship, and remains committed to patient care despite long hours and high stress.

Each attribute is visible: intrinsic drivers (grandmother’s experience), extrinsic reinforcement (supportive environment), goal-directed action (certification pursuit), persistence/resilience (reflection and mentorship), and commitment to profession.

Step 6: Identify Additional Cases

After your model case, you construct four additional case types. Each case type serves a specific purpose in clarifying your concept’s boundaries.

Case Types Explained

⚠️ Critical student mistake: Don’t confuse related cases with model cases. Related cases share similarities but do NOT contain all defining attributes. If they do, it’s a model case, not a related case.

Worked Example — Motivation in Nursing (Amoah & Adeola, 2026):

Borderline case (Michael): A goal-oriented nurse who is driven by recognition and money rather than patient care. He works efficiently but lacks resilience and long-term commitment. He leaves when a better-paying job opens elsewhere.

Contrary case (Jennifer): A 25-year-old emergency department nurse who chose nursing due to parental pressure. She performs minimum work, avoids learning opportunities, and openly states she plans to leave the profession entirely.

Related case: A nurse who provides excellent technical care but does so purely procedurally, without the intrinsic motivation or emotional connection that defines true professional motivation.

📖 Read the full example: Motivation in Nursing concept analysis — Amoah & Adeola, 2026

Step 7: Identify Antecedents and Consequences

This is where most student guides and online resources make a critical error. Antecedents and consequences belong in Step 7 (not Step 3, as several popular websites incorrectly state).

• Antecedents: What must happen before your concept occurs. These are the triggers, conditions, or context that set up your concept.
• Consequences: What results after your concept manifests. These are the outcomes, impacts, or downstream effects.

How to identify antecedents:

• What context, conditions, or events precede the concept?
• What makes the concept possible?
• Look at literature discussing the concept’s origins or triggers

How to identify consequences:

• What happens when the concept is present or absent?
• What are the downstream effects on patients, nurses, or systems?
• Look at outcomes studies, effect analyses, and discussion sections of your literature

Worked Example — Exnovation (Nashwan et al., 2026):

Antecedents: Technology advancements, evidence-based practice adoption, regulatory pressure, organizational cost reduction goals.

Consequences: Enhanced patient care quality, improved job satisfaction, streamlined workflows, increased innovation capacity.

Worked Example — Poor Care (Khalili & Heydari, 2022):

Antecedents: System failures, staffing shortages, inadequate training, poor communication between team members.

Consequences: Patient deterioration, increased mortality/morbidity, patient/family dissatisfaction, staff moral distress, legal action against healthcare providers.

Step 8: Define Empirical Referents

Empirical referents are measurable, observable indicators that prove your concept exists in practice. This is where your theoretical concept becomes tangible and researchable.

Types of empirical referents:

• Validated scales or questionnaires
• Clinical indicators (e.g., infection rates, patient fall rates)
• Documented behaviors or observed practices
• Organizational metrics (e.g., staff retention rates, turnover rates)
• Patient-reported outcome measures (PROMs)

Common mistake: Students often skip this step entirely, leaving their analysis purely theoretical. Empirical referents are what make your concept operational — without them, your paper lacks measurability.

Worked Example — Motivation in Nursing (Amoah & Adeola, 2026):

Empirical referents include: (1) Staff retention rates; (2) Employee engagement surveys; (3) Professional development participation rates; (4) Self-report measures of intrinsic vs. extrinsic motivation.

Worked Example — Exnovation (Nashwan et al., 2026):

Empirical referents include: (1) Technology adoption rates; (2) Old-system retirement schedules; (3) Training completion metrics; (4) Patient outcomes post-implementation.

📖 Read the full example: Exnovation in Healthcare concept analysis — Nashwan et al., 2026

Walker & Avant vs Wilson vs Rodgers: Which Method Should You Use?

Your instructor may mention three major concept analysis methods. Understanding their differences helps you know which one your professor wants.

Adapted from Gunawan et al., 2023.

