Leveraging a funding collaborative to develop more PhD prepared nurse scientists and leaders

BackgroundOver its almost 50 year history, The Robert Wood Johnson Foundation (RWJF) has provided about $500M to nursing initiatives focused on education, practice, policy and leadership development. While RWJF was most often the sole funder of many of these initiatives, it has also joined with others to create a larger and more sustained impact on particularly challenging nursing, health, and health care issues.PurposeThe purpose of this article was to describe the challenges and opportunities of a unique funding collaborative developed to engage new partners, increase the visibility of doctoral nursing education and increase funding of the RWJF Future of Nursing Scholars program to develop more PhD prepared nurses and nurse faculty.MethodsInterviews were conducted with several members of the FNS Funders Collaborative as well as the scholars they supported. The perspectives of three funders, a regional philanthropy (IBC Foundation) and two health systems (Cedars Sinai and Sharp HealthCare) are presented here. Together they supported 13 nurses to complete their PhD through the RWJF Future of Nursing Scholars program.FindingsRWJF contributed $20 M and 13 other funders contributed an additional $3Mto the initiative. The additional funds supported 42 nurses to earn their PhD degree through the program. Six of the 13 funders are health systems, four are regional or health related philanthropies, and others include United Health Care, Johnson & Johnson, and the Care Institute.DiscussionThere were many lessons learned for RWJF and the other funders. Given the size of RWJF, some other philanthropies were concerned about how contributions would be represented, others wanted their funding to go directly to care improvement. Some health systems were not prepared for their nurses to decrease work time while pursuing further education. The nurse faculty and nurse PhD shortages have persisted now for over a decade. Although FNS made a significant contribution by developing over 200 new nurse PhDs (faculty and leaders), more funding collaborations that engage new and different partners must be developed so that nursing education does not have to focus on the same problems in the next decade.     

Barriers for BSN students to pursue a PhD in nursing and recommendations to address them: A scoping review

BackgroundIncreasing the BSN-PhD pipeline could address the shortage of nursing faculty to conduct research, develop nursing science, and train new nurses and faculty.PurposeTo identify barriers to BSN students’ pursuit of PhD education, and to compile recommendations to increase their numbers.MethodsThis scoping review follows PRISMA guidelines, including articles in English that discussed barriers to BSN students’ pursuit of PhD education and recommendations to address them.FindingsBarriers to pursuing a PhD include misunderstanding PhD education and its impact on population-level health, insufficient funding for PhD studies, and perceived need for clinical experience. BSN program recommendations include education on doctoral and postdoctoral options, mentorship, and hands-on research experiences. PhD programs should be accessible, fully funded, and address students’ perceived need for clinical experience.DiscussionThe nursing profession must take coordinated action across individual, interpersonal, program, policy, and cultural levels to increase the pipeline of well-prepared BSN-PhD students.     

RWJF Future of Nursing Scholars experience and recommendations: Focus group results at final convening

BackgroundThe Robert Wood Johnson Foundation launched the Future of Nursing Scholars program to support nurses to complete PhDs in 3 years in schools across the United States.PurposeTo explore why scholars participated in the program and to articulate challenges and facilitators to successful completion of their doctoral degrees.MethodThirty-one scholars representing 18 different schools participated in focus groups at a convening in January 2022.FindingsScholars identified that funding and planned length of degree completion were important factors in their choosing the accelerated program. Mentorship, networking, and support were identified as facilitators to program completion with the tight timeline of three years noted as a challenge.DiscussionAccelerated students require adequate resources including access to data, mentoring, and financing to overcome challenges presented by accelerated PhD training programs. Cohort models provide support and clarity of expectations for both students and mentors is critical.     

