Components of the doctoral curriculum that build success in the clinical nurse researcher role

Increasing numbers of hospitals and medical centers are creatively allocating positions for clinical nurse researchers. Since this type of position offers an outstanding opportunity to develop and test nursing theory, as well as to conduct and apply nursing research, it is important that doctoral programs provide students with the skills required to implement a research role within the context of a hospital organization. The purpose of this article is to demonstrate how doctoral programs in nursing can develop the foundation graduates need to implement the clinical nurse researcher role, not necessarily by revising the curriculum, but by adding occasional single seminars, guiding students to specific learning experiences, and deliberately emphasizing the links between course content and role applications.     

Conflicts Within the Discipline of Nursing: Is There a Looming Paradigm War?

This paper presents a view of the current sources of potential conflicts in the academic discipline of nursing. It suggests that these conflicts could lead, in the Kuhnian sense, to a paradigm war. The differing paradigms underlying the education and traditions of the PhD prepared nurse scientist/researcher/scholar and the DNP prepared nurse practitioner are a challenge for the discipline. DNP programs are swelling and faculty are needed to teach in these programs, and their position with regard to the usual rank and tenure structures of academe are not yet clear. Concern arises when the tenured PhD nurse scientist faculty numbers drop as the DNP faculty numbers increase. The body of nursing science is threatened as fewer students enter PhD programs and faculty retire. The DNP faculty paradigm does not provide for the rigor and preparation need to carry forward the disciplinary scientific knowledge mission. Rather than a fruitless war between the two paradigms, ways are suggested to fully embrace the differences as important to nursing, and to increase the number of PhD prepared nurse scientists.     

Alignment of a PhD program in nursing with the AACN report on the research-focused doctorate in nursing: A descriptive analysis

Those involved in preparing the next generation of nurse scientists face numerous challenges, including but not limited to: relatively older age at completion of doctoral studies, insufficient funding for full-time PhD students in nursing, inadequate funding for nursing research, and the limited number of well-funded mentors in nursing doctoral programs. These issues have limited the number of students enrolled in PhD nursing programs and graduates to supply the research faculty of the future and generate nursing science. This phenomenon persists despite numerous calls to increase the number of PhD doctoral students and graduates and expedite the PhD process without compromising educational integrity. This article describes the BSN-to-PhD Pathway and the Accelerated (3 year) Pathway to the nursing PhD at an established research doctoral program that required a shift in the approach to student recruitment, curriculum development, and timely progression. Implications for practice and research are discussed.     

Historical development of doctoral programs: shaping our expectations

The history of doctoral education for nurses in the United States is reviewed with emphasis on the nurse scientist training model, changing student characteristics, and developing scientific perspectives and programs. Recommendations are made for cross-disciplinary training in a revised nurse scientist model and for greater research emphasis on fundamental processes (for example, host factors) to understand human ecology in health and illness.     

Making explicit the development of PhD-prepared nurses to steward the discipline

Leadership is a core curricular element of PhD programs in nursing. Our PhD faculty began a dialogue about being a leader, a steward of the discipline. We asked ourselves: (a) What expertise do PhD prepared nurse needs to begin to steward the discipline? (b) How do faculty engage PhD nursing students to assume responsibility for stewarding the discipline? Lastly, (c) How do we work with PhD nursing students to create their vision for how their work contributes to stewarding the discipline, from doctoral coursework throughout their career? We support the need for PhD graduates to have the skills to generate knowledge, conserve that which is important, and transform by disseminating new knowledge to a broad audience. Examples of nurses stewarding the discipline when pioneering research, critiquing traditional approaches to inquiry or trends in nursing practice, and developing policy, are highlighted along with examples of how PhD nursing students begin to steward the discipline.     

Expanding horizons: Lonergan's philosophy as a guide to PhD program pedagogy

Historically, research-focused doctoral programs in nursing have used the apprenticeship model to educate and prepare nurse scientists for research careers. The assumption is that students learn best when paired with a faculty member who is working on the same topic. This model works well when there is a stable workforce, adequate funding streams and sufficient faculty with diverse expertise to capture the enthusiasm and varied topics of incoming doctoral students. However, we believe there are alternative approaches that are worth exploring. We propose an alternative way of preparing students for entry into nursing science.The purpose of this paper is to describe one PhD program’s new approach, based on the philosophical premises of Bernard Lonergan, to create a generation of creative, insightful thinkers who expand the horizons of the nursing discipline.     

