Grantee Research Findings

University of Portland—Dedicated Education Unit Evaluation

An evaluation of the DEU model at four schools of nursing and their acute care partners that operate both DEUs and traditional teaching sites. Data from student and nurse faculty surveys were used to compare teaching capacity, faculty work satisfaction and quality of clinical learning environments.

Faculty Capacity:

Academic faculty serve more students on a DEU:

• 1:8 faculty to student ratio on traditional unit
• 1:16 faculty to student ratio on DEU

Faculty Work Life:

• Compared to national and traditional groups, a higher percentage of the DEU faculty members indicated they were satisfied with their work compensation, schedule, and work load.

Professional Development and Faculty Support:

• Compared to nurses from traditional units, DEU nurses reported significantly higher levels of professional development and faculty support for performing their clinical role.

Related Publication: “Dedicated Education Unit: Implementing an Innovation in Replication Sites.”

Read an in-depth Spotlight interview on the University of Portland’s DEU evaluation HERE.

University of Massachusetts Boston—Project PDQ – Partnering for DEU Development and Quality

A controlled evaluation of Project PDQ’s DEU model of clinical education – which uses academic Clinical Faculty Coordinators (CFC) and staff nurse Clinician Instructors (CI) – and the traditional model.

Work-Place Role Satisfaction:

• DEU CIs indicated higher satisfaction in their opportunities to work with nursing students.

Work Life – Morale and Role:

• Compared to staff nurses working on DEUs, CIs report more positive morale and changes in morale.

Quality of Education:

• DEU clinical education quality is found to be comparable or better than traditional clinical education.

Related Publication: “Partnering and Leadership Core Requirements for Developing a Dedicated Education Unit,” coauthored by EIN grantee Dr. Joanne Mulready-Shick (UMass-Boston) and partners from two academic research centers – Massachusetts General Hospital and Brigham and Women’s Hospital.

Read an in-depth Spotlight interview on the UMass-Boston’s DEU evaluation HERE.

University of Hawaii at Manoa—The Impact of Implementing the Hawaii Statewide Nursing Consortium Curriculum on Faculty Work Life, Teaching Productivity and Quality of Education

A mixed-methods evaluation to study the impact of implementing the Hawaii Statewide Nursing Consortium Curriculum on faculty work life, teaching productivity and quality of education.

Faculty Work Life:

• Intervention faculty reported higher levels of university-wide collaboration and collegiality than comparison faculty.
• Intervention faculty reported increases in life satisfaction, while comparison faculty reported decreases, during the first year.

University of North Carolina—Chapel Hill-Evaluation of State-Based Support-for-Service Programs Targeted at Nurse Faculty

An evaluation of  State-level Support-for-Service (SFS) Programs Targeting Nurse Faculty. State-level SFS programs can: 1) offer scholarships for nursing master’s or doctoral degrees in exchange for a nursing teaching commitment and/or 2) offer loan repayment options. Findings  are based on data from 2 web-based surveys fielded in 7 states that have  SFS programs:  1) deans/directors of nursing programs and 2) SFS program participants. Read HERE for a summary of the research project, its objective, design and principal findings.

• Most deans & directors indicated they believe that SFS programs have had some impact in their state in increasing the educational qualifications of current and newly hired faculty, retaining faculty, improving teaching quality, increasing the pool of qualified applicants and increasing the #’s of students their programs could enroll.
• Sixty-four percent responded that the SFS program in their state helps to alleviate the nurse faculty shortage.
• Participant responses suggest that SFS programs have more influence on retention than on recruitment:  a sizable minority (14%) believe they would not be a nurse educator without the program; 70% believe that the program made it easier to become a nurse educator; more than half of participants (65%) indicated that the SFS program influenced their decision to remain in a nurse faculty position.

New York University—Using a Simulation Clinical Teaching Model to Increase Faculty Capacity in an Undergraduate Nursing Education Program

The study team evaluated the impact of substituting clinical simulation experiences for half of the traditional clinical days in the hospital (high dose) for the medical surgical rotation for all nursing students at New York University (NYU). The evaluation was conducted using The Johns Hopkins University School of Nursing (JHU) as a comparison program. At JHU, simulation is used as a supplement to, not as a substitute for, clinical hours in the hospital and the dose does not get above 25% in any course (low dose).

Faculty Capacity:

• The NYU clinical teaching model substantially expanded faculty capacity by increasing by up to 70% the ratio of students to “faculty days” allocated for both clinical and simulation teaching in a course.
• Between-school comparisons reveal a general pattern of higher ratings of quality of faculty work life and student self-ratings by NYU faculty and students than by JHU faculty and students.

Student Enrollment:

• Since implementation of the NYU model, student enrollment increased from 600 to 990 (2011).

