DNP and PhD scholarship: Making the case for collaboration

BackgroundThe Institute of Medicine calls for meaningful collaboration between doctor of nursing practice (DNP)- and doctor of philosophy (PhD)-prepared nurses to improve health outcomes.PurposeThe purpose of this paper is to answer the questions: 1) how do Colleges of Nursing influence DNP and PhD collaboration for faculty and students? 2) how does DNP and PhD collaboration in an academic setting impact health care practices and patient outcomes?MethodsTwo examples of DNP and PhD collaboration (one faculty and one student) are presented.ResultsShared faculty responsibilities and a supportive organizational culture influenced collaboration between faculty and students. Research and practice roles can complement and strengthen each other while improving health outcomes.ConclusionColleges of Nursing should build processes and culture that encourage faculty and students to collaborate across doctoral programs. Successful intraprofessional collaboration has the potential to positively impact healthcare quality, and outcomes, while advancing the nursing profession.     

Doctoral-prepared nurses in the Veterans Health Administration: A cross-sectional survey

BackgroundDoctoral-prepared nurses with diverse skillsets are required to meet nursing care needs in a complex and changing healthcare environment. A better understanding of the roles of doctoral-prepared nurses in Veterans Health Administration (VHA) workforce will help leverage their expertise to meet the needs of Veterans.PurposeAssess the current roles of doctoral-prepared nurses within the VHA.MethodA cross-sectional survey was used to collect information on doctoral-prepared nurses within the VHA in 2016. Multiple strategies were used to identify doctoral-prepared nurses to recruit for an online survey. Survey invitations were sent electronically to unique individuals identified (N = 2403).ResultsResponses were received from 1015 nurses (42.2% response rate), with 929 nurses with a doctoral degree identified. DNP/DNAP degrees were most common (55%), followed by a PhD or DNS (33%). Significant differences were noted between nurses in different doctoral education categories across four main roles: research, clinical, educational, and administration.ConclusionsThis survey generated the first comprehensive list of VHA doctoral-prepared nurses. Findings are being used by the VHA Office of Nursing Services to align degree types, duties of different positions, functional statements, and position expectations. Results support the continued need for collaboration between nurses with PhDs and DNPs to achieve research and clinical goals.     

Nursing student and faculty competency improvement through a nurse-bridging program in Cambodia

BackgroundAn adequate number of high-quality nurses are a key factor for superior patient outcomes. However, in 2015, Cambodia reported only 52 nurses with bachelor's degrees, three with master's degrees, and one with a doctorate. The fast track to getting a highly educated nursing workforce requires providing a bridging program for associate's degree nurses to achieve baccalaureate degrees.ObjectivesTo assess improvement in the competency of nursing students and faculty members through a program that prepares associate's degree nurses to obtain bachelor's degrees in Cambodia.DesignMixed methods.SettingEducational institutes in Phnom Penh, Cambodia.ParticipantsA total of 45 Cambodian nursing students participated in the Cambodian nurse-bridging program and 12 Cambodian faculty members served as co-teachers.MethodsWe conducted three surveys to compare the competence of nursing students and faculty members before, during, and after the bridging program. We conducted focus-group interviews to support the qualitative results and explored changes in student and faculty competencies after the program.ResultsQuantitative analysis revealed significant improvements in students' nursing competency (p < .001), critical thinking (p < .001), and research competency (p < .001) and faculty members' teaching competency (p < .001) and research competency (p < .001) after the program. Through qualitative analysis, students showed improvement in physical assessment, patient communication, critical thinking, evidence-based nursing, and research competency. Faculty members indicated they had experienced new teaching strategies and subjects, gained increased confidence in teaching, and even though research competency had been improved, more training was required.ConclusionsThis study provides evidence to support the effectiveness of higher nurse education in developing countries, and illustrates an opportunity to produce high-quality human resources in nursing.     