Philosophy of science in doctoral nursing education revisited

Because every scientific theory and all research methods are tied to some philosophical framework, it is important that scientists within a given discipline be aware of the philosophical orientations that serve as the basis for developing theory and advancing knowledge. Nurse scientists have been challenged recently to examine the discipline's philosophical underpinnings in order to understand the evolutionary process of nursing science. The inclusion of the study of philosophy of science in doctoral nursing curriculum has remained a topic of periodic discourse. Whereas some assert that it promotes the essential process of philosophical reflection necessary for scientific exploration of relevant phenomenon, others contend that nurse scientists' preoccupation with this issue has diverted their attention from the real business of nursing science—that of knowledge development that will lead to legitimization of nursing as a discipline. Philosophy of science provides a useful frame of reference in which to appreciate the unfolding of nursing as a discipline. It should not be viewed as a distraction but rather a critical step in the transformation of the doctoral student into a productive nurse scientist. Doctoral programs remain the most logical place in which to educate future scholars regarding nursing's unique philosophical foundations and their implications for scientific inquiry and continued knowledge development. Creating and maintaining liaisons between nursing and philosophy departments—as well as requiring courses that emphasize the interrelationships among philosophy of science, nursing theory, and nursing research—are just a few of the strategies whereby doctoral programs can actively promote advancement of the discipline.     

Preparing the next generation of scientists in translation research

AIM: Four questions about translation research are considered in this article. (1) Why should there be concern about preparing nurse scientists for translation research? (2) Are current research-intensive doctoral programs in nursing preparing graduates for translation research? (3) Should targeted efforts be made to systematically prepare nurses in translation research? (4) What strategies would be useful? QUESTION 1: It is argued that translation research is needed in order to increase the odds that interventions found to be efficacious can be effectively translated into practices that will produce desired outcomes. Thus, evidence from translation research is a very important component of the science base needed to guide innovation in practice. Another reason of concern in preparing translation researchers is the growing pace of research into the efficacy of interventions, which accelerates the need for translation research. Furthermore, the emergence of clinical doctoral programs in nursing that will be seeking faculty with expertise in translation research supports the need for preparing scientists in translation research. QUESTION 2: To determine whether translation research was visible in current research-intensive doctoral programs, a Web-based review of these programs offered by colleges and universities in the database of the American Association of Colleges of Nursing (AACN) was conducted in the fall of 2003. The search revealed that in the 79 programs surveyed, no school identified an area of emphasis in terms that suggested a component of translation science such as research dissemination or utilization, knowledge transfer, diffusion of innovation, or technology transfer. Less than a dozen courses could be located that focused on topics related to translation research or translation science. QUESTIONS 3 AND 4: The case is made that more attention should be given to preparing translation scientists in research-intensive doctoral programs in nursing, and several strategies were suggested for moving toward that goal.     

Creating a successful environment for preparing doctoral-level nurse educators

The ongoing nursing shortage requires that universities be creative in developing alternative methods to enhance the supply of nursing faculty. We report on an innovative collaborative program between colleges of nursing and education to prepare future nursing faculty. The evaluation of this initiative was accomplished using comparative data from doctoral students in other non-nursing programs. We found that the nurse educator program was positive in influencing students' knowledge and skill development and perceptions of faculty support, compared with other non-nursing doctoral programs.     

Opportunities and challenges presented by recent pedagogical innovations in doctoral nursing education

The demand to expand the nurse scientist pipeline over the past decade has generated numerous pedagogical innovations in nursing doctoral education. A PhD nursing education summit was held at the University of Pennsylvania in October 2019 to discuss pedagogical innovations. The main pedagogical innovations discussed by Summit attendees included: 1) the expansion of both 3-year PhD programs and BSN to PhD programs; 2) changes in learning opportunities and curricula content; and 3) the role of postdoctoral fellowships. This overview examines the numerous opportunities and challenges generated by these innovations. Opportunities include producing scholars with research careers that are potentially longer than historically seen in the nursing profession, as well as the emergence of unique educational and mentoring opportunities both during and after doctoral studies. Challenges involve the impact condensed program timelines have had on both the content and delivery of curricula, as well as the research expertise and skillsets of nursing PhD program graduates. There is a need to conduct a national coordinated evaluation of PhD program using shared metrics in order to better evaluate the effect of these pedagogical innovations on the development of nurse scientists, and ultimately, the discipline.     