A scholarly concentration program to promote public health nursing for generalist Clinical Nurse Leader students

BackgroundThe number of public health nurses has decreased consistently and significantly since the 1920's. The recent COVID-19 pandemic has put a spotlight on the need for more public health nurses in the workforce. The number of novice nurses entering into public health roles is declining, demonstrating a clear need to mentor pre-licensure nursing students into the public health nursing workforce. Scholarly concentration (SC) programs are a method to explore specialty roles through in-depth scholarly activities, outside of core curriculum. However, SC programs have not been described in the nursing literature. The purpose of this paper is to describe the development of a SC program to engage pre-licensure Clinical Nurse Leader (CNL) students in scholarly activities related to public health nursing.Program overviewThis Public Health Nurse Scholars program was developed in 2014 with the goal of developing a cadre of generalist CNL students with experiences in public health nursing scholarly activities. The program aimed to increase awareness of career and scholarship opportunities through mentorship with public health nursing faculty. Students were encouraged to attend and present at professional conferences, participate in active scholarly projects and conduct quality improvement projects from a public health nursing perspective. The program was designed to foster students' public health nursing leadership and presentation skills and enhance their self-directed learning.ResultsTo date, 46 pre-licensure nursing students were selected as Public Health Nurse Scholars. Sixty-seven percent (n = 31) have graduated as Public Health Nurse Scholars; 33% (n = 15) are current Public Health Nurse Scholars. Twelve public health nursing faculty have served as mentors. As a result of the program 15 scholars attended and 3 scholars presented respectively at community/public health nursing conferences, and several scholars had related professional development opportunities. A majority of Public Health Nurse Scholars have designed and implemented a capstone quality improvement project with a public health nursing perspective, 15 of which were completed at community-based sites.ConclusionsIn the face of our current global, public health crisis, there is a clear need to develop a cadre of novice nurses prepared to enter the public health nursing workforce. The Public Health Nurse Scholars program shows promise towards encouraging an interest in public health nursing scholarship. Schools of nursing may consider the implementation of similar SC programs as an approach to mentor pre-licensure nurses in other specialty areas such as gerontological and neonatal nursing.     

Experiential clinical learning for newly licensed PhD students: Transforming nursing PhD education through academic-practice partnerships

The growing national and international need for nurse scientists to transform health care has encouraged advances in nursing doctoral programs. The Hillman Scholars in Nursing Innovation, a program integrating BSN and PhD education, inspired the creation of the Hillman Clinical Fellowship (“Fellowship”). The Fellowship helps students transitioning from the BSN to PhD gain clinical experiences as newly graduated registered nurses, thus mitigating a common concern that students are naïve about the clinical setting. In collaboration with a practice partner, the Fellowship fosters development of clinical skills consistent with Patricia Benner's Novice to Expert Model. Fellows build clinical skills concurrent with the development of research proficiencies in the PhD program. This Fellowship can be adapted by other schools seeking to introduce curricular innovations that address the needs of early career PhD students, enhance academic-practice partnerships, and meet the growing need for more clinically focused PhD prepared nurses.     

Preparing nurse scientists for health services and policy research: Five-year outcomes of interprofessional postdoctoral training in the National Clinician Scholars Program

BackgroundThe National Clinician Scholars Program (NCSP) is an interprofessional postdoctoral fellowship for physicians and nurses with a PhD. or DNP focused on health services research, policy, and leadership.PurposeTo evaluate 5-year outcomes of nurse postdoctoral scholars in the NCSP.MethodsWe describe the 5-year outcomes of nurse fellows and graduates from six NCSP sites (positions, number of peer-reviewed publications, citations, and h-index).ConclusionThere were 53 nurses in the sample (34 alumni, 19 fellows). Approximately half (47%, n = 16) of alumni had tenure-track faculty positions and had bibliometric performance indicators (such as h-indices) 2 to 4 times greater than those previously reported for assistant professors in nursing schools nationally. NCSP nurse scholars and alumni also had an impact on community partnerships, health equity, and health policyDiscussionThis study highlights the potential of interprofessional postdoctoral fellowships such as the NCSP to prepare nurse scientists for health care leadership roles.     

