417CHAPTER 19

Research and Evidence-Based Practice in Nursing Education

Sarah B. Keating

OBJECTIVES

Upon completion of Chapter 19, the reader will be able to:

OVERVIEW

Nursing faculty have three major roles in academe: teaching, scholarship/research, and service. This chapter examines the roles of scholar and researcher as they apply to nursing faculty. A scholar reviews the current state of knowledge in the discipline and applies that knowledge to practice, while at the same time observing phenomena in practice (nursing and education) that need further investigation, searching for the truths that surround them, and bringing them to the attention of others for further study and research if indicated. Scholars share these observations with others through reflection, discussion, debate, and writing scholarly papers/articles that are based on evidence surrounding the topic. Their scholarly works should lead to research that generates new knowledge and builds the sciences of the profession and education.

Researchers likewise observe the environment, raise questions about phenomena and, by exploring the factors surrounding them, ask questions that merit further investigation. The research questions generate inquiries and/or hypotheses that result in proposals for investigation. They require in-depth literature reviews to identify concepts and theories that relate to 418the topic and help to shape the nature of the proposed research from a pilot study to in-depth studies that include qualitative, quantitative, and mixed-methodology approaches. Faculty members in research-focused programs are usually expected to engage in research, and although it usually holds higher value than scholarly activities, both are respected. Faculty members in multipurpose institutions are not held to as high expectations for research but scholarly activities and research are still part of their academic responsibilities. Research and scholarship competencies play into the responsibilities associated with faculty positions when tenure and promotion are under consideration. Nursing faculty seeking teaching positions need to investigate the institution’s policies on scholarship and research prior to accepting a position in order to be aware of the expectations of the institution.

Bridging scholarship and research is translational science that applies research and leads to evidence-based practice. It crosses all disciplines and hence leads to interdisciplinary collaboration and evidence-based practice based on the newest breakthroughs and research in science and, specifically for nursing, in health care, nursing, and education. It plays an increasingly important role in its contributions to nursing practice and specifically to the professional doctorate role (doctor of nursing practice [DNP]). Chapter 19 examines the role of nursing faculty in nursing education research and scholarly activities, reviews the literature related to nursing education and indications for further study, and lists possible topics for investigation that relate to curriculum development and evaluation.

FACULTY ROLE IN NURSING EDUCATION RESEARCH

Faculty Qualifications

Although the National Council for State Boards of Nursing (NCSBN, 2009) recommends that nursing faculty have at least a master’s degree to teach in nursing programs and preparation in pedagogy as well as the science of nursing, the faculty shortage in some states resulted in the necessity to hire clinically experienced baccalaureate-prepared nurses. To ameliorate this situation, administrators, faculty peers, and the individual faculty member have a responsibility to support baccalaureate-prepared faculty (and master’s-prepared faculty) to complete advanced degrees including the master’s and/or doctorate. At the same time, doctorally prepared faculty members are encouraged to further their postgraduate scholarly work by becoming certified as nurse educators, continuing their clinically focused research, and conducting research related to nursing education, that is, curriculum development, evaluation, and instructional design and strategies.

Importance to Personal Professional Development

Depending on faculty’s educational preparation and experience, it is expected that they engage in scholarship that relates to their expert knowledge and serves as content expertise for sharing with students in the teaching/learning process. 419In addition to content expertise, educators should have knowledge and skills in the art of teaching and learning, student assessment, and program development and evaluation. Each individual should conduct a personal assessment of these knowledge foundations and skills and identify those that need updating, strengthening, or assimilating.

Notwithstanding personal motivation, need, and responsibility for scholarship and research activities, support for these activities is also a responsibility of the academic administration and the institution. Released time, costs for attendance at professional meetings and conferences, and in some cases, tuition for advanced degree or specialty certifications are included as employment benefits. Many research-focused institutions expect faculty to generate studies that will fund not only research activities, but also the individual faculty position, which is bought out by replacing the faculty member’s teaching assignments with adjunct faculty for the duration of the funding. As Roberts and Glod (2013) point out, nursing faculty in research-focused institutions face the dilemma of meeting teaching responsibilities but at the same time, those in tenured or tenure-track positions are expected to produce scholarship and research to either retain or gain tenure. Their research activities take away from assigned clinical and theory teaching responsibilities, leaving those activities to adjunct faculty who have the clinical expertise and knowledge, but not necessarily the time for scholarship. This results in a two-tier faculty system that can affect the curriculum, student learning and program outcomes, and faculty morale.