Global quality criteria, standards, and indicators for doctoral programs in nursing; literature review and guideline development

BACKGROUND: Nursing profession has intensified education and training of nurse researchers who could enhance the health of people through the discovery and dissemination of knowledge. This resulted in rapid increase in the number of doctoral programs in nursing in many countries in recent decades, but the guidelines for quality programs are lacking. OBJECTIVES: To develop guidelines for quality criteria, standards, and indicators for doctoral programs in nursing that may be used worldwide. METHODS: The work of the quality criteria, standards and indicators (QCSI) committee of the International Network for Doctoral Education in Nursing formed the basis of this paper and authors supplemented it by a literature review and consultation with international experts. FINDINGS: The major criteria of quality of doctoral program were: the nature of the mission, the quality of faculty, the students, the curriculum, program administration, and resources. Sub-criteria, standards and indicators for each of these criteria were identified in sufficient detail to provide guidance for quality doctoral programs in nursing. Concerns as to whether the QCSI would apply to those countries and doctoral programs that focus on a research thesis only, without formal coursework were addressed. Experts from across the world felt that the QCSI would be applicable for most program types. CONCLUSIONS: Global criteria, standards, and indicators for doctoral programs in nursing presented in this article may serve as guidelines for most doctoral programs in the world as these were developed by experienced nurse scholars representing eight countries from five continents. The degree of detail in these parameters is sufficient to enhance the utility of the QCSI for all doctoral programs worldwide.     

From vision to action: Next steps in designing PhD programs of the future

Declines in PhD enrollment, funding and support for PhD students, and the quality and quantity of the nursing research pipeline has fueled the concern about providing high-quality education in research-focused nursing doctoral programs. To address the challenges and opportunities facing research focused PhD education, the University of Pennsylvania School of Nursing convened an invitational summit, Re-Envisioning Research-Focused PhD Programs of the Future, of research-intensive institutions. Both as a dissemination strategy and as an effort to engage perspectives from other Schools with PhD programs, we presented a summary of the Penn Summit discussion at the AACN Doctoral Education Conference (AACN Doctoral Conference). Focused discussions at both events further identified opportunities for research focused PhD programs, including recruiting undergraduate students, establishing research-focused partnerships, creating clear evaluation methods. AACN Doctoral conference participants also discussed the need to discuss and identify competencies, common subject areas, and financial resources for PhD students and graduates. This synthesis of discussions, considerations, and challenges affecting research-focused doctoral programs of nursing serve as a basis and catalyst for further discussion and action to ensure PhD research focused programs are preparing successful nurse scientists of the future.     

PhD programs and the advancement of nursing science

Nurses are well-positioned to be groundbreaking researchers, scientists, leaders, and innovators to improve the health and well-being of individuals, families, and communities. Nurse scientists are needed to contribute to scientific discoveries that inform effective strategies to improve patient care and outcomes and to inform future policies. Thoughtful consideration is required about the preparation of nurse scientists to ensure they are equipped with the knowledge and skill sets to meet the needs of society. Evolving health needs and priority areas of inquiry along with an ever-increasing array of sophisticated methodologies and centrality of interdisciplinary teams to solve complex problems should drive how we prepare PhD students. This paper reflects a panel and subsequent dialogue with nurse leaders at the PhD summit held at the University of Pennsylvania in October 2019. Three aspects of PhD education and the advancement of nursing science are discussed 1) examining important elements to support nurse scientist development; 2) identifying key gaps in science that the discipline needs to address in educating the next generation of nurse scientists; and 3) preparing nurse scientists for the competitive funding environment.     

