This paper presents the findings of the third stage of a research study, the overall aim of which was to evaluate the educational preparation for cancer and palliative care nursing for children and adolescents in England. The specific aim of this stage was to define the attributes of 'threshold' and 'higher level' practice in nursing in order to inform the outcomes of future educational programmes. The research design involved children, their parents and their nurses at two different stages in the study. The first stage was the construction of the research instruments, in this case video and audio recordings of episodes of care in which the children participated. The second stage was the review of the recordings by the children, their parents and other stakeholders involved in their care. Service users were also involved in the management of the project. The study findings suggested that although there was considerable agreement between service users and other stakeholders about the characteristics of adequate or threshold practice, for both cancer and palliative care, there was less agreement about what constituted higher level or expert practice - other than 'more of the same but better'. The key areas of importance for future professional development courses were agreed as partnership working, clinical skills, multidisciplinary working and the personal attributes of the nurse.