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ORIGINAL ARTICLES
Nursing Faculty Practice: An Organizational Perspective
SARA E. BARGER, DPA, RN, FAAN,* KATHERINE E. NUGENT, PHD, RN,TAND
WILLIAM C. BRIDGES, JR, PHD$
After reviewing the faculty practice literature of the 1960s and finding philosophical support for practice but also growing concerns about faculty role over- load, the authors report a study to identify organiza- tional factors that influence the role expectations of faculty members about practice. A survey was sent to the deans or directors of all National League for Nurs- ing-accredited baccalaureate nursing programs (n = 462). Of the 356 respondents (76 per cent), 224 (63.3 per cent) reported that their school had practicing fac- ulty, but only 20 schools (6.6 per cent) required prac- tice. W&ten faculty practice plans were reported by 23 schools (10.2 per cent), and nursing centers by 41 schools. Thirty-six respondents (16 per cent) repotted that practicing faculty generated revenue for the school. Practice was required for promotion in 15.6 per cent and for tenure in 15.3 per cent of all schools surveyed. The study showed significant direct rela- tionships between master’s and doctoral programs and practicing faculty, but there was an inverse rela- tionship between the presence of a health science center and schools with practicing faculty. Organiza- tional factors relating to both the number and per cent of faculty who practiced included requiring practice, having a practice plan, and having practice as a cri- terion for promotion and for tenure. Revenue genera- tion and presence of formalized practice arrange- ments were related to the number of faculty who prac- tlced but not the per cent of the total faculty who
*Professor and Chair, School of Nursing, Northern Illinois
University, DeKalb, IL.
TAssistant Head, Department of Nursing Science, College of
Nursing, Clemson University, Clemson, SC. *Associate Professor, Experimental Statistics, College of Agri-
cultural Sciences, Clemson University, Clemson, SC.
Address correspondence and reprint requests to Dr Barger: De-
partment of Professional Services, School of Nursing, Northern
Illinois University, 1240 Normal Rd, DeKalb, IL 60115.
Copyright 0 1992 by W.B. Saunders Company
8755-7223/92/0805-0005$03.00/O
practiced. The study’s findings have Implications for nursing education in designing organizational struc- tures and rewards that support faculty practice. (In- dex words: Faculty issues, practice; Nurslng faculty practice) J Prof Nurs 8:263-270, 7992. Copyr/gM 0 1992 by W.8. Saunders Company
F ACULTY PRACTICE, an important issueinthe
198Os, continues to capture the attention of
nurse educators in the 1990s as efforts continue to
unify the profession. This interest is evidenced by the
inclusion for the first time of faculty practice items in
the fall 1990 survey of the American Association of
Colleges of Nursing sent to all academic institutions
offering a baccalaureate or higher degree in nursing.
Although philosophical and theoretical literature on
the subject abounds, there is little research on orga-
nizational factors that influence faculty practice.
Therefore, the purpose of this study was to identify
organizational factors in schools of nursing that affect
faculty members’ practice. This article summarizes
the current literature on faculty practice, with partic-
ular emphasis on faculty practice research. Then the
subject is examined within the conceptual framework
of role theory, focusing on the influence of the orga-
nization. Next, a study of organizational factors af-
fecting faculty practice is described, and findings are
presented. Finally, these results are examined in the
context of the impact of nursing educational organi-
zations in shaping the roles of nurse educators.
Review of the Literature
Faculty practice emerged as one of the major philo-
sophical issues of the 1980s. Although models to
Journal of Professsionul Nursing, Vol 8, No 5 (September-October), 1992: pp 263-270 263
264 BARGER. NUGENT, AND BRIDGES, JR
unify nursing education and practice began with
Smith’s (1964) efforts at the University of Florida in
the 1950s and were continued by Schlotfeldt (Fagin,
1985) at Case Western Reserve, Christman (1979) at
Rush, and Ford (Ford & Kitzman, 1983) at the Uni-
versity of Rochester in the 197Os, it was not until the
1980s that everyone began talking about faculty prac-
tice. Perhaps it was the resolution of the American
Academy of Nursing (1979 to 1980), released in
1979, stating that “the American Academy of Nurs-
ing endorses the idea of cementing the relationship of
service and education through such devices as faculty
practice” (p. 4) that launched the issue for the 1980s.
