Challenges to research productivity of doctoral program nursing faculty

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  • Accepted Manuscript

    Challenges to Research Productivity of Doctoral Program Nursing Faculty

    Suzanne C. Smeltzer, EdD, RN, FAAN Nancy C. Sharts-Hopko, PhD, RN, FAANMary Ann Cantrell, PhD, RN Mary Ann Heverly, PhD Nancy J. Wise, MSN, RNAmanda Jenkinson, MSN, RN Serah Nthenge, MSN, RN

    PII: S0029-6554(14)00090-6

    DOI: 10.1016/j.outlook.2014.04.007

    Reference: YMNO 933

    To appear in: Nursing Outlook

    Received Date: 24 May 2013

    Revised Date: 16 February 2014

    Accepted Date: 9 April 2014

    Please cite this article as: Smeltzer SC, Sharts-Hopko NC, Cantrell MA, Heverly MA, Wise NJ,Jenkinson A, , Nthenge S, Challenges to Research Productivity of Doctoral Program Nursing Faculty,Nursing Outlook (2014), doi: 10.1016/j.outlook.2014.04.007.

    This is a PDF file of an unedited manuscript that has been accepted for publication. As a service toour customers we are providing this early version of the manuscript. The manuscript will undergocopyediting, typesetting, and review of the resulting proof before it is published in its final form. Pleasenote that during the production process errors may be discovered which could affect the content, and alllegal disclaimers that apply to the journal pertain.

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    Challenges to Research Productivity of Doctoral Program Nursing Faculty

    Suzanne C. Smeltzer, EdD, RN, FAAN (Corresponding Author)

    Professor and Director, Center for Nursing Research

    Villanova University College of Nursing

    Villanova PA 19085-1690

    610-519-6282

    Suzanne.smeltzer@villanova.edu

    Nancy C. Sharts-Hopko, PhD, RN, FAAN

    Professor and Director, PhD Program

    Villanova University College of Nursing

    Nancy.sharts-hopko@villanova.edu

    Mary Ann Cantrell, PhD, RN

    Professor

    Villanova University College of Nursing

    Mary.ann.cantrell@villanova.edu

    Mary Ann Heverly, PhD

    Adjunct Associate Professor

    Villanova University College of Nursing

    Maryann.heverly@villanova.edu

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    Nancy J. Wise, MSN, RN

    PhD Student

    Villanova University

    Nancy.wise@villanova.edu

    Amanda Jenkinson, MSN, RN

    PhD Student

    Villanova University

    Amanda.jenkinson@villanova.edu

    Serah Nthenge, MSN, RN

    PhD Student

    Villanova University

    Serah.nthenge@villanova.edu

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    Abstract

    The Institute of Medicine (IOM), responding to a national health care crisis and related

    nursing labor force concerns, has called for an increase in the proportion of registered nurses

    with baccalaureate or higher degrees to 80% and a doubling of the number of nurses with

    doctorates by 2020. Simultaneously, large numbers of senior faculty are starting to retire, while

    the movement of doctorally-prepared nurses into academia is insufficient to replace them. Issues

    associated with the efforts of nursing programs to increase their capacity to respond to the IOMs

    recommendations, particularly the effect on scholarly productivity among nursing faculty in

    doctoral programs, are examined in this paper. Creative strategies for promoting scholarly

    productivity among doctoral program faculty are identified.

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    Introduction

    In response to the widely acknowledged crisis in health care in the United States (US)

    and related nursing labor force concerns, the Institute of Medicine (IOM) called for an increase

    in the proportion of nurses with a baccalaureate nursing (BSN) degree to 80 percent and a

    doubling of the number of nurses with doctorates by 2020 (IOM, 2010). The subsequent

    implementation of the Affordable Care Act (ACA) has increased the demand for advanced

    practice nurses (APNs), including nurse practitioners (NPs), because it is refocusing the US

    health care delivery system on primary and preventive services (Naylor & Kurtzman, 2010;

    Health Policy Brief, 2013). Moreover, the ACA is enabling millions more Americans to access

    non-emergency services amidst an already existing shortage of primary care providers (US

    Department of Health & Human Services, 2014). Both of these trends clearly increase the

    demand for nursing faculty who are prepared for the faculty role to staff new and expanding

    educational programs that will prepare more nurses at all levels to address these urgent societal

    needs.