Nurse scholars of the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program

BackgroundThe challenge to increase the diversity, inclusivity, and equity of nurse scientists is a critical issue to enhance nursing knowledge development, health care, health equity, and health outcomes in the United States.PurposeThe purpose of this paper is to highlight the current nurse scholars in the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program (AMFDP).DiscussionProfiles and the programs of research and scholarship of the current AMFDP nurse scholars are described and discussed. Scholars share lessons learned, and how the AMFDP program has influenced their thinking and commitments to future action in service of nursing science, diversity efforts, legacy leadership, issues of health equity.ConclusionRWJF has a history of supporting the development of nursing scholars. AMFDP is an example of legacy leadership program that contributes to a culture of health and the development of next-generation nursing science scholars.     

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.     

Assessing postgraduate outcomes of research-intensive nursing science PhD programs: Methods and metrics

BackgroundAcross disciplines and within higher educational systems, assessing postgraduate outcomes is essential for evaluating doctoral programs, including research-intensive nursing science doctoral programs. However, there are limited reports regarding methods and metrics related to postgraduate longitudinal evaluation of research-focused nursing doctoral programs.PurposeThe purpose of this paper is to summarize studies in the area of postgraduate outcome assessment and provide recommendations regarding outcome methods and metrics for evaluating the effectiveness of research-focused nursing doctoral programs.MethodsPubMed/Medline, CINHAL Complete, and Google Scholar databases were searched using key words including PhD program, doctoral program, longitudinal evaluation, evaluation, program evaluation, PhD alumni survey, education outcomes and PhD program outcomes. We excluded non-English and full-text articles that were not available for review.DiscussionBased on a review of the literature, there are few reports on methods and questionnaires for postgraduate outcome assessment. There is a critical need to develop standardized core metrics/questions, longitudinal assessments, and a shared data repository. The latter will allow for comparisons across nursing doctoral programs.ConclusionRobust standardized longitudinal assessment of nursing doctoral programs is a necessary step for comparison across programs and re-envisioning the nursing doctoral education of the future.     

Interventions to boost enrollment in nursing doctor of philosophy (PhD) programs

BackgroundNursing Doctor of Philosophy (PhD) enrollments are languishing, and little is known about PhD enrollment strategies that may lessen nursing's PhD shortage.PurposeThis study examined strategies for bolstering PhD enrollments or enrollment intentions among college students and graduates.MethodsAn integrative review was undertaken using Whittemore and Knafl's methodology and Garrard's Matrix Method. Nine databases were searched, and a hand search was conducted.FindingsStrategies were predominantly situated in science, technology, engineering, and mathematics (STEM) disciplines. Features of successful strategies contained core components of faculty mentoring, hands-on research, funding and compensation, undergraduate participation, summer timeframe, informational sessions, and social support.DiscussionLess rigorous study designs and mostly STEM samples inhibit the transferability of these strategies to nursing. Qualitative research is needed to better understand nursing students’ perspectives about the PhD. Additionally, current PhD enrollment strategies within nursing schools need to be systematically evaluated and the findings disseminated.     

Defining the role of individuals prepared as a doctor of nurse practice in symptoms science research

