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The impact of the Nurse Faculty Scholars program on schools of nursing
Abstract
Background
The Robert Wood Johnson Foundation Nurse Faculty Scholars program was conceptualized as not only promoting the growth and development of early-career faculty but as enhancing the research infrastructure of scholars’ schools of nursing.
Purpose
At the completion of the scholars’ three years of support, deans/directors were asked to provide feedback regarding the institutional impact of the scholars’ participation in the program.
Methods
Phone interviews were conducted on the first five completed cohorts and a six-item questionnaire was developed to obtain some quantitative data. Discussion: The program was viewed as having accelerated the scholars’ leadership and scholarship, and their influence within the school/university and regionally/nationally. Deans/directors generally agreed that the scholars’ experience helped build the school’s research portfolio.
Conclusion
Looking back on how the participating schools of nursing fared, one can say that the program’s institutional expectations were achieved most of the time. The program helped scholars build their own reputations and that in turn had consequences for the school’s standing as a whole. A number of components are described that can be replicated singly or in various combinations by schools/universities interested in adopting aspects of this program.
The Impact of the Robert Wood Johnson Foundation’s Nurse Faculty Scholars Program on Deans’ Perceptions
When the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars (NFS) program was conceptualized, it was intended to promote the growth and development of junior faculty and enhance the research infrastructure of scholars’ schools of nursing, especially those schools that were less research intensive. The shortage of nursing faculty was the driving force behind the development of the NFS program. It was important that an initiative be developed to address the faculty shortage because it was predicted that there would not be enough faculty available to teach in PhD programs in future years (Dreher, Smith Glasgow, & Cornelius, 2012). The number of research-focused doctoral programs increased 65% between 2001 (n = 86) and 2010 (n = 133), intensifying the demand for research-savvy faculty (Kim, Park, Park, Khan, & Ketefian, 2014). The nursing faculty shortage was exacerbated by growth in practice-focused doctoral education that dramatically outpaced research-focused education (Smeltzer et al., 2015), thus further affecting the number of faculty prepared to mentor fledgling researchers. In 2014, there were only 3,065 students enrolled in 134 PhD programs in comparison with 18,352 students enrolled in 264 DNP programs (AACN, 2015; Broome and Corazzini 2016).
Research career development is important to the development of nursing academia, nursing knowledge, and the discipline (Happell & Cleary, 2014). In addition to contributing to the overall productivity of individual scholars, it was anticipated that the program would positively affect other aspects of the institutional development of each school of nursing (SON), so that the scholar and the school’s scholarship would become better known in the wider university, in part through the scholar’s mentorship by a research mentor outside of the SON. Scholarly productivity is a function of both individual characteristics, such as a passion for research; intrinsic motivation; solid research training; and environmental factors, such as institutional supports; and the number of senior professors who can serve as role models and mentors (Bevil, Cohen, Sherlock, Yoon, & Yucha, 2012; Bland, Center, Finstad, Risbey, & Staples, 2005; Dundar & Lewis, 1998).
In addition to the faculty shortage, the expectation for scholarship at schools of nursing was considered when developing the NFS program. Schools of nursing at research universities are expected to have faculty who can sustain a high level of scholarly productivity, including research funding, in order to be seen as academic equals (Kulage et al., 2013; Pierce, Cook, & Larson, 2004), but faculty at comprehensive universities are also increasingly expected to demonstrate scholarly productivity (Ahmad & Prelock, 2012; Travis & Anthony, 2011). These heightened expectations for scholarship can be seen in the range of institutions—more research intensive and less research intensive—that have been home to American Nurses Foundation scholars in recent years (Messmer, Zalon, & Phillips, 2014) and that have joined the National Hartford Center of Gerontological Nursing Excellence (Harden & Watman, 2015). Even when the primary institutional focus is on the scholarship of teaching and learning, faculty are still expected to have a programmatic focus, be knowledgeable about and able to use appropriate research methods, and obtain research funding (Broome, Ironside, & McNelis, 2012; Glassick, Huber, & Maeroff, 1997). Having a strong foundation in research methodology is becoming ever more important as nurses achieve leadership positions in academic and health care systems that have changed to maximize patient-centered outcomes and efficient care (Toles & Anderson, 2011).