Following closely was the National League for Nurs-
ing’s (1980) Council of Baccalaureate and Higher De-
gree Programs meeting, which focused on faculty
practice roles in nursing education.
Concentration on the issue of faculty practice was
made possible by a grant from the Robert Wood
Johnson Foundation to the American Nurses Founda-
tion, which funded four symposia on faculty practice
(Barnard, 1983; Barnard & Smith, 1985; Feetham &
Malasanos, 1986). Cosponsored with the American
Academy of Nursing, these symposia were held in
1983, 1985, 1986, and 1987. Through these confer-
ences and the resulting publication of their papers,
the philosophical, theoretical, and practical issues of
faculty practice were described, explored, and ana-
lyzed. Noticeably absent were research on faculty
practice.
Similarly, the faculty practice literature of the
1980s was largely philosophical and descriptive in
nature. Beginning with Mauksch’s (1980) seminal ar-
ticle, “Faculty Practice: A Professional Imperative,”
faculty practice was exhorted as a vital role component
for nursing educators. Reasons cited in the literature
in support of faculty practice included enhancement of
the quality of teaching, increased credibility in the
classroom, identification of research opportunities,
improved patient care (Millonig, 1986), insurance of
clinically competent faculty, improvement of rela-
tionships with nursing service, revenue for the college
of nursing, and increased control over the practice
environment for the faculty and the college (McClos-
key & Kerfoot, 1984).
Ford and Kitzman (1983) identified two criteria for
activities to be considered faculty practice: “they must
be scholarly in orientation with associated scholarship
outcomes and they must have the care of patients or
clients as their central focus” (p. 13-14). This defini-
tion was expanded by Algase (1986), who contended
that faculty practice must also contribute to advance-
ment of the discipline. She described four conditions
for meeting this criterion: (1) the practice must be
focused in some way, with clear boundaries or limits;
(2) the practice must include the realities and com-
plexities of everyday patient care; (3) the practice
must move the faculty member beyond mere acquisi-
tion and maintenance of clinical skills; and (4) the
practice ought to be funded differently than teaching.
m . . for activities to be
considered faculty practice: “they must be scholarly in
orientation with associated scholarship outcomes and they must have the care of patients
or clients as their central focus”. . .
As the decade of the 1980s progressed, the litera-
ture shifted from theoretical and philosophical sup-
port for faculty practice to more emphasis on the iden-
tification of the practical issues of that practice. Mil-
lonig (1986), while identifying the benefits of faculty
practice, also identified the following barriers: ( 1) the
time needed for practice conflicts with time needed
for teaching and scholarly pursuits, (2) difficulties ob-
taining appropriate and acceptable practice sites, (3)
barriers to reimbursement of faculty for practice, (4)
conflicts of commitment to both the educational and
practice setting, and (5) limited recognition for fac-
ulty practice in the promotion and tenure area. Fur-
thermore, she identifies a barrier that is “in some way
related to all of the other barriers” (p. 170), the bar-
rier of role strain.
In fact, a number of articles on faculty practice
focus on role issues. Wakefield-Fisher (1983) identi-
fies potential sources of role strain when the expecta-
tion of practice is added to the current role obligations
of nurse educators and questions if faculty practice is
a realistic expectation for faculty. Rodgers C 1986) sup-
ports this point of view because the majority of faculty
members hold master’s degrees as their highest earned
credential. She states that if faculty members add both
practice and doctoral study to the standard faculty role
requirements of teaching, research and service,
chronic overload will result. Neely et al. (1986)
clearly disagree, contending that practice is a piece of
the development of the nursing faculty role that oc-
curs through the synthesis of theory, education, re-
NURSING FACULTY PRACTICE 265
search, and practice. Although these authors conclude
that more research is needed on faculty practice as a
component of faculty role, in fact faculty practice re-
search is extremely limited. Nevertheless, the existing
research, limited as it is, addresses both organiza-
tional and personal factors related to faculty practice
as a component of faculty role.