Faculty in schools of nursing based in non-research-focused institutions has a responsibility for scholarship, evidence-based practice, and research as well. For those without the terminal degree required for the discipline or faculty position qualifications, enrolling in and completing the required degree is an expectation. It is hoped that the employer will support this activity through released or flexible time and, in some cases, tuition support. In addition, to maintain the curriculum’s currency and relevance, faculty must engage in scholarly activities that keep them updated and enriched in their content and pedagogical knowledge base and skills. Attending workshops and conferences in education and the clinical specialty should be an expectation, and the school should include support for faculty development to update educational skills. Research activities are not precluded in these institutions and have an important role for educators to advance their knowledge in nursing and education and to contribute to the science of the discipline. Since financial support and released time might not be as available as in research-focused institutions, collaborative research among faculty members, other disciplines, practice colleagues, and other schools of nursing offer scholarly opportunities for faculty.

Martin and Hodge (2011) describe their experience in developing a research model for faculty to meet the scholarship and research expectations in a non-research-focused institution. The authors list the expectations for faculty in their school and describe how a model for mentoring faculty research was implemented. Major components of the model included, among others, administrative support and a culture of support for scholarship and research, assigned time for research, goal setting and clear expectations, the mentorship and collaboration of other faculty, and external resources. Klemm (2012) described a research project that 420took place in an undergraduate research course. Throughout the semester, a faculty member acted as mentor for the students to study women’s adjustment to breast cancer. The qualitative research experience was successful with students learning about the research process as well as participating in a faculty member’s research through the collection and analysis of data.

An issue in nursing research when students conduct independent research, usually for thesis or dissertation purposes or when they assist faculty with the faculty’s research, is the authorship of scholarly works resulting from the research. Welfare and Sackett (2011) surveyed faculty and students at research-intensive institutions to study their beliefs about authorship of research findings when students assisted faculty or conducted independent research. Welfare and Sackett developed case scenarios that described student research activities from collecting data and analysis to collaborative or independent research. They found differences between students’ and faculty’s perceptions about authorship and the order of the list of authors. While the instrument they developed was checked for content validity, the authors point out that similar studies using the tool should be conducted for validity and reliability of the tool. However, their findings brought forth many recommendations including an understanding or contract between faculty and student prior to initiating the research. They refer to student and faculty responsibilities and eventual authorship as listed by several professional organizations, which have guidelines and principles of ethical conduct (American Psychological Association [APA], 2014; Association for the Study of Higher Education [ASHE], 2014). With the growth of doctoral programs and research in nursing, this becomes a pressing issue to address for the profession, educators, and students.

The Scholarship of Teaching and Application to Nursing

Conducting research or earning an advanced degree in one’s own clinical or functional area of nursing lends credence to the faculty member’s knowledge and skills in that specialty and contributes to the curriculum’s currency in nursing science and practice. At the same time, adding to the knowledge base of learning theories, pedagogy, student assessment, and program development and evaluation is equally as important. Boyer’s theory of scholarship in teaching (1990) comes to mind with its four components that promote faculty’s application of teaching activities to research and scholarship. The four components are the scholarship of discovery, integration, application, and teaching and are succinctly described by Boyer in his Scholarship Reconsidered document. The model provides a framework for faculty as they carry out their activities in teaching and search for scholarship and research opportunities. Such activities contribute to the disciplines of nursing and education, and research findings when disseminated and translated can lead to evidence-based practice in the art of curriculum development, evaluation, and teaching and learning.

Briefly, Boyer (1990) describes the scholarship of discovery as those activities that result in the generation of new knowledge from experiences and phenomena observed while developing and evaluating programs and during the interactions 421and delivery of teaching and learning between the educator and the student. The scholar studies the new knowledge discovered and tests it for its usefulness and application to practice. The scholarship of integration is the summation of activities and interactions that occur in the educational environment and cause the educator to observe and synthesize the information into new approaches and knowledge. It is closely related to discovery and Boyer makes the case for its application to interdisciplinary studies, an issue that nursing has long been affiliated with but not always successful in carrying out. The scholarship of application refers to the application of new knowledge to teaching activities to test it for validity and reliability. It is evidence-based practice and deserves to be tested, studied for its relevance, and perfected as it evolves. Translational science has a close relationship to this concept. Teaching as scholarship is a way of viewing the activity as a scholarly pursuit for sharing knowledge with the learner and discovering new knowledge and ways of applying it to the sciences of nursing and education.