NFS Program Expectations
The NFS program was developed with both short- and long-term expectations for scholars and their schools of nursing. A full description of the program with scholar outcomes is in the first article in this issue; a subsequent article also describes the leadership training in detail. In the short term, the expectation was that scholars would receive leadership training that exposed them to current issues in general academic higher education and nursing, and this exposure would lead them to knowledgeably discuss such matters and engage others in their schools to address key trends in health care, nursing education, and academia. Long-term expectations for scholars as they completed the program included development of a cogent program of research that included productive dissemination of their research findings, obtaining additional funding, and qualifying for various prestigious honors and recognitions, thus building personal and school reputations. In addition, scholars were also mentored to provide additions to the scholarly literature on nursing and interdisciplinary education (IOM, 2003), collaborations with communities, addressing the goals of the 2010 IOM report on The future of nursing, and its subsequent assessment (National Academies of Sciences, Engineering, and Medicine, 2016); and the importance of creating continuously learning systems (IOM, 2013). Therefore, the longitudinal expectation for schools was that each participating school would become of greater value to the academic health center or university in which it is embedded.
Schools in the NFS Program
Although an individual applied to the program, formal institutional support was required as part of the application process. Schools were required to submit letters of support from the university’s chief academic officer (e.g., provost) and the nursing dean/director that specified what support would be made available and confirmed how the scholar’s work assignment would include protected time (60%) for research. In addition, the potential scholars submitted letters of support from persons who would serve as primary mentors (a senior leader in the SON, not necessarily with expertise in the scholar’s field) and research mentors (from outside the SON but in the university)—expecting that the mentors’ time investment in the scholar was institutionally donated. Primary mentors were expected to attend the orientation and three annual meetings. Although travel costs were borne by the scholar’s grant award, this commitment in time was substantial. Because it was envisioned that both mentors would facilitate networking at the university level, the expectation was that their joint birthing of someone who could achieve tenure and promotion would leave the scholar with important university allies in future undertakings and increase collaboration both within the university and between the SON and the research mentor’s division or school.
There were 66 scholars in the first 5 completed cohorts, and they were based at 46 different universities (schools could have up to 2 scholars in any 3-year period).
Table 1 lists the 27 states represented and the names of the involved schools of nursing. Less than half of the schools of nursing (n = 22) were judged to be research intensive, meaning that they had $1.5 million or more in National Institutes of Health (NIH) funding when their scholars were selected, and 52% had not achieved that level of funding.
Table 1
Participating Schools (Cohorts 2008–2012)
| State | University |
|---|---|
| Arizona | University of Arizona (2) |
| California | University of California—Los Angeles (3) |
| University of California—Davis | |
| University of California—Irvine | |
| University of California—San Francisco | |
| San Diego State University | |
| Colorado | University of Colorado—Denver |
| Connecticut | Yale University |
| Florida | University of South Florida |
| University of Miami | |
| Georgia | Emory University |
| Medical College of Georgia | |
| Illinois | University of Illinois at Chicago |
| Rush University | |
| Indiana | Indiana University |
| Iowa | University of Iowa |
| Maryland | Johns Hopkins University (3) |
| University of Maryland—Baltimore | |
| Massachusetts | MGH Institute of Health Professionals |
| Michigan | Calvin College |
| University of Michigan (3) | |
| Wayne State University (2) | |
| Missouri | Saint Louis University |
| University of Missouri | |
| Montana | Montana State University (2) |
| New Jersey | Rutgers University |
| New Mexico | University of New Mexico |
| New York | Columbia University (2) |
| New York University | |
| University of Rochester (2) | |
| North Carolina | Duke University |
| East Carolina University | |
| University of North Carolina—Chapel Hill (3) | |
| University of North Carolina—Charlotte | |
| North Dakota | University of North Dakota |
| Ohio | Ohio State University (2) |
| University of Cincinnati (2) | |
| Pennsylvania | Duquesne University |
| Jefferson University | |
| University of Pennsylvania (2) | |
| Tennessee | Vanderbilt University |
| Utah | University of Utah |
| Virginia | University of Virginia (2) |
| Washington | University of Washington (3) |
| West Virginia | West Virginia University (2) |
| Wisconsin | University of Wisconsin—Milwaukee |
The numbers in parentheses indicate schools that had more than one scholar during this time period.