Employment characteristics and role functions of recent PNP graduates

The role of pediatric nurse practitioner (PNP) was initiated in the late 1960's with baccalaureate pediatric nurses trained and educated to provide well care, screening, and common illness management to essentially healthy children in rural areas not adequately served by physicians (Silver & Ford, 1967). Nurse practitioner educational programs have evolved to the graduate level with doctoral preparation proposed for entry into practice by 2015 (American Association of Colleges of Nursing [AACN], 2004). A current survey monitors the change in practice settings and role functions of PNPs to determine trends of professional practice and appropriateness of educational programs in preparing new graduates for the contemporary work place.     

An analysis of clinical teacher behaviour in a nursing practicum in Taiwan

Aim and objectives. The aim of this study was to identify and assess the teaching behaviours (knowledge, attitudes and skills) observed in nurse educators as they taught in the clinical setting. Background. Many quantitative studies have defined and evaluated teaching effectiveness in the clinical area. Some of these studies established instruments to evaluate faculty effectiveness in the clinical setting; however, they tended to be so broad that they were of limited use in understanding clinical teaching behaviours in nursing education. Design. This study explored clinical teaching behaviours in a nursing practicum. Ten nurse educators taught 10 students in the medical–surgical unit at a hospital in Taiwan for about four weeks. Each teacher was observed by the researcher and one other observer for two days during regularly scheduled clinical teaching time. Methods. Data collection and analysis were done by a qualitative approach. Content analysis is a process of identifying, coding and categorizing the themes in the data. Conclusion. The themes of clinical teaching that emerged from data analysis included teaching aims (task‐oriented and learner‐centred), teacher competence (teacher knowledge, instructional strategies, planning learning experience, teaching priorities, feedback and caring) and teaching commitment (professional identity and giving of self). These findings offer a holistic blueprint of clinical teaching for nursing faculty members, which will enhance the quality of nursing education. Relevance to clinical practice. Complexity in nursing education has increased as it is challenged to meet the needs of diverse populations in rapidly evolving and highly technical health‐care settings. Clinical teachers must be enabled and empowered to provide students with appropriate knowledge and skills to meet the needs of patients. To develop students’ professional nursing identity now and in the future, nurse educators have to commit themselves to both nursing and teaching in clinical settings. More nurses need to be prepared for careers in education at the master's and doctoral levels.     

The nurse executive role. A structural and functional analysis

This study analyzes the structure and functions of the position of nurse executives to determine competencies required in the role, to provide a base for planning educational programs, and to identify areas for future research. These nurse executives have a dynamic role, one that has evolved as a result of role making on their part. In interviews they show a concern for meeting society's nursing needs. The interviews also show that in their positions at the executive level of the organization, they deal with complex patterns of interactional behaviors and have an ever-evolving role as the organization's power structure changes. Implications emerge for educational preparation that will help executives in their roles as nurse, administrator, and educator/researcher.     

The nursing role in assisted reproductive technologies.

The role of the nurse in assisted reproductive technologies (ART) has evolved as the needs of couples and infertility programs have changed. This multidimensional nursing role encompasses skill as a manager, educator, counselor, researcher, and professional. Such skills are combined with a specialized knowledge base of reproductive endocrinology and infertility. This chapter describes the various facets of the role, including the interdependence of other team members.     

Nursing students’ awareness and perceptions of nurses’ role in antimicrobial stewardship

Antimicrobial resistance is a major threat to public health worldwide. Antimicrobial stewardship programs and interventions aiming to optimise the use of antibiotics, are increasingly used to ensure judicious use of antibiotics and limit the emergence of antimicrobial resistance. Nurses are pivotal in antimicrobial stewardship however nursing students’ awareness of such programs has not been investigated. This study aimed to elicit nursing students’ perspectives and perceptions of the nurse’s role in antimicrobial stewardship. A cross-sectional design was utilised to survey pre-registration nursing students. A total of 321 nursing students enrolled in an Australian university participated. The survey comprised questions on knowledge and opinions regarding the nurse’s role in AMS and on a range of topics relating to antimicrobial stewardship and antimicrobial resistance, through closed and open-ended questions. While 44.5% of participants indicated they were familiar with the term Antimicrobial Stewardship, 70.7% believed they had very little or no knowledge of the principles. Completion of subjects with a focus on quality and safety in nursing practice and quality use of medications was associated with greater awareness. Findings underscore the need to engage nursing students in discussions exploring the problem of antimicrobial resistance and the important role nurses play in Antimicrobial Stewardship programs.