A study by Anderson and Pierson (1983) explored
the problems of faculty practice to determine facili-
tating and/or inhibiting factors that faculty perceive
when trying to maintain their clinical skills. Deans of
National League for Nursing (NLN)-accredited bac-
calaureate programs (N = 306) identified faculty
members who were engaged in practice. Of the 972
practicing faculty members who were sent question-
naires, 573 (59 per cent) responded. The majority of
participants were 40 years old or under (57 per cent),
married (54 per cent), without dependants (57 per
cent), and had been teaching 5 years or less. The
majority were not engaged in research or scholarly
writing. They practiced mainly for personal reasons,
specifically, enriching their teaching, maintaining
clinical skills, and personal satisfaction. Concerning
institutional supports, only 37 per cent reported that
their school’s written philosophy included faculty
practice. The majority reported that their school al-
lotted no time for faculty practice. Only 10 per cent
stated that their school had a reimbursement policy.
Practice was a component of the evaluation criteria for
a teaching position in the schools of only 26 per cent
of the respondents. Respondents identified adminis-
trators as the greatest facilitators and work load as the
primary inhibitor of faculty practice. Most (95 per cent)
believed that students reacted positively to their prac-
tice, but only half felt that faculty viewed it positively.
In a more recent study (Barger & Bridges, 1987),
the relationships of both personal and organizational
factors to the extent of faculty practice were explored.
In the first phase of the study, deans or directors of
NLN-accredited baccalaureate programs provided de-
mographic data on their schools and administrative
policies. A sample of 41 schools was selected for the
second phase. In a survey of 1,507 faculty members of
these schools, 1,036 (68.7 per cent) participated by
providing demographic data on themselves and infor-
mation about the extent to which they practiced. Re-
sults indicated that administrative policies do not af-
fect the extent of faculty practice, but personal factors
such as age, marital status, and education (doctoral
degree) do. Of particular concern to the authors was
the inverse relationship between an earned doctorate
and the extent of practice.
Although these were the only studies that exam-
ined organizational and individual facilitators and in-
hibitors of faculty practice, three other studies inves-
tigating the effects of faculty practice and faculty de-
veloped clinical sites were identified. Kramer,
Polifroni, and Organek (1986) studied the relation-
ship between faculty practice and student acquisition
of beliefs, values, and attributes associated with pro-
fessional craftsmanship. The sample consisted of 137
senior baccalaureate nursing students and 14 faculty
from one school of nursing. Results indicated that
students taught by practicing faculty scored higher on three of the seven professional characteristics vari- ables-integration of theory into practice, realistic
perception of the work environment, and use of nurs- ing research. They reported more internal source of control, a higher degree of autonomy, higher self-
concept and self-esteem, and more professional and bicultural role behavior than did their classmates who
were taught by faculty not in practice (p. 297).
Boettcher (1989) examined the effect of academic
nursing practice centers on faculty job satisfaction.
Thirty-two centers in 25 states and 124 faculty mem-
bers participated in the study. Findings indicated a
high level of job satisfaction among faculty, the ma-
jority of whom were untenured in these centers.
. . . administrative policies do not affect the extent of faculty practice, but personal factors
such as age, marital status, and education (doctoral degree) do.
Maurin (1986a, 1986b) also studied nursing ser-
vices provided by schools of nursing. Of the 400
schools surveyed, 58.5 per cent responded, but only
23 per cent (n = 55) indicated that their school spon-
sored a clinical project. Effects of the clinical project
on the school’s degree program in rank order were (1)
better clinical learning experiences for students, (2)
clinical research initiated, (3) higher faculty satisfac-
tion, and (4) solved a clinical learning site shortage
problem. Moreover, statistically significant differ-
ences were found between schools that sponsored clin-
ical projects and those that did not. Schools with
clinical projects were more likely to have the status of
a school or college, be in a health sciences center, and
offer a master’s degree program. These schools also
266
had more intramurally and extramurally funded re-
search projects.
Although the studies of Kramer, Polifroni, and Or-
ganek (1986), Boettcher (1989), and Maurin (1986a,
1986b) examined the effects of faculty practice and
faculty-developed clinical sites, only the studies by
Anderson and Pierson (1983) and Barger and Bridges
(1987) focused on factors that influence the likelihood
that faculty will practice. Because the Barger and
Bridges study was completed 5 years ago, the authors
believed that a reexamination of organizational and
personal factors affecting faculty practice was indi-
cated.