PurposeThe Doctor of Nursing Practice (DNP) programs have grown exponentially for the last 10 years across the United States. However, the intra-professional collaboration among DNP and PhD scholars is not clearly demonstrated in the literature as it relates to frequency, training models, and the outcomes of these collaborations on translation. The purposes of this paper are to: (1) examine the role for DNP nurses in symptom science research and (2) describe training models to cultivate the PhD-DNP collaboration to strengthen the translation of discoveries from nursing research, to facilitate implementation of discoveries, and to improve clinical practice of nurses.MethodsA targeted review of the literature was conducted to identify, (1) the role of the DNP, (2) examples of PhD-DNP collaborations, (3) training models that support collaborations, and (4) the outcomes of these intra-professional collaborations.ResultsTwo articles reported on PhD-DNP collaboration within a university setting; however, they did not address how the partnership was modeled. One additional article described an academic-hospital partnership model aimed at MSN-prepared advanced practice nurses (APRN) by which outcomes were measured. No examples were found outside of academic settings. The National Institute of Nursing Research (NINR) has established the Symptom Science Center (SSC) with an interest in training the next generation of symptom scientists. By developing a training curriculum through the NINR SSC, DNP-prepared students and practitioners can be exposed to the research enterprise and potentially develop early partnerships with PhD-prepared students and scholars that lead to research translation.ConclusionThe NINR Department of Intramural Research (DIR) and National Institutes of Health Clinical Center are dedicated to building stronger ties between PhD- and DNP-prepared scientists. The SSC can serve as an optimal platform to promote the collaboration of PhD and DNP nurses to advance symptom science translation.Clinical RelevanceNurses have a remarkable role in early detection of disease progression. Training opportunities to cultivate the PhD-DNP collaboration have significant relevance for expediting the translation of nursing science to nursing practice.     

Increasing the pipeline and diversity of doctorally prepared nurses: Description and preliminary evaluation of a health disparities summer research program

Despite calls to increase the number and diversity of doctorally prepared nurses, recent data indicate a severe shortage of PhD‐prepared nurses, especially those of racial/ethnic minority backgrounds. This is concerning, given that evidence indicates that racial/ethnic minority PhD‐prepared nurses are well‐positioned to address health disparities, by attending to the needs/concerns of medically underrepresented groups. The purpose of this article is to describe and provide a preliminary evaluation of a summer research program for minority nursing students. Online surveys were administered to assess for student satisfaction, knowledge gains, attitudes toward research, and intentions to pursue a PhD among minority undergraduate nursing students (N = 6) participating in the 10‐week program. Favorable trends were observed related to satisfaction, knowledge gains, and attitudes toward research. Fifty percent of the sample intended to pursue a PhD immediately after the program, compared to none before the program, and this result was maintained at 1‐year post‐program. The summer research program appears to be a promising strategy for increasing the number/diversity of PhD‐prepared nurses. More research on the implementation of programs exposing minority nursing students to health disparities research is needed to strengthen evidence that similar programs can serve to increase the pipeline of diverse doctorally prepared nurses.     

Helping Scholars Overcome Socioeconomic Barriers to Medical and Biomedical Careers: Creating a Pipeline Initiative

Abstract

Problem: To achieve their potential in medical and biomedical careers, students (scholars) from under-resourced backgrounds must build sophisticated skills and develop confidence and professionalism. To flourish in an advanced educational system that may be unfamiliar, these scholars also need networks of mentors and role models. These challenges can affect scholars at multiple stages of their education. Intervention: To meet these challenges, we created a broad and innovative biomedical research-focused pipeline program: the Johns Hopkins Initiative for Careers in Science in Medicine (CSM Initiative). This initiative targets three levels: high school, undergraduate, and post-baccalaureate/pre-doctoral (graduate and medical). We provide training in essential academic, research, professional, and social skills to meet the unique challenges of our scholars from under-resourced backgrounds. Scholars also build relationships with mentors who provide career guidance and support. We present an overview of the training and assessment at each level of this initiative. Context: The initiative took place at an institution located in the greater Baltimore area and that is endowed with exceptional doctoral and postdoctoral trainees, staff, and faculty including clinicians, physician-scientists, and scientists who served as key role models and mentors. Our pipeline program draws from local high school students and a local and national pool of undergraduates and post-baccalaureates preparing for medical or graduate school. Impact: Our goals for the high school scholars are significant improvement in academic skills, increased confidence, and matriculation into higher education systems. Currently, at least 83% of high school scholars have matriculated into four-year college programs and 73% have chosen science, technology, engineering, math, and medicine (STEMM)-related majors. Among undergraduate participants, 42% have matriculated thus far into medical or biomedical graduate programs and this number is expected to rise as more scholars graduate from college and either enter graduate training or pursue STEMM careers. Another 25% have returned to our post-baccalaureate program. Among post-baccalaureate scholars, 71% have now matriculated into doctoral-level graduate biomedical programs (medical or graduate school) and the remaining 29% are pursuing careers in STEMM-related fields such as biomedical research with some still aiming at graduate-level education. Our long-term goal is to see a large majority of our scholars become successful professionals in medicine, biomedical research, allied healthcare, or other STEMM fields. Analysis of the early phases of the CSM initiative demonstrates such outcomes are attainable. Lessons Learned: This program provides experiences in which scholars develop and practice core competencies essential for developing their self-identity as scientists and professionals. The most important lesson learned is that mentorship teams must be highly dynamic, flexible, thoughtful, and personal in responding to the wide range of challenges and obstacles that scholars from under-resourced backgrounds must overcome to achieve career success.     