Following the Path; A Grounded Theory Study Regarding Doctoral Roles

BackgroundDecades after the AACN (2004) position statement regarding the clinical doctorate, the DNP, shows ongoing dialogue without professional consensus regarding the two terminal degrees. The lack of understanding and confusion surrounding the two doctoral degrees in nursing subsequently projects a negative image about the profession; suggesting a lack of cohesiveness; promotes an environment of distrust, thereby creating confusion for the public about the nursing profession.PurposeThe purpose of this qualitative research was to develop a substantive theory about the perceptions and the attitudes of doctoral nurses regarding their roles.MethodAn adapted approach of Strauss and Corbin's grounded theory methodology was used. Sampling was purposive, snowball, and theoretical. Theoretical sampling with an expert group validated concepts, themes, and categories.ResultsThe main categories of advancing, collaborating, transforming, and stewarding emerged from the data. The basic social process of Following the Path identified and explained the meaning ascribed by DNP and PhD nurses about their doctoral roles.ConclusionsThe theoretical framework provides information about the DNP and PhD nurse. The findings support evidence the nursing profession is moving forward towards self-definition. Acceptance and need for the doctoral roles were identified. Understanding the perspectives of the doctoral nurses in the profession has identified forward movement in practice and cohesion of the nursing discipline.     

A “Co-CREATES” framework to foster a positive learning environment for nursing students’ professional development in Rwanda

AimThe future of the nursing profession in Rwanda in large part depends on the students who join the workforce and the education they have received. Preparing students with the necessary knowledge, values and judgement requires practice settings to be learner-centered. This study aimed at exploring strategies that might improve the current practice-based learning environment.DesignA focused ethnographic approach was used.MethodsNursing students, staff nurses, clinical instructors and nurse leaders from three hospitals and an educational program participated in individual interviews.ResultsFive key areas of improvement emanated from study data: 1) strengthening institutional support; 2) improving school-hospital collaboration; 3) building the capacity of nurses and clinical instructors; 4) restructuring clinical placement; and 5) reviewing the current supervision model. Based on these findings a “Co-CREATES” framework grounded in the actions of collaboration, care, recognizing, empowering, actively engaging, transforming, enhancement and support was developed. The framework offers a collaborative approach that engages every stakeholder in “cocreating” conditions that build positive practice environments which are conducive to preparing students as professional nurses.ConclusionThe positive outcomes stemming from such a collaborative approach can further enhance a positive culture of collaboration in nursing education and practice.     

Pediatric Oncology Nursing Research in Low- and Middle-Income Countries: Exemplars from Three Regions

ObjectiveThis study examined the status of pediatric oncology nursing research in three low- and middle-income countries (LMICs) as examples across three World Health Organization regions: East Africa, Eastern Mediterranean region, and Latin America.Data SourcesPublished literature was identified from Google Scholar, PubMed, Scielo, Virtual Health Library, and reference lists of some articles.ConclusionThe experiences of the three LMIC pediatric oncology nurses illustrate the situation of nurse research in their setting and identify relevant published literature. The authors highlight the challenges for nurses to conduct research (eg, lack of training, mentors, funding, and opportunities). Local evidence to inform nursing practice in LMICs is needed. Recommendations for ameliorating the situation include increased advanced practice nurse education, physician and hospital support, funding, and protected time.Implications for Nursing PracticePediatric oncology nursing practice is culturally and context-driven and requires locally acquired evidence to support best practices. Only when sufficient, sustainable, and local nursing research training and education is available in LMICs, will this evidence be generated. Nursing research training (eg, master's and PhD programs), funding, and protected time are three key steps to guide and motivate staff nurses as well as academic nurses to participate in research that informs the care of children and adolescents with cancer across all countries and not only those with significant resources.     

Understanding the motivation of nurses volunteering for non-disaster humanitarian service

BackgroundNurses who volunteer in a nondisaster humanitarian surgical mission receive little attention in the research literature.PurposeThe purpose of this study was to explore how nurses involved in short-term nondisaster humanitarian care perceived and managed their experiences of working in a volunteer nursing capacity in a low- to middle-income country.MethodAn immersive ethnographic method was used. Participants comprised 150 international registered nurses from 12 countries. Data collection incorporated 49 semistructured interviews and reflections on 1,500 hours of participant observation. Data were analysed using a thematic, inductive approach, following the consolidated criteria for reporting qualitative research guidelines.ResultsThe results of this qualitative enquiry revealed essential aspects of the nursing culture within a specific humanitarian nursing context—that is, promoting social justice and addressing health disparity through the delivery of compassionate surgical care. This paper presents data describing nurses’ motivations for participating as volunteers in humanitarian work.DiscussionNurses are more likely to offer increased effort and enthusiasm when there is congruency between their beliefs, their professional identity, and their ability to enact on these. Understanding humanitarian nurses’ motivations gives guidance to leaders involved in managing, attracting, and retaining suitable nursing staff and orienting, debriefing, and supporting re-entry after withdrawing from short-term medical assignments that share a common imperative to care for the underserved.     

