The Future of Nursing Science
Thirty years ago, nurses drawn to scientific inquiry and problem-solving were just beginning to carve out a space in the academic terrain to call their own.
In the 1980s, PhD programs had difficulty gaining acceptance in universities across the country. Terry Lennie, PhD, MS, BSN, senior associate dean at the UK College of Nursing and former director of the College’s PhD Program, says the early nurse researchers were intent to demarcate the intellectual territory that defined their developing discipline to establish legitimacy.
He recalls administrative resistance to opening a nursing PhD program at the University of Wisconsin-Madison, his alma mater. In the 1980s, the administration rejected a proposal for a stand-alone nursing PhD program, as the school of nursing was required to partner with the psychology department. Consequently, students like Dr.
Lennie were required to complete a dual PhD in nursing and psychology to gain doctoral-level training. Other schools of nursing were denied the ability of open PhD programs and instead opened doctor of nursing science programs.
“It became clear over the next decades that nursing programs were preparing scientists,” says Dr. Lennie. “At that point, schools were allowed to open stand-alone PhD programs. Additionally, universities that required schools of nursing to open doctor of nursing science programs began to retroactively award nurses with DNP degrees a PhD degree.”
While other university administrations resisted the formation of stand-alone PhD degrees in nursing, leaders at the University of Kentucky College of Nursing were able to convince the administration to allow the College of Nursing to open a PhD program to train doctoral-prepared nurse researchers. Dean Emeritus Carolyn Williams, PhD, RN, FAAN, who served as College of Nursing dean from 1984 to 2006, spearheaded the establishment of the PhD program in the UK College of Nursing.
While other university administrations resisted the formation of stand-alone PhD degrees in nursing, leaders at the University of Kentucky College of Nursing were able to convince the administration to allow the College of Nursing to open a PhD program to train doctoral-prepared nurse researchers.
Thanks to Dr. Williams’ efforts, the UK Board of Trustees approved the program in 1985, and the school admitted its first PhD class in 1987. Last year, the UK College of Nursing doctoral program surpassed 30 years preparing more than 130 students for careers at top-ranked research institutions and health care organizations across the globe.
Now firmly integrated into the academic framework, today’s nurse scholars are less concerned with defining the scope of nursing research and more focused on making an impact on people’s lives through outcome-driven research. Dr. Lennie says nurse researchers address health problems and seek to improve nursing practice through evidence-based interventions and public policy.
“We’re focused on people, patients and populations, and that includes individuals, families and communities,” says Dr. Lennie. “Helping people live healthy is the bottom line, and that means physically, mentally and emotionally.”
Nurse scholars study a broad spectrum of health issues with a unifying goal of generating new knowledge to improve nursing practice and the treatment of patients inside and outside the health system. While some researchers study workplace efficiency and nursing practices, others disseminate interventions or test the effectiveness of new therapies.
After 30 years of training academic nurses, the College’s PhD faculty have garnered an international reputation for excellence in research, mentorship and service. In the last fiscal year, the College of Nursing was ranked 14th in research funding by the National Institutes of Health (NIH) among all public nursing schools.
Balancing Roles of an Academic Nurse
Doctoral-prepared nurses are committed to three pillars of academic life: teaching, research and service at the university and in their local communities. Balancing these roles, doctoral faculty in the UK College of Nursing conduct research on a broad spectrum of health issues.
For instance, Elizabeth Salt, PhD, MSN, BSN, associate professor, studies the potential to use cognitive therapy as an alternative to pharmaceutical reliance for low back pain, in addition to conducting nationally funded research examining patient-centered communication and pharmaceutical efficacy. Kristin Ashford, PhD, MSN, BSN, associate dean of undergraduate faculty and interprofessional education affairs, studies and implements interventions to curb tobacco use and improve pregnancy outcomes for women with substance use disorders. Misook Chung, PhD, MSN, BSN, professor, examines the dynamic relationships between chronic cardiovascular patients and their caregivers, focusing on effective interventions to improve the psychological and physical well-being of both parties. Merging research and public policy advocacy, Ellen Hahn, PhD, RN, FAAN, Marcia A. Dake Professor of Nursing, collaborates with the UK Markey Cancer Center to study lung cancer prevention and communicate the risks of radon exposure. Other researchers explore topics including the promotion of breastfeeding mothers, using social media to promote health screenings, nursing protocols in critical care units, occupational health risks of agricultural workers and dietary interventions to reduce cardiovascular disease in the Appalachian region.
Thomas Kelly, PhD, associate dean of research and PhD faculty affairs, oversees faculty scholarship and advises nursing faculty on the pursuit of competitive grants to support their research.
He says the strong emphasis on research at the University of Kentucky benefits doctoral students who are engaged in the research process, from forming research questions and project planning, to conference presentations and publication in academic journals.
“Here at the College of Nursing, our faculty are actively participating in research activities as well as training students,” says Dr. Kelly. “That [research] role is a critical role for the University of Kentucky and provides nursing students with broader experiences.”
Known as collaborators in clinical settings, nurse scholars are equally adept at forging relationships and coordinating projects alongside scholars from other disciplines and departments. Dr. Kelly says opportunitiesfor interdisciplinary research abound at UK, with faculty members in the College of Nursing crossing disciplinary divides and joining projects with researchers outside their field of expertise. College faculty members collaborate with researchers from several colleges, including Pharmacy, Medicine, Dentistry, Public Health, Communication and Engineering, and the Department of Psychology.