    The purpose of this paper is to explore the known challenges of doctoral nursing faculty

    to contribute to nursing science and evidence-based practice through research and scholarship>

    At the same time, doctoral nursing faculty are required to balance the demands associated with

    teaching and mentoring growing numbers of doctoral students, foster the development of new

    faculty colleagues, provide leadership to the profession, and in some cases, continue clinical

    practice to maintain advanced practice credentials.

    Nursing Faculty Shortage

    Prior to the IOM (2010) report that recommended major changes in the preparation and

    deployment of nurses, a shortage of nurses and of nursing faculty was well-documented

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    (National Research Council, 2005; Yordy, 2006). The US Bureau of Labor Statistics (2013a)

    indicates that from now until 2022, the registered nurse labor force will need to be 22% greater

    than it is currently, while the advanced practice nurse labor force will need to increase by 31%

    (US Bureau of Labor Statistics, 2013b). Concurrent with these growing labor force needs, the

    nursing faculty shortage, which resulted in almost 75,000 potential baccalaureate and graduate

    student nurses being turned away in 2011 because of insufficient faculty to teach them, has

    increased in recent years (American Association of Colleges of Nursing, 2012; National League

    for Nursing, 2008, 2010). To be eligible for employment, faculty members in baccalaureate and

    higher-degree nursing programs need to be prepared at the doctoral level and need to be

    productive in research and scholarship to retain their positions (Hinshaw, 2001).

    The American Association of Colleges of Nursing (AACN) recently reported a 7.7%

    national nurse faculty vacancy rate, with over 91% of the positions requiring a doctoral degree

    (AACN, 2012). Schools of nursing typically have a lower percentage of faculty with doctoral

    degrees than other disciplines. Recent AACN data indicate that in 2012, there were 620

    graduates from 131 research-focused doctoral programs, and in 2013 there were 2443 graduates

    from 241 Doctor of Nursing Practice (DNP) programs (AACN, 2014; Fang, 2013). Fewer than

    40% of research-focused doctoral (PhD) program graduates assume roles in academic

    institutions, while the rest accept research positions in clinical settings, industry and health

    advocacy organizations, leadership positions in health care systems, and health administration

    positions in government agencies (National Advisory Council on Nurse Education and Practice,

    2010). Over 30% of DNP graduates currently accept positions in schools of nursing without

    preparation for the faculty role; many enter academia as DNPs with no prior experience in

    nursing education (National Advisory Council on Nursing Education and Practice, 2010).

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    Doctorally-prepared nurse faculty have shorter careers than academics in other

    disciplines. They tend to earn their terminal degrees in midlife and retire earlier than faculty from

    other fields (Berlin & Sechrist, 2002). The number of nursing faculty with doctorates who are

    younger than 45 years of age has been decreasing (Berlin & Sechrist, 2002), thus increasing the

    average age of nursing faculty. The retirement of faculty members in the post-World War II

    Baby Boom generation will deplete the numbers of faculty with doctorates, increase the teaching

    roles of those who remain, and diminish the time they have available for research and

    scholarship (Hinshaw, 2001; Brady, 2010). Those teaching in PhD programs are ideally

    seasoned faculty who are highly productive in research and scholarship; they also tend to be

    leaders in their institutions who are expected to shoulder increasing administrative and

    institutional service demands. To summarize briefly, the demands on doctorally-prepared nursing

    faculty to educate a growing nursing labor force, including registered nurses, advanced practice

    nurses, as well as those with doctorates, are increasing concurrently with the retirement of large

    numbers of senior nursing faculty.

    Needs of New Faculty

    Nurses often move into faculty positions upon completion of a graduate degree, the focus

    of which is most often clinical practice or research. As is true in most academic disciplines, new

    faculty typically lack formal preparation for the faculty role. They need to learn to effectively

    prepare classes and design effective clinical practica, actively engage their students, evaluate

    learning, and participate more broadly in the processes of their schools within the context of an

    academic culture that differs markedly from the world of health care delivery. In order to be

    retained by their institution, faculty may at the same time be expected to quickly institute a

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    program of research that may require acquiring external funding as well as the generation of a

    stream of peer-reviewed publications.