The theoretical model of factors involved in the
taking of organizational roles developed by Katz and
Kahn (1978) provides the conceptual framework for
the study. In this model,
the role expectations held by members of a role-set- the prescriptions and proscriptions associated with a particular office-are determined by the broader or- ganizational context. The technology of the organiza- tion, the structure of its subsystems, its formal poli- cies, and its rewards and penalties dictate in large degree the content of a given office. What the occu- pant of that office is supposed to do, with and for
whom, is given by these and other properties of the organization itself (p. 196).
Thus, if we are to understand the role expectations
and the role sent by the role senders, and the role
received and the role behavior of the office of faculty
member, we must first understand the organization.
Purpose
Because Katz and Kahn (1978) assert that there is
“a causal relationship between certain organizational
variables and the role expectations held about and sent
to a particular position (p. 196), the purpose of this
study was to identify organizational factors that in-
fluence the role expectations of faculty members about
practice. The investigators questioned if schools
where faculty members practice differ from schools
where no faculty members practice. Also of interest
was the identification of organizational factors that
facilitate or inhibit faculty practice as a follow-up
study to the earlier work by Barger and Bridges
(1987). Specific research questions examined in-
cluded:
1. Are the demographics of schools where fac-
ulty members practice different from schools
where they do not?
BARGER, NUGENT. AND BRIDGES, JR
2. What is the relationship between specific or-
ganizational factors and the number of fac-
ulty members who practice?
3. What is the relationship between specific or-
ganizational factors and the percent of the
total full-time equivalent (FTE) faculty who
practice!
An exploratory survey was conducted to examine these
questions. The following operational definitions were
used in this study.
Faculty practice has the following attributes:
1.
2.
j
4.
Provision of service or care to clients IS the
central focus.
Practice occurs at times other than when the
faculty member is engaged in the clinical
teaching of nursing students.
Practice has as its goal the continued dd-
vancement of nursing care of patients/clients,
a goal congruent with the advancement ot
nursing knowledge.
The practice leads to individual growth and
consists of more than maintenance of clinical
skills,
Al~rtlnll$ting is not included in the definition of
faculty practice for the purposes of this study. It
should be noted that the authors specifically excluded
moonlighting with this closing statement, even
though statements I through 4 excluded it by virtue
of the specific criteria. This definition of faculty prac-
tice refined the operational definition used in the ear-
lier work by Barger and Bridges ( 1987), which in-
cluded activities in the clinical environment for the
purpose of supplementing income or fulfilling a per-
sonal need to practice (moonlighting). The authors
believed that a higher level definition was in order,
given the advancement of the area of faculty practice
since the previous survey.
Nursing center was defined as a nursing practice site
that is an integral component of the nursing academic
unit. This was the same definition used in the earlier
work by Barger and Bridges (1987).
Methodology
A survey instrument for deans and directors of
schools of nursing was developed after extensive re-
view of the literature and the content of the four
Academy Faculty Practice Symposia (Barnard, t983;
Barnard&Smith, 1985; Feetham & Malasanos, 1986)
NURSING FACULTY PRACTICE 267
and the meeting of the Council of Baccalaureate and
Higher Degree Programs addressing faculty practice
roles (NLN, 1980). To maximize participation, the
structure and length of the questionnaire allowed it to
be completed in less than 10 minutes. Specific data
were collected on the school’s affiliation, whether it
was a part of a health sciences center, its academic
programs (bachelor’s, master’s, doctoral), the number
of faculty, the theoretical basis of its curriculum, and
whether it had faculty who practiced. If there were
practicing faculty in the school, additional data were
collected regarding the number of faculty who prac-
ticed, the school’s requirements for practice, the ex-
istence of a practice plan, the existence of a nursing
center, formalized practice arrangements, revenue,
and criteria for promotion and tenure.
In January 1990, questionnaires were sent to all
NLN-accredited baccalaureate nursing programs (n
= 462). Three hundred sixty-two schools responded,
for a response rate of 78 per cent.
For purposes of analysis, schools were divided into
two groups: schools with practicing faculty and
schools with no practicing faculty. The relationship
between the two groups and nominal data was tested
using chi square (Question 1). For schools with prac-
ticing faculty, the number of practicing faculty was
coded, and the percent of faculty who practice of the
total FTE faculty was calculated. A linear model was
defined that related number of practicing faculty to all
the factors of interest (both quantitative and qualita-
tive). Analysis of variance was used to test significance
of factors in the model. Similarly, a second linear
model was defined for the relationship of the percent
of practicing faculty to all the same factors, and re-
sults of the two models were compared. The statistical
analysis system computer software package (SAS,
Cary, NC) was used to perform the calculations.