Another sign of the program’s success is the research faculty’s reputation for acquiring competitive extramural funding from organizations, including the National Institutes of Health and the Patient-Centered Outcomes Research Institute (PCORI). Dr. Kelly provides assistance and mentorship to faculty members seeking extramural research funding. Currently, the research faculty serve as principal investigators on $20 million dollars in total grant funding.
“Faculty in the regular title series are encouraged to develop independent programs of research supported in part through grants and contracts,” says Dr. Kelly. “College faculty with regular title series appointments are highly successful in their efforts, with annual research expenditures per faculty member [$285,000] that are comparable to the most successful colleges at the university.”
Nurse scholars also emphasize teaching and service as integral components of academic life. Nurse scholars dedicate a portion of their time to mentoring graduate-level students and some undergraduate students interested in research. In addition, they seek to deliver excellent academic curricula designed to prepare the next generation of nurses for successful careers in practice. According to Dr. Kelly, researchers will adapt their service and teaching roles depending on their research obligations and funding.
Finally, nurse scholars are involved in academic service, which includes leadership roles at the institution level and with national nursing associations, including the American Academy of Nursing and the American Academy of Nurse Practitioners. Many UK nurse scholars serve as fellows of these two organizations, as well as other stakeholder groups, including the American Heart Association. Others serve as editors and reviewers for academic health journals. Nurse scholars are also keenly aware of the health needs and disparities in their communities. For instance, research faculty members saw a need to volunteer as tutors at William Wells Brown Elementary, a local school at the bottom of the academic achievement rankings.
Training Future Generations
Given the breadth of expertise available within the doctoral faculty, students in the program partner with faculty mentors who help them develop an individualized research program that mirrors their interests and career goals. Debra Moser, DNSc, RN, FAAN, professor, assistant dean of the PhD program and Scholarly Affairs and Linda C. Gill Endowed Chair of Nursing, says students enter the program with an idea of what they’d like to study and build upon that idea as they matriculate through the program. Doctoral students take two years of course work then typically study for an additional one to two years drafting and refining a dissertation proposal and completing the dissertation project. By the time they defend their dissertation in their third or fourth year, the students have usually published in academic journals and gained a wealth of research experience working alongside faculty members. Each year, six to 10 new students are admitted and three to five students defend dissertations.
While students learn how to conduct an independent research project from start to finish and write up their findings, they also learn how to succeed in an academic or industry career. Dr. Moser says the students receive training on how to define their research agenda, apply for academic jobs and interview for positions. They are encouraged to participate in conferences, network with fellow nurse scholars and collaborate across disciplines.
“We teach them all aspects of the research process—how to see and think as a scientist, how to write papers scientifically and how to conduct rigorous research that is then disseminated through publishing and presenting,” says Dr. Moser. “Essentially, we prepare them to assume the role of an independent research scientist.”
They also learn how to be stewards of the profession and effective teachers of the next generation of nurse practitioners or researchers. Dr. Moser invites her mentees to shadow her classes and encourages doctoral students to mentor junior graduate students. She also says opportunities to collaborate and assist with research projects gives UK doctoral student an edge when going on the job market. Several doctoral students have accepted positions at research-one universities, including Indiana University, the University of North Carolina at Chapel Hill and Vanderbilt University, as well as at international universities.
“Our students always come back and are delighted with the process and their preparation,” Dr. Moser says. “They go on to secure amazing jobs at top-tier universities.”
On Feb. 8, administrative leaders, faculty members, alumni and current doctoral students celebrated the program’s productivity and reputation preparing prolific nurse scholars for 30 years. Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, dean and Warwick Professor of Nursing, commends the efforts of her predecessors, including Dean Marion McKenna, who originally conceptualized the program, and Dr. Williams, who followed through on McKenna’s vision.
“Their leadership and vision has made our success possible,” says Dr. Heath. “They set us on a path that will continue to allow future generations of doctoral students the ability to impact the health and well-being of patient populations and communities around the world.”
Dr. Moser says the success of the program also continues because of the faculty’s dedication to their work and maintaining high standards for their research. Faculty members compete at the highest level for funding, and the awards obtained demonstrate the excellence of the collective department.
“The faculty here really excel in their areas of expertise,” says Dr. Moser. “They all have well-funded programs of research, and they have been successful getting funding from NIH, the Centers for Medicare and Medicaid and PCORI. They can compete successfully at the highest levels.”
Dr. Kelly echoes this view, noting that the doctoral program’s emphasis on science mirrors the research objectives of the institution. Nurse scientists are contributing to a collective effort across the campus to elevate the University of Kentucky’s status as a leading research institution.
He also mentions the College’s newest commitment to advance scholarly research—its new Office of Nursing Research and Scholarship, located on the fifth floor. The office, built in 2017, houses several research powerhouses at the College, including the Perinatal Research and Wellness Center and Occupational and Rural Health Research. In celebration of the newly renovated space, the College held an open house in February to mark a significant, historical milestone in its history.
“The space is a testament to our nurse leaders and their continued commitment to the PhD program since it was first initiated,” says Dr. Kelly. “UK is a tier-one institution, and contributions to knowledge are a critical responsibility of all faculty, and so the commitments to growing that academic research within faculty in the College of Nursing are consistent with the overall mission of the university.”