Difficult professional choices: deciding between the PhD and the DNP in nursing

Although the PhD has been the traditional doctoral degree in nursing, nurses now have a choice between that degree and the Doctor of Nursing Practice (DNP) degree. An Internet-based exploratory survey of DNP students (n= 69) investigated the motivation of nurses to pursue doctoral education, factors that influenced the decision between the two degrees, rationale for choosing the DNP program, and career plans after graduation. A majority reported considering the PhD but decided the DNP would be more appropriate for their professional and personal goals. Nursing education was ranked as an important career intention for 55% of respondents, dispelling the concern that the DNP will increase the shortage of nursing faculty. The results indicate that the DNP degree is a desirable option for clinically oriented nurses considering doctoral education and provides nurses with a choice of educational pathways for their professional careers.     

Creating Synergy between Academia and Practice: The Arizona State University and Mayo Clinic Arizona Model

BackgroundThe academic-practice partnership began in 2005 with a collaborative Pre-licensure Bachelor of Science in Nursing (BSN) program. Since that time the partnership has broadened to include faculty development, evidence-based practice, interprofessional education, and research initiatives.PurposeThe purpose is to share the outcomes of this academic-practice partnership and to provide a model for other institutions.MethodsThis successful partnership is grounded in the American Association of Colleges of Nursing and the American Organization of Nurse Executives' eight guiding principles for academic-practice partnerships. The cornerstones to the partnership are communication, collaboration, and mutual respect.ResultsThe initial outcomes of this collaboration increased enrollment, thereby increasing the number of BSN prepared registered nurses; created opportunities for clinical nurses to teach; increased the number of nursing faculty; and capitalized on the strengths of each partner.ConclusionThe most exciting aspect of this partnership is the shared commitment to decrease the gap between nursing education and practice; thus, improving the quality of nursing education, advancing the practice of nursing and healthcare delivery, and enhancing the health of our community. Consistent with the AACN-AONE recommendations, this academic-practice partnership prepares nurses of the future to be evidence-based practitioners and creates opportunities for nurses to achieve educational and career advancements.     

Supporting dissertation work through a nursing PhD program federal grant writing workshop

BackgroundNurse researchers need skills to secure external funding; therefore, we created a grant writing workshop for PhD students focused on the F31 Individual Fellowship and R36 Dissertation Grant.PurposeDescribe a nursing PhD program federal grant writing workshop and present participant impressions and outcomes.MethodsWe designed a three half-day workshop covering essential aspects of grant writing combined with mentor participation and follow-up. We assessed participant satisfaction in evaluations, subsequent grant submissions, project implementation, and time from PhD program entry to completion.FindingsEvaluations were overwhelmingly positive. Seventeen of 29 (58.6%) participants submitted 21 applications; five (23.8%) were funded. The majority (75.0%) conducted the proposed dissertation project regardless of funding. Writing and submitting a grant did not increase time to program completion.DiscussionThe workshop efficiently supports PhD students' dissertation research. Timing and mentor participation are key for success. We recommend schools of nursing implement PhD program grant writing workshops.