Motivations and challenges of Israeli nurses on their journey to a PhD: A qualitative study

AimThis qualitative study aimed to examine the motivations and challenges encountered by Israeli nurses during their journey to achieve a doctoral degree (PhD).BackgroundThe increasing numbers of nurses studying for a doctoral degree may contribute to improving nursing education, expanding the body of knowledge and promoting the status of nursing as a research profession. However, many countries have reported a shortage in nurses with doctoral degrees.DesignQualitative content analysis study using semi-structured interviews.MethodsSixteen senior nurses (mean age 47.35 years, 75% women) who completed their doctoral studies in the past five years were interviewed. The interviews were transcribed and their content was analyzed inductively. COREQ checklist was used to report the study.ResultsThe ability to persevere in doctoral studies was related to the support provided by the learning environment as well as to family support. External barriers were related to administrative bureaucracy, tedious search for a mentor, unsupportive workplace and socio-economic burdens. PhD studies were perceived as a means for self-fulfillment, while major motivators were aspiration for professional advancement, a responsibility for promoting the image of nursing and a lack of recognition by colleagues.ConclusionsNurses study for doctoral degrees in order to advance their career and achieve personal fulfillment, as well as to increase the prestige of the nursing as profession. To allow nurses with PhD to fulfill their abilities and to advance the nursing profession, their research and academic support should be increased, and appropriate professional positions should be developed.Tweetable abstractThis study highlights the facilitators of doctoral studies such as family and academic support, a strong need for personal and professional fulfillment, and a desire for professional change, and obstacles such as academic and bureaucratic barriers, low wage increases, and a lack of recognition of nursing by the medical world.     

Video-based tools to enhance nurses' geriatric knowledge: A development and pilot study

BackgroundThe need for health care professionals with geriatric knowledge is expected to increase due to aging of society. Educational tools that fit the specific learning styles of nurses and nursing students might be useful for this. Serioussoap.nl (available in Dutch and English) is an educational tool that integrates video-based gaming and storytelling, and it might be an effective way to improve the geriatric knowledge of nurses or nursing students.ObjectivesTo investigate the effect of Serioussoap.nl on the geriatric knowledge of nurses and nursing students, and to evaluate its usability.DesignWe conducted a development and an explorative pilot study, using a pretest posttest quantitative design to investigate the effect of Serioussoap.nl on geriatric knowledge. A qualitative approach was used to evaluate its usability.Participants and settingThree vocational nursing schools (n = 119 second/third year students), one baccalaureate nursing university (n = 77 first year vocational nurses) and one home-care organization (n = 44 vocational nurses) in the Netherlands participated in the quantitative study, and 94 vocational students participated in the qualitative study.MethodsWe measured the effect on geriatric knowledge with the Knowledge of Older People Questionnaire (KOP-Q, score 0–30). The qualitative study included observations of 94 participants while they played Serioussoap.nl, four semi-structured focus groups and eleven individual interviews.ResultsThe study demonstrated a significant increase of geriatric knowledge of 7.8% (+2.3 score on the KOP-Q, 95% Confidence Interval (1.4–3.2, p < 0.001). The qualitative data showed that Serioussoap.nl contributed to the reflective learning-style and enhanced meaningful learning.ConclusionSerioussoap.nl increased the students' geriatric knowledge and was perceived as a suitable and effective educational tool for vocational nursing students and nurses.     

Experiences after international clinical placement as nursing students in a paediatric ward

AimThe aim of this study is to investigate nurses’ experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward.BackgroundStudent mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients.Design and methodIn this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward.ResultsMeetings with children’s destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role.ConclusionAll participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents’ and nurses’ roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country.     

What influences student nurses’ intention to work with older people? A cross-sectional study

BackgroundStudies have reported that student nurses hold positive attitudes towards older people; nevertheless, working with older people has consistently remained one of the least desired career choices among student nurses in most countries.ObjectivesThe current study aimed to assess student nurses’ intentions to work with older people and to determine the predictors of working intentions among nursing students.DesignThe study adopted a cross-sectional design.SettingsMultistage sampling was used to recruit nursing students from five states in Malaysia.ParticipantsA total of 1462 nursing students from eleven nursing education institutions participated in this study.MethodsA self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students’ intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.ResultsThe present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.ConclusionThe primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.     