Findings
Of the 354 respondents, 224 (63.3 per cent) re-
ported that their school did have practicing faculty,
and 130 (36.7 per cent) reported no practicing fac-
ulty. Only 20 schools (8.8 per cent) required practice.
The remaining demographics are reported for schools
with practicing faculty. Twenty-three schools (10.2
per cent) reported a written faculty practice plan; 53
(23.6 per cent) reported an informal practice plan; and
149 (66.2 per cent) reported no plan. Of those schools
with either formal or informal plans, 23.3 per cent
had existed for less than a year, and 46.7 per cent had
existed for 1 to 5 years. Only 41 schools operated a
nursing center, down by 10 from the 51 schools re-
porting these centers 5 years ago (Barger, 1986). Nev-
ertheless, 58 schools (25.9 per cent) identified other
formalized practice arrangements, including those
with hospitals, screening programs, clinics and health
departments, contracts, a unification model, private
case loads, and joint appointments.
Thirty-six respondents (16 per cent) reported that
practicing faculty generated revenue for the school,
with revenue amounts ranging from $300 to
$600,000. In the majority of these schools (53.8 per
cent), all the income was kept by the schools. In 12
schools, a percent of the revenues went to the faculty,
with percentages to the faculty ranging from 11 per
cent to 100 per cent.
In the areas of promotion and tenure, 35 schools
(15.8 per cent) required practice for promotion, and
34 (15.3 per cent) required it for tenure. The number
of faculty practicing in schools ranged from 1 to 140,
with a median of 4, a mean of 8, and a standard
deviation of 12.03 practicing faculty/school. The per-
cent of faculty who practice in each school ranged
from less than 1 per cent to 94 per cent; the median
was 30 per cent, the mean was 36 per cent, and the
standard deviation was 0.27.
. . . having a master’s program greatly increased the likelihood of the school having practicing
faculty.
Schools with practicing faculty differed from
schools without practicing faculty in several key areas.
There was a significant inverse relationship between
the presence of a health science center and schools
with practicing faculty. In contrast, having a master’s
program greatly increased the likelihood of the school
having practicing faculty. The relationship between
the presence of a doctoral program and practicing fac-
ulty was also significant, although not at the same
level (Table 1). Larger schools also were more likely to
have practicing faculty (Table 2).
Specific organizational factors were found to be re-
lated to the number of faculty members who practice.
As seems obvious, requiring practice related strongly
to the number of faculty who practiced. Moreover,
having practice as a criterion for promotion and tenure
also related strongly to the number of faculty who
practice. Other organizational factors related to the
BARGER, NUGENT, AND BRIDGES, JR
TABLE 1. Differences in Demographics Between Schools With and Without Practicing Faculty
Variable
Schools With Schools With Practicing No Practicing
Faculty Faculty X2 P
Ownership
Public
Private
Presence of health
science center
Center present
No center
Master’s degree
program Has master’s
program
No program
Doctoral program
Has doctoral
program
No program
129 64 2202 138
99 68
51 16 5652 017
177 115
130 54 8681 003
98 78
33 9 4 754 029
195 123
number of faculty who practiced were having a prac-
tice plan and generating revenue. Having a nursing
center was not related to the number of faculty who
practice, but having other formalized practice ar-
rangements was related at the .OOl level (Table 3).
Finally, the relationship between specific organiza-
tional factors and the percent of a school’s total FTE
faculty who practice was investigated. Again, requir-
ing practice had the expected impact on the per cent
of faculty who practiced. Including practice in the
criteria for both promotion and tenure also continued
to exhibit strong relationships to the per cent of prac-
ticing faculty. However, generating revenue and hav-
ing formalized practice arrangements, as well as hav-
ing a nursing center, fell out of significance in this
model (Table 4).
Discussion
The findings of this study lend support to Katz and
Kahn’s (1978) theoretical model of factors involved in
TABLE 2. Differences in Number of Faculty Between Schools With and Without Practicing Faculty
Schools With Schools With No Practicing Faculty Practicing Faculty
(N = 224) (N = 130) P
Mean no. of faculty
Standard deviation
28 19 0004
31.6 164
TABLE 3. Factors Relating to the Number of Faculty in a School Who Practice
Factor
School requires practtce
School has practice plan
School has nursing center
Other formalized practtce arrangements Criterion for promotion
Criterion for tenure
Revenue generated
l f = ,001. tP = .Ol.