Methods
At the conclusion of the scholars’ 3 years in the program, feedback was sought from deans/directors to obtain their estimate of the NFS program’s institutional impact. If the dean had not been witness to the individual’s growth over all 3 years, then the administrator with that perspective or the individual’s current dean was interviewed. When the first cohort (2008) completed the program, open-ended phone interviews were conducted by members of the National Advisory Committee (NAC) who immediately wrote down answers to the following questions: How did the scholar change over the 3 years? Has the scholar’s participation affected the school in some ways? Has the scholar’s involvement influenced in any way how the school has addressed the issues of the day? Has the scholar’s participation in the NFS program affected the school’s engagement on campus and with the rest of the university? What changes would you recommend in the program?
These open-ended questions remained the same for subsequent cohorts and shaped the qualitative findings. However, a quantitative instrument was also developed and used at the completion of the program by the second cohort (2009) and subsequent ones. The quantitative instrument was based on the key themes expressed in the first series of interviews. The key themes were determined after the answers to the open-ended questions were examined by the National Program Director, the Deputy Director, and the NAC Chair. See Appendix A for the six items constituting the quantitative instrument. Both the open-ended interview schedule and subsequent quantitative instrument were reviewed and approved by the Institutional Review Board of Johns Hopkins University.
Results
Qualitative Findings
Box 1 lists the six key themes that emerged from the interviews and illustrates those thoughts with quotes from open-ended interviews conducted with deans associated with the first five completed cohorts (2008 through 2012). Overall, the deans provided more examples of how the program changed the scholar and that individual’s influence within the school and/or university than the other areas. The program was generally viewed as having accelerated the scholar’s leadership and scholarship, and in the process, the scholar’s achievements positively shaped the behavior of other junior faculty. Not every dean, however, was enthusiastic about the program. A few thought their scholars now had a misguided (inflated) sense of their own importance in relationship to the work of the school. This tended to be the case in the early cohorts. The program responded to this feedback by developing additional programming that underscored the significance of service leadership to the school and university, including the importance of building the research infrastructure of the school along with one’s own program of research and not developing a distorted sense of one’s own importance or concentrating exclusively on personal development.
Deans who had originally recommended and provided resources to a scholar—who was then recruited to a position elsewhere—were disappointed when their investment didn’t reap the desired benefits. However, only 5 of the 66 scholars (7.5%) in the first 5 cohorts changed universities by the end of their 3 years in the program. One dean strongly believed the program should be earmarked for the tenured associate professor level, not the tenure probationary level, because the program’s overall emphasis on leadership and the tripartite faculty mission—teaching, research, service/practice—scattered the scholar’s focus at a time when it should be primarily on establishing a program of research.
Yet there were schools that were arguably transformed as a result of the program. Box 2 describes how the University of New Mexico College of Nursing and the larger university were affected by the participation of their scholar in the program. The case study was written by that school’s dean and the RWJF NFS.