Overall:

• Increasing the dose of simulation does not affect the quality of work life and student confidence and competence.

Related Publication: “Shifting the Clinical Teaching Paradigm in Undergraduate Nursing Education to Address the Nursing Faculty Shortage.”

Read an in-depth Spotlight piece on the New York University’s impact of clinical simulation evaluation HERE.

American Association of Colleges of Nursing—Identifying Barriers and Facilitators to Nurse Faculty Careers

The researchers conducted a study to identify barriers and facilitators to faculty careers among doctoral nursing students. Two major research questions were examined: 1) what are the factors that attract or discourage doctoral nursing students from pursuing nurse faculty careers; 2) what is the impact of doctoral education on the likelihood of choosing faculty careers for doctoral nursing students? Using descriptive and multivariate analyses of the survey data of PhD and DNP students, researchers found that:

• Students with post-graduation plans for academic careers were more likely to work in teaching or research before and after they entered their doctoral programs, to receive financial support from the Nurse Faculty Loan Program, to have faculty status during doctoral education, to participate in teaching development activities, to have a faculty member as a mentor, and to interact more frequently with their mentors. The most important facilitators influencing student’s decision to pursue academic careers were passion for nursing profession, and the level of interest in teaching and research.
• For students who planned to seek nonacademic careers, financial compensation in academic nursing, family financial responsibility, and negative perception of academic nursing were most influential in dissuading them from pursuing academic careers.
• The undecided students were influenced by both barriers and facilitators and could not decide on their career plans.

Recommendations:  The project team offered following recommendations for increasing the likelihood of choosing faculty careers for doctoral nursing students:

• Prepare nursing students for doctoral education and academic careers early at the baccalaureate and master’s levels.
• Select applicants for PhD programs who are more likely to seek academic careers
• Improve student experiences during doctoral education
• Build a longitudinal database of doctoral students nationwide to monitor their outcomes.

Related Publication:

• "Attrition of full-time faculty from schools of nursing with baccalaureate and graduate programs, 2010 to 2011."

Indiana University School of Nursing: Exploring the State of Doctoral Education: Implications for the Nursing Faculty Shortage

 Using mixed-methods design, the researchers conducted a study to describe the relationship between doctoral education and nurse’s perceptions of the faculty experience. Three major research questions were examined: 1) factors associated with nurse’s intent to seek a doctoral degree; 2) factors associated with doctoral (PhD/DNP) students’ and recent graduates’ decisions to seek a PhD versus a DNP; and 3) factors associated with current doctoral (PhD/DNP) students’ and recent graduates’ (since 2010) choices to seek or maintain a faculty role. Survey participants were invited from seven purposively selected states using cluster random sampling accomplished through dividing the US into six sections by longitude and latitude. A seventh state was added to represent the three states in the US that at the time of the data collection, did not have a PhD program. Findings from both survey and interviews were grouped into 4 major inter-related themes: 1) time; 2) money; 3) program/frustration; and 4) teaching/faculty role.

• Time was a critical factor when choosing a doctoral program. Time for degree completion was more important for DNP students and graduates than PhD.
• Money was an equally important consideration for nurses considering doctoral education for three reasons: 1) paying for their education, 2) (potential) return on investment, and 3) impact on their salary after graduation.
• Program characteristics: participants shared no preference for geographic location of the program, and traditional face-to-face programs versus online program. There also appeared to be a lack of clarity about the differences between the PhD and DNP degrees.
• Both DNP and PhD students and shared intent to become doctorally prepared nurse educators, but there was dissatisfaction with how their doctoral program was preparing or did prepare them for this role since they expected more emphasis on nursing education in their coursework. The current mentored teacher training model and the stress of learning to teach in that first postdoctoral year or two, took time away from developing other areas of the tripartite role leading to stress and role dissatisfaction

Recommendations:
The project team offered several changes to current doctoral education practices to prepare graduates to be successful in the faculty roles:

• Reconsider the current emphasis on making the time to PhD graduation shorter but leave this as a distinguishing characteristic between the PhD and DNP. No other discipline has a PhD trajectory less than five years since the emphasis of education at this level is deep thinking and knowledge acquisition.
• Continue to offer traditional in-class as well as online modalities with residential experiences to foster cohort and faculty relationships.
• Revise the curriculum for both PhD and DNP students to include coursework that prepares them for faculty positions: pedagogy, instruction and the expectations for the tripartite role. 

Villanova University College of Nursing—The Effect of Teaching Demands on Research Productivity of Doctoral Program Faculty

A mixed-methods evaluation to examine the research and scholarship productivity and work-life balance of doctorally-prepared nursing faculty, and the effect of demands on them to teach and mentor doctoral students on their programs of research and scholarship.