$P = .05.
df F
35 72’
2 4 62t I 2 37 ’ 23 30”
17 75’
9 87~
4 60$
the taking of orgaruzational roles. They contend that
an organization’s formal policies, rewards, and penal-
ties dictate in large degree the content of a given role,
and that is the finding of this study. When faculty
practice is required or rewarded through inclusion in
the criteria for promotion and tenure, both the num-
ber and per cent of practicing faculty increase. Other
organizational supports, such as having a practice
plan, generating revenue, and developmg formalized
practice arrangements. may also help, but rhe rela-
tionships were not as strong.
Although the study showed that formahzed prac-
tice arrangements and revenue generation were related
to the number of faculty who practiced, they were not
related to the per cent of faculty in a school that
practice. These differences appear to be due to the
difference in the standard deviations for the two mea-
sures of faculty participation. The standard deviation
for the number of practicing faculty was much greater
than is possible within a standard deviation for per-
centages. This greater spread that was possible in the
raw number of faculty who practiced probably ac-
counted for these factors being significant in the
model relating the number of practicing faculty to
these factors, but not in the model relating the per
cent of practicing faculty to these same factors. The
TABLE 4. Factors Relating to the Per Cent of Faculty in a School Who Practice
Factor df F
School requires practice 1 1837’
School has practice plan 2 8 09”
School has nursing center 1 0 47
Other formalized practice arrangements I 0 71
Criterion for promotion 1 13 99* Criterion for tenure 14 40‘
Revenue generated 1 69
*P = .OOl.
fP = .Ol.
*P = .05.
NURSING FACULTY PRACTICE
lack of a relationship between having a nursing center
and either the number or per cent of practicing faculty
supports the findings of the previous study by the
authors (Barger & Bridges, 1987).
It should be noted that the models and analyses
used assessed the individual effects of practice as a
criterion for promotion and tenure. The joint and
possibly synergistic effects of these two factors in com-
bination was not assessed. In future studies, it would
be important to assess the combined effects of these
and other factors on the number and percent of faculty
who practice.
The size and structure of the organization also were
found to be important in whether faculty practiced.
The school’s location within a health science center
was not conducive to practice, in spite of presumed
excellence and complexity in facilities. The size of the
faculty was also important, with larger schools being
significantly more likely to have practicing faculty
than smaller schools. In addition, the existence of
master’s and doctoral programs increased the likeli-
hood of practicing faculty.
Because findings from the present study were pri-
marily quantitative and presented the deans’ perspec-
tive on faculty practice, additional research is needed
to focus on the more qualitative aspects of faculty
practice. Therefore, the authors are in the process of
conducting a delphi survey of practicing faculty that
will address from the point of view of faculty members
the following questions:
1. What personal factors facilitate faculty prac-
tice?
2. What personal factors inhibit faculty practice?
3.
4.
5.
269
What organizational factors facilitate faculty
practice?
What organizational factors inhibit faculty
practice?
How do peers react to faculty who practice?
Although the findings of the present study appear
self-evident and in fact support the findings of earlier
studies (Anderson & Pierson, 1983; Barger &
Bridges, 1987), the likelihood of their use remains in
question. Institutional supports for faculty practice,
such as faculty practice plans and formalized practice
arrangements, were in evidence in only approximately
one fourth of the schools in this study. Moreover,
when over 80 per cent of the schools with practicing
faculty in the current study have no practice criteria
for promotion and tenure, it is unlikely that the num-
ber of practicing faculty will increase. In fact, Katz
and Kahn’s (1978) model suggests that they will de-
cline. It seems then that leaders in nursing education
must decide what is the desired role of the nurse
educator. We spent the decade of the 1980s in philo-
sophical support of the inclusion of faculty practice in
that role. The decade of the 1990s will require prac-
tical support through organizational structures and
rewards that send a clear message: Nursing is a prac-
tice profession, and our educators are practitioners par
excellence.
Acknowledgment
The authors gratefully acknowledge the assistance and support of deans and directors who not only completed the organizational survey, but who also assisted in the identifi- cation of practicing faculty for the next qualitative study.
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