Quantitative Findings
Table 2 describes the quantitative perceptions of deans with scholars in Classes 2009 through 2012. The overwhelming majority of participating deans in these completed cohorts (30 of 34) who filled out the quantitative items either agreed or strongly agreed that the program had widened their scholars’ influence regionally and/or nationally and had led them to exert greater leadership within their school and/or university. Strong agreement (85%) was also noted for the program broadening scholars’ understanding of the faculty role. They were less likely (68%) to credit the program with influencing the extent to which the school addressed the issues of the day, largely because the deans saw many factors influencing how the school implemented the recommendations of the 2010 IOM report on The future of nursing and similar matters. It is important to note, however, that more deans (47 out of a possible 51) in cohorts 2009–2012 participated in the phone interviews, which were formally set up by the national office, and only 72% of these interviewees went on to fill out the quantitative instrument via Survey Monkey. Thus, their quantitative ratings may be less informative than their responses to the open-ended questions.
Table 2
Percentage of Deans Agreeing With Statements
| Class of 2009 | 2010 | 2011 | 2012 | Average | |
|---|---|---|---|---|---|
| Broadened understanding of faculty role | 90% | 66% | 90% | 87% | 85% |
| Widened influence at school/university | 90% | 66% | 90% | 100% | 82% |
| Widened influence regionally/nationally | 100% | 66% | 80% | 100% | 88% |
| Influenced school on issues of day | 80% | 33% | 70% | 75% | 68% |
| Greater leadership school/university | 90% | 66% | 90% | 100% | 88% |
| Scholar an ambassador for school | 70% | 66% | 90% | 100% | 82% |
Boldfaced numbers are the average across cohorts.
Note: Quantitative data are available for 34 deans (72%) out of 47 who participated in the qualitative interviews; 4 deans did not participate in either quantitative or qualitative evaluations.
Lessons Learned
The overwhelming majority of deans were enthusiastic about the program, and their feedback, in turn, shaped improvements in the program. Early complaints that some scholars had a misguided sense of their own importance led to a redoubling of programming aimed at describing the pitfalls of “diva” behavior and helping the scholars reflect on how they might be of service to colleagues in their home institution who did not have the benefits they enjoyed for the good of the whole. If an NFS or an alumnus of the program was contemplating a move, that individual received some individual guidance from the Program Director on how to consider such a move very carefully and how to conduct interviews elsewhere and leave an institution gracefully without burning bridges.
The assumptions made in planning were that there was institutional commitment to the scholar’s success and the primary mentor would be responsible for ensuring that the scholar met institutional expectations for progress, but in about three cases, the primary mentor was as surprised as anyone when the scholar did not successfully achieve tenure/promotion. A few primary mentors were emeritus faculty or close to retirement, and they may not have been as up to date in understanding changing expectations, especially if there was a new dean. The program added content to the orientation and extra meetings with primary mentors at the national meeting each year to reinforce the role for them. Over time, the program took an increasingly active role in orienting all three kinds of mentors to their roles, and there were a few instances when the research mentor seemed to have exerted even more influence in shaping the scholar’s progress than the primary mentor.
Although deans signed a letter of commitment when application was made to the program, they varied in how much they knew about the program. The deans were not seen as in need of such an orientation, but in hindsight, it would have been wise to see the deans as another stakeholder whose insights mattered in terms of individual scholars over the course of the program because institutional commitment to the scholar’s success cannot be assumed particularly when the leadership of the school changes hands. It is not that new deans do not want to be helpful, but they are more likely to be supportive if they feel connected to the program, and primary mentors varied tremendously in whether and how they oriented new deans to the program and kept them apprised of the NFS progress.
Given the aforementioned caveats, the program demonstrated that it successfully developed individuals who subsequently played a role in the development of their schools, including their school’s reputation within the university or academic health center. The alumni of this program developed programs of research with demonstrable outcomes—additional grants, refereed presentations/publications, and honors (see first article in this special issue for such evidence)—making them faculty prepared to teach and mentor in the nation’s expanding number of doctoral programs. For example, participation in the NFS program supported the scholars at West Virginia University who went on to develop reputations as competitive researchers within the West Virginia Clinical and Translational Science Institute. By the end of her 3 years in the NFS program, one of them was appointed as the Associate Director of Clinical Translational Research for the Stroke Center where she collaborated on a COBRE grant of $10.7 million to build an infrastructure for clinical translational stroke research, making her the first nursing faculty member to be included in center funding at West Virginia University.