    With the retirement of growing numbers of senior faculty and the need to prepare

    growing numbers of doctoral graduates, new faculty will have to assume responsibilities for the

    education of doctoral students early in their careers. Senior faculty who remain will need to

    devote increased time to mentoring larger numbers of new faculty in their faculty roles, in the

    development of their programs of research, and in the mentorship of doctoral students (Dreher,

    Smith & Cornelius, 2012).

    Increased Emphasis on Advanced Practice and the Emergence of the DNP

    Nursing programs are responding to societal need by expanding their preparation of

    nurses for advanced practice, particularly nurse practitioners (NPs). Faculty who teach in these

    programs must, in additional to the traditional tripartite role of nursing faculty (Hinshaw, 2001),

    actively engage in clinical practice so that they maintain their own advanced practice credentials.

    For example, the DNP was conceived as a way to prepare clinical leaders who would

    have parity with other health professionals. To date the AACN does not promote the preparation

    of DNP graduates for teaching roles, yet over 30% of DNP graduates teach in schools of nursing

    and increasingly they are needed to teach in DNP programs as these programs grow in size and

    number.

    The AACN (2006) identified the need for a culture of inquiry and practice scholarship in

    programs that prepare DNPs. DNP program faculty are expected to be actively engaged in

    practice and expected to develop and implement programs of scholarship that range from

    knowledge development through original research to the translation of research into clinical

    practice. They may be expected to obtain extramural grants for support of practice innovations,

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    publish in peer-reviewed journals, present scholarly papers, engage in peer-review, provide

    leadership in professional organizations, engage in health policy activities, and develop and

    disseminate clinical practice improvement products (AACN, 2006). Some DNP faculty are being

    asked to meet the same requirements as PhD faculty for retention and promotion (Nicholas &

    Dyer, 2012). Evidence about DNPs success in faculty roles is not yet available.

    In terms of the faculty of the future, another challenge is that compared to PhD programs,

    DNP programs now graduate approximately four times as many graduates annually. Given the

    lack of emphasis in DNP programs on teaching and research, there is concern about who will

    encourage BSN and MSN students to consider advanced study in teaching and research as well

    as who will teach these areas of content in the future. Currently some faculty prepared with

    research doctorates are engaged in teaching DNP students, or both DNP and PhD students.

    Mentorship of DNP students differs from mentorship of PhD students due to the typically shorter

    length of the DNP program, creating additional challenges for doctoral faculty (Dreher et al.,

    2012; Author, in review).

    The Robert Wood Johnson Foundation Evaluating Innovations in Nursing Education

    Program has made public data for the July 2009-June 2010 year that provides some insight into

    PhD and DNP productivity, though the survey only included people specifically in nursing

    faculty roles (National Survey of Nurse Faculty, 2009). During that year, 20% of faculty had

    published one or more peer-reviewed articles while 80% published none. Among faculty

    prepared as DNPs, 33% published one or more peer reviewed articles during the year, compared

    to 63.4% of faculty prepared as PhDs. During that time period 29% of nursing faculty prepared

    one or more grant proposals, while 71% prepared none. Among faculty prepared as DNPs,

    40.7% reported submission of one or more grant proposals, while among faculty holding a PhD,

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    66.5% prepared a grant proposal. To contrast the national data with data from top research

    institutions in nursing, the Chronicle of Higher Education most recently reported 2007 Faculty

    Scholarly Productivity Index data for ten top-ranked research institutions in nursing. The range

    of percentages of faculty with a journal publication was 72-95%, and the range of journal

    publications per faculty was 2.5-7.23. The range of percentage of faculty getting a new grant was

    12-41%, and the range of new grants per faculty was .15-.59% (The Chronicle, 2013).

    Faculty Retention Issues

    Faculty members, particularly those under age 45, are increasingly likely to leave

    academia because of opportunities in other sectors (Berlin & Sechrist, 2002; National Advisory

    Council on Nurse Education and Practice, 2010). The Healthcare Research and Services

    Administrations (HRSA) National Advisory Council on Nurse Education and Practice studied

    issues associated with nurse faculty recruitment and retention in 2009-2010. Barriers that the

    council identified included the existence of many alternative career choices for doctorally-

    prepared nurses, job dissatisfaction with the faculty role, non-competitive salaries, competition

    among health professions for a diverse workforce, and lack of outreach to pre-college and

    college students sugges...

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