📖 Read the comparison source: Comprehensive look at concept analysis methods — Gunawan et al., 2023

Concept Analysis Topic List (40+ Ideas)

Clinical & Patient Care

• Empathy
• Pain
• Comfort
• Hope
• Resilience
• Vulnerability
• Palliative care
• Patient advocacy
• Cultural competence
• Health literacy

Professional & Practice

• Patient-centered care
• Evidence-based practice
• Moral distress
• Burnout
• Leadership
• Teamwork
• Communication
• Professional autonomy
• Role clarity

Educational & Systems

• Critical thinking
• Clinical judgment
• Mentorship
• Preceptorship
• Nurse retention
• Workforce planning
• Patient safety
• Nursing informatics
• Ethical decision-making
• Shared governance
• Telehealth in nursing
• Patient satisfaction

Emerging Concepts

• Exnovation
• AI literacy in nursing
• Compassion fatigue
• Nurse wellbeing
• Caring partnership
• Practice environment
• Work engagement

Avoid overused concepts like “caring” or “resilience” unless your instructor specifically assigns one. These concepts have been analyzed dozens of times and are harder to differentiate your work from.

Case Construction Guidance

Here’s a practical framework for building your cases. Use this checklist as you draft:

Model Case Checklist

• Contains ALL defining attributes (reference each one explicitly)
• Is a realistic clinical scenario with specific patient details (age, condition, setting)
• Reads like a real case, not a textbook description
• 150-250 words, one paragraph

Borderline Case Checklist

• Contains SOME attributes (not all)
• Shows what happens when the concept is partial or incomplete
• Can be confused with the concept but isn’t quite there
• Explains which attributes are missing and why

Contrary Case Checklist

• Contains NONE of the defining attributes
• Is the opposite or negation of the concept
• Helps by showing what the concept is NOT
• Can be a real scenario or clearly hypothetical

Related Case Checklist

• Shares similarities with the concept
• Does NOT contain all defining attributes
• Clarifies boundaries by showing a closely related but distinct concept
• Explains clearly how it differs from your concept

Assignment Specifications by Academic Level

BSN (Undergraduate)

• Word count: 1,500–2,500 words
• Pages: 5–10 pages
• Key requirements: Select a concept, define it, identify attributes, construct cases, define empirical referents
• Common mistakes: Choosing compound concepts, failing to connect cases to attributes

MSN (Graduate)

• Word count: 2,500–4,000 words
• Pages: 8–15 pages
• Key requirements: Same as BSN plus deeper literature review, theoretical implications, practice recommendations
• Common mistakes: Superficial literature review, theoretical implications too vague

DNP/PhD (Doctoral)

• Word count: 3,500–7,500+ words
• Pages: 12–25+ pages
• Key requirements: Exhaustive literature review, comprehensive case construction, measurement implications, theoretical framework integration
• Common mistakes: Inadequate theoretical integration, insufficient empirical referents

Formatting (APA 7th):

• Times New Roman, 12pt, double-spaced
• 1-inch margins on all sides
• Level headings matching rubric categories (Defining Attributes, Antecedents, etc.)
• Reference list not included in word count
• Title page not included in word count

Common Student Mistakes

1. Choosing a compound/broad concept — “Nursing leadership and innovation” should be two separate analyses. Pick a single term.
2. Placing antecedents before attributes — The most common structural error. Attributes are Step 4; antecedents are Step 7.
3. Constructing model cases without connecting each attribute — Every case must explicitly reference the defining attributes.
4. Using Wikipedia or general sources — Always use peer-reviewed nursing journals and nursing theory textbooks.
5. Confusing related cases with model cases — Related cases share similarities but don’t have all defining attributes.
6. Failing to define empirical referents — Students stop at theoretical definition without identifying measurable indicators. This is a major grading penalty.
7. Skipping the interdisciplinary search (Step 3) — Don’t limit your search to nursing literature. The Walker & Avant method requires dictionary definitions and multidisciplinary usage.
8. Ignoring the original source — Always cite Walker & Avant’s original book (6th edition, 2018) alongside your literature review.

Worked Example: Building a Complete Case Framework

Let’s walk through a complete case construction using “Patient Safety Culture” as our example concept. This concept is relevant to all nursing levels and has clear definitional gaps in recent literature.

Defining Attributes (4):

1. Staff willingness to report errors without fear of punishment
2. Leadership prioritization of safety over productivity
3. Interdisciplinary communication protocols
4. Patient involvement in safety processes

Model Case:

At St. Mary’s Hospital, a nurse reports a near-miss medication error through the unit’s anonymous reporting system. Her supervisor thanks her rather than blaming her. The interdisciplinary safety committee meets weekly to review reports. Patients are enrolled in their own safety checks (e.g., verifying their own identity before procedures).