What are the take-away lessons learned in this program for supporting tenure-probationary junior faculty? There were a number of components that constituted the NFS program that can be replicated singly or in various combinations by schools/universities without adopting every aspect of this program:
- Provide agreed-on dedicated time for scholars to develop their programs of research including support for attendance at NIH and other governmental summer institutes or training programs on randomized controlled trials, genomics, various initiatives, grant writing, and the like.
- Furnish resources to develop interventions, assess outcomes measures, test research protocols, and obtain foundational research data.
- Connect scholars to different kinds of mentors—a seasoned nursing faculty member and someone in a related field concerned about similar matters—because there is a greater likelihood of the mentoring bearing fruit if scholars are exposed to several advisors/supporters from different perspectives.
- Consider providing a national nursing mentor who is a recognized expert in the scholar’s area of research as this RWJF program did; such an external mentor may be particularly helpful to the scholar if the school is not research intensive and has few senior faculty (Mundt, 2001).
- Offer opportunities for a cohort of junior faculty to meet regularly and talk about their concerns because such interactions encourage networking and social support, normalize the inevitable problems facing every new hire, and raise expectations for one and all. If these cohorts can be across schools, such as through the regional nursing research societies (Eastern Nursing Research Society, Midwest Nursing Research Society, Southern Nursing Research Society, and Western Institute of Nursing) or the Council for the Advancement of Nursing Science, this would be ideal and better mirror the RWJF NFS experience.
- Make available leadership training over time that can help junior faculty understand what it means to be an academic at this point in history and increase innovative engagement in the tripartite mission—knowledge development and dissemination, creative teaching, organizational and professional leadership.
- Encourage nursing participation in the four new interdisciplinary RWJF leadership programs (http://www.rwjf.org/en/library/articles-and-news/2015/11/major-new-leadership-initiatives.html).
Looking back on how the schools of nursing participating in the first five cohorts fared, one can say that the program’s institutional expectations were achieved most of the time. The program helped scholars build their own reputations and that in turn had consequences for the school’s standing as a whole. The RWJF NFS program thus benefitted schools of nursing and the discipline of nursing beyond the accomplishments and leadership training of the individual scholars because it offered an enormous opportunity for each participating academic enterprise to learn from the program and work to develop additional programs to provide these kinds of outcomes. The growth and development of individual scholars and schools also set in motion the potential for collaborative research, practice, and teaching that has already been realized and will continue to develop over the years. For example, one member of the Class of 2012 partnered with someone in the Class of 2013 to get funding for a grant concerned with training nursing students to address workplace violence and bullying. Because multisite clinical trials are increasing in importance in nursing research, scholars profit all the more from getting to know their peers across the country (Mulready-Shick, Flanagan, Banister, Mylott, & Curtin, 2013; Whittemore et al., 2012).
Appendix A. Perceptions of Deans Questionnaire
Since NFS are nominated by their deans/directors, it is important that any evaluation from the dean/director of the program includes her/his estimation about whether completing the NFS program made a perceptible difference. Please rate each of the following statements, bearing in mind the performance of your scholar.
- I believe that being in the NFS Program broadened the scholar’s understanding of the faculty role
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
- I believe that being in the NFS Program widened the scholar’s influence at school/university
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
- I believe that being in the NFS Program widened the scholar’s professional influence locally, regionally, and or nationally
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
- I believe that being in the NFS Program influenced how our school tackled the recommendations of the IOM report on The future of nursing and/or other issues of the day
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
- I believe that being in the NFS Program caused the scholar to assume greater leadership within the school/university
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
- I believe that being in the NFS Program caused the scholar to see her/himself as more of “an ambassador for the school”
- ○Disagree strongly
- ○Disagree somewhat
- ○Can’t say
- ○Agree somewhat
- ○Agree strongly
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