Qualitative Findings

• High demands of teaching and mentoring all levels of students, including doctoral students
• Importance of institutional structure and climate to research and scholarship
• Concern about sustainability of oneself, the institution, and the discipline

Quantitative Findings

Online survey of faculty members teaching in PhD and DNP programs Hours per week spent on research was strongest predictor of faculty research productivity. PhD program faculty were more likely to have previous research-related experience and to engage in grantsmanship and spend more time on scholarship than DNP program faculty. Organizational supports for scholarship were seen as less available by DNP faculty than PhD faculty. Work-life balance of respondents was reported as better than expected. Current faculty position was the best predictor for work-life balance.

Survey of deans and program directors Perceptions of deans/overall program directors and PhD program directors were significantly more positive about availability and effectiveness of administrative supports for faculty research and scholarship than DNP program directors. Organization, passion for work, and a positive attitude were identified by deans/overall program directors and doctoral program directors as the most important characteristics for faculty members’ success. DNP program directors differ in their responses about administrative supports available to faculty for their research and scholarship activities when compared to deans and PhD program directors.

Recommendations

• Educate PhD and DNP applicants and graduates about the differences in the programs and to prepare them to approach employment with knowledge needed
• Include curricular components in PhD and DNP programs to ensure that graduates are prepared for academic roles
• Offer coursework/ experiences to prepare students for academic positions as an optional track or certificate program;
• Develop job descriptions with specific requirements for PhD vs. DNP prepared nurses
• Develop and implement efforts to inform potential employers about PhD and DNP education and what can be expected of graduates in the workplace.

Related Publications:

• "Challenges to research productivity of doctoral program nursing faculty."
• "Nursing doctoral faculty perceptions of factors that affect their continued scholarship."
• "A profile of U.S. nursing faculty in research- and practice-focused doctoral education."

University of North Carolina at Chapel Hill School of Nursing: Hiring Practices and Intentions of Directors of Nursing Programs Related to DNP and PhD-prepared Faculty

The researchers surveyed deans, directors, and other program heads of Associate Degree, and Baccalaureate and higher degree programs to find out: 1) hiring preferences and practices;2)roles and responsibilities; and 3) perspective on preparation for faculty role.

ADN Programs Neither intentionally hiring nor looking to hire doctorally prepared nurse faculty Expect to hire, on average 1.7 doctorally prepared faculty next year Doctorally prepared faculty in ADN programs are not paid or deployed differently than master’s degree-prepared faculty Preference for PhD vs DNP-prepared faculty is 4:1

BSN+ Programs Expect to hire 3.1 (mean) doctorally prepared faculty next year, with PhD-prepared at 1.9/school and DNP-prepared 1.3/school Do differentiate aspects of the roles between DNP- and PhD-prepared faculty Preference for PhD vs DNP-prepared faculty is 2:1 The principal barrier to recruitment of doctorally prepared faculty is geographic location and non-competitive salaries BSN+ programs do not see the DNP-prepared and PhD-prepared faculty as interchangeable An increase in PhD hiring is expected to cover expansion and retirements

Recommendations

There is a large number of DNP-prepared nurses who have or will soon complete their programs, many of whom will seek teaching positions. However, fewer DNP-prepared faculty will be hired versus PhD-prepared faculty. The researchers recommend a multi-faceted approach for increasing the number of PhD-prepared faculty:

• Encourage delay in retirements of faculty projected to leave their positions in the next 5 – 10 years.
• A change in emphasis from opening additional DNP programs to enhancing the capacity of existing PhD programs by:
• Shortening the time for PhD completion
• Increasing financial support for PhD students throughout their education
• Guiding nurses interested in education positions into PhD programs rather than DNP programs.
• Encouraging promising scholars early in their nursing careers to consider nursing PhD programs.

Related Publication: "Hiring and incorporating doctor of nursing practice-prepared nurse faculty into academic nursing programs."

University of Wisconsin – Madison School of Nursing—Building a New Cadre of Nursing Faculty

The study team compared the early entrance to PhD education with two more conventional entry points, Mid-entry students and Delayed-entry students. Three areas of interest were examined: 1) career decision-making; 2) facilitators and challenges of PhD study, and 3) student admission and progression measures. The findings provide data to guide the development of new early-entry programs and revise existing programs.

Recommendations: While generalizability of the evaluation is limited by the use of a single site with small sample sizes, recommendations related to Early-Entry PhD program design were offered by the project team:

• Increase undergraduate students’ awareness, and expand the number, of Early-Entry PhD programs
• Provide early and continued financial support
• Consider offering a menu of clinical options to address concerns about clinical experience
• Provide sufficient teaching preparation for the faculty role

Related Publication: “Early Entry to a Doctoral Degree in Nursing Program: Analysis of Student Experiences.”