Every attribute is present: anonymous reporting (1), leadership prioritization (2), interdisciplinary protocols (3), patient involvement (4).

Borderline Case:

At General Hospital, staff report errors through an informal system, but supervisors sometimes reprimand reporters for “making trouble.” Leadership discusses safety only during quarterly meetings. Patients are not involved in safety processes.

Missing attributes: leadership prioritization is weak, interdisciplinary communication is poor, patient involvement absent.

Contrary Case:

At County Hospital, a nurse who reports errors is publicly reprimanded. Leadership prioritizes patient throughput over safety reviews. No interdisciplinary protocols exist. Patients are treated as passive recipients with no input.

None of the four attributes are present.

What Should You Do Next?

Here’s what we recommend most students do when tackling this assignment:

1. Confirm with your instructor whether they require the Walker & Avant model specifically (most nursing programs do).
2. Choose a concept from the topic list above that you’re genuinely interested in — this paper is long, and you’ll need motivation.
3. Start your literature search on PubMed, CINAHL, and Scopus using your concept as the keyword. Aim for at least 10 peer-reviewed sources.
4. Build your attribute list from the recurring themes in your literature. Don’t guess — let the literature tell you what the defining characteristics are.
5. Construct your cases using the framework above. Make each one specific and realistic.
6. Don’t skip Step 8. Empirical referents are often the difference between a B and an A.

If you’re feeling overwhelmed, our academic writers can help you complete this assignment with a custom-written concept analysis paper that follows the Walker & Avant model and includes all worked examples, case constructions, and properly formatted citations.

Quick Resources You Should Know About

• University of Wisconsin Library Guide — Step-by-step instructions for concept analysis with student tips: researchguides.library.wisc.edu/c.php?g=861013&p=11146882
• Metro State University NURS 700 Guide — Includes downloadable sample paper: libguides.metrostate.edu/nurs700
• Walker & Avant (2018) — Original source: Strategies for Theory Construction in Nursing, 6th ed. Pearson/Prentice Hall. ISBN: 978-0-13-753037-3

Summary

A concept analysis paper using the Walker & Avant method requires you to follow 8 specific steps in order: select a concept, determine your purpose, identify all uses across disciplines, define attributes, construct a model case, add borderline/contrary/related cases, identify antecedents and consequences, and finally define empirical referents. The most common mistake is placing antecedents (Step 7) before attributes (Step 4) — always keep the correct order.

Every step needs a worked example from the literature. Published papers like Nashwan (2026) on exnovation, Amoah & Adeola (2026) on motivation in nursing, Khalili & Heydari (2022) on poor care, and Pereira et al. (2024) on positive nursing practice environments all demonstrate how professional researchers construct their cases with full narratives you can emulate.

The empirical referents step (Step 8) is where most students lose points. Don’t skip it — identify measurable indicators, validated scales, clinical metrics, or documented behaviors that prove your concept exists in practice.

References

• Amoah EO, Adeola MT. Motivation in Nursing: A Concept Analysis. Nursing Open. 2026 (in press). PMC13415745.
• Gunawan J, Aungsuroch Y, Marzilli C. Beyond the classics: A comprehensive look at concept analysis methods in nursing education and research. Business & Nursing Journal. 2023;9(5):406-410. PMC10600704.
• Khalili H, Heydari A. Poor Care: A Walker and Avant Concept Analysis. Care. 2022. PMC10131165.
• Nashwan AJ, Joy GV, Mannethodi K, Kunjavara J, Alhalaiqa F, Alomari AMA, Abujaber AA. Exnovation: A Concept Analysis. Nursing Open. 2026;13(1):e70349. PMC12789811.
• Pereira S, Ribeiro M, Mendes M, Ferreira R, Santos E, Fassarella C, Ribeiro O. Positive Nursing Practice Environment: A Concept Analysis. Nursing Reports. 2024;14(4):3052-3068. PMC11503395.
• Walker LO, Avant KC. Strategies for Theory Construction in Nursing. 6th ed. Pearson/Prentice Hall; 2018. ISBN: 978-0-13-753037-3.

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See Also

• Annotated Bibliography 2026: Complete Guide with APA + MLA + Chicago Templates
• How to Write a Literature Review: Complete Search to Synthesis Guide for Students
• Research Paper Methodology Section Writing Guide: Complete Structure & Examples