Global assessment instrument for quality of nursing doctoral education with a research focus: Validity and reliability study

ObjectivesThis study was designed to assess the content and construct validity and reliability of the Quality of Nursing Doctoral Education (QNDE) instrument for nursing doctoral programmes with a research focus.DesignA cross-sectional, survey study.SettingsUsing Qualtrics survey, the research team sent emails to potential participants providing a link to the study and the QNDE instrument.ParticipantsA total of 234 faculty and doctoral students participated: 17 faculty from 14 countries in the first stage; 111 faculty and 106 doctoral students from 20 countries in the second stage.MethodsThe content validity, internal consistency reliability, and construct validity of the four domains (program, faculty, resources, and evaluation) of the QNDE were examined in two stages. Data were collected from purposive samples of faculty and students between June 2018 and March 2019. Confirmatory factor analysis was conducted in ordinal scale using robust weighted least square mean and variance (WLSMV) adjusted estimator in MPlus 8.ResultsContent validity of the items in the four domains was accepted when the item showed content validity (I-CVI > 0.78). Internal consistency reliability in four domains was computed using Cronbach's alpha, α = 0.88 to 0.97. Construct validity of the QNDE was established by confirmatory factor analysis based on model fit statistics. Factor loading coefficients for all items in each domain were statistically significant (>0.5; p < .001).ConclusionsParticipation of 234 faculty and doctoral students from 20 countries on four continents confirmed content validity, internal consistency reliability, and construct validity of the QNDE instrument. These findings support the credibility of this revised QNDE instrument for assessing the quality of nursing doctoral education with a research focus. This is a significant step forward in enhancing the capability for evaluating doctoral programmes.     

Comparing undergraduate student nurses' understanding of sustainability in two countries: A mixed method study

AimTo explore sustainability education in nursing students in two countries.DesignMixed methods including a sustainability survey and focus groups.MethodsFirst-year undergraduate nursing students from two countries were invited to participate. 69 students from China and 32 students from England agreed to take part. Data were collected between December 2015 and February 2016. Students completed the Sustainability Attitudes in Nursing Survey (SANS_2) and a purposive sample were invited to participate in focus groups in each country.ResultsAll students had a positive attitude towards sustainability. However, for these four items, the results indicated that Chinese nursing students rate them significantly higher in importance than English students:Climate change is an important issue for nursingIssues about climate change should be included in the nursing curriculumSustainability is an important issue for nursingSustainability should be included in the nursing curriculum.The qualitative data identified four themes:Student nurses' conceptual understanding of sustainability focused mostly on environmental aspects and clinical waste management;Promoting sustainability within nursing education: teaching and learning methods.Promoting sustainability within nursing education: evaluating and certifying learning.Factors to consider when introducing sustainability to nursing education.The paper outlines the similarities and differences between Chinese and English nursing students' perceptions.ConclusionSustainability in nurse education has similar concerns across countries.ImpactSustainability is an important issue for student nurses but strategies promoting incorporation of sustainability issues within nursing curricula are needed.     

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.     

A model (CMBP) for collaboration between university college and nursing practice to promote research utilization in students' clinical placements: A pilot study

BackgroundA collaborative project was initiated in Norway between a university college and a hospital in order to improve RNs' and nursing students' research utilization in clinical placements. This paper describes the model (CMBP) that was developed, its first application, and evaluation.AimThe evaluation aimed at describing nurses' and students' experiences of the CMBP related to collaboration, facilitation, learning, and impact on nursing care.MethodsThirty-eight students from the second and third year of nursing education, and four nurses answered questionnaires with closed and open ended questions. In addition two of the nurses wrote diaries. Data were subjected to qualitative and quantitative analysis.FindingsAlmost all participants reported that collaboration between nursing college and nursing practice had been beneficial. Most students and all nurses reported about valuable learning, increased understanding of research utilization, and improved quality of nursing care. Both students and RNs recommended the CMBP to be used in all clinical placements to support academic learning and increase research utilization in clinical practice.ConclusionDespite study limitations the findings indicate that the CMBP has a potential to be a useful model for teaching RNs' and students EBP. However, further refinement of the model is needed, followed by a more comprehensive implementation and evaluation.