Examples of the application of Boyer’s model to nursing education can be found in the American Association of Colleges of Nursing’s (AACN) Defining Scholarship for the Discipline of Nursing paper (AACN, 1999). The definition of nursing scholarship that helps to guide nursing educators’ research and scholarship is as follows:

Using Boyer’s (1990) and the AACN’s (1999) models for nursing research, scholarship, and translational science as they apply to curriculum development and evaluation, the following fictional examples are offered to illustrate opportunities for faculty research and scholarship. Discovery occurred when members of a curriculum committee analyzed accelerated bachelor of science in nursing (BSN) and basic BSN graduates’ and their employers’ ratings of clinical performance. The findings indicated that for the most part, employers’ and accelerated BSN ratings of performance were similar (P < .001), while basic BSN graduates rated their performance as lower than their employers’ ratings (P < .001). Based on these findings, several members of the committee agreed to investigate the findings by randomly selecting 10 representatives from each class and interviewing the graduates and their employers to identify what factors in their curricula, demographics, and academic records influenced these differences. Depending on the results, revisions of the curriculum or changes in instructional strategies would be recommended.

Integration opportunities occurred during a semester when medical, nurse practitioner, and pharmacy students worked together in a standardized patient-learning lab. The disciplines were brought together to practice in a case scenario of an elderly patient, recently widowed and presenting with multiple 422chronic disease diagnoses. Instructors from the three disciplines supervised their discipline-specific students. In the process, both students and instructors identified crossovers of knowledge and skills among the three types of professions. This effect brought about some confusion to the standardized patient, students, and faculty. Based on the situation, the faculty team decided to review the literature in the disciplines and in interprofessional science to identify other studies conducted, and to invite other faculty from other disciplines to review the case scenario and observe the interactions that occurred during the student practice sessions. Based on the findings, the faculty developed several models of interdisciplinary education and practice to test in a scenario. As numbers of participants grew as well as enthusiasm, the group decided to apply for a grant to support the project and the research related to it.

The scholarship of application took place in a doctor of nursing practice program when faculty and students studied the process of influencing health care policy as it applied to state legislation and regulations related to the definition and regulation of nursing practice. Both advanced practice and nursing administration students raised the issue of independent practice for nurses in their state in an analysis of health care policy course. Through an integrated review of the literature, analysis of other states’ legislative history on the issue, and meetings with legislators, other stakeholders, professional organization representatives, and possible adversaries, the students and faculty developed a plan of action to bring about change. The plan was carried out and proved to be successful in bringing about legislative and regulatory changes. Analyses of the literature and detailed records of their processes and actions were documented and resulted in authorship of articles in refereed professional journals as well as presentations for other nursing groups and organizations across the country.

Teaching scholarship was illustrated in an associate degree in nursing program when faculty members were in the process of curriculum revision. The school of nursing recently received a fully furnished simulation lab for clinical skills including several high-fidelity mannequins (an infant, child, and adult) as a gift from an anonymous benefactor. The gift meant that instructional strategies for acquiring clinical skills and their application to practice would change with the implication that the curriculum’s courses would need realignment. The curriculum committee members and the faculty teaching clinical skills met to review the needs for integrating the new lab into the plan of study. A task force was assigned to review the literature for curriculum development/revision models and instructional strategies for the use of simulation labs. Several instructional models were identified that would be tested and compared for the best fit to the school’s curriculum. A research proposal for comparing the models was developed and approved by the institution’s insitutional review board (IRB). The faculty involved in the change and those teaching in the skills lab reported on results from the study to the faculty as a whole. The curriculum plan of study was revised and plans were in place for formative and summative evaluations of the revision. The process for curriculum revision was described and the evaluation findings were summarized in an article published in a refereed professional journal. Although these are fictional scenarios, they provide ideas for research 423and scholarship activities that nursing faculty can generate and participate in to meet scholarship expectations of the faculty role.

Importance to the Profession

Nursing faculty scholarship, translational science, and research contributions to the profession are innumerable. Clinical specialty and functional areas (administration, quality assurance, risk management, epidemiology, etc.) translational science, and research lead to evidence-based practice in the health care setting. Collaborative research with nursing colleagues and other health disciplines in the health care setting fosters positive patient outcomes, quality/safe health care, and changes in health care policy. An example of interprofessional collaboration and research occurred at Columbia University. The social media interactions of PhD and DNP students and faculty during one semester were studied by Merrill, Yoon, Larson, Honig, and Reame (2013). Merrill et al. described the curriculum enhancements that were added during the study, which included required seminar meetings during the time of the study and the PhD and DNP students took two courses together (Ethics and Quantitative Statistics). The students’ and faculty’s utilization of social networks among themselves during the semester was collected. It was found that during the first week, most communications occurred among faculty but by the end of the study (10 weeks later), the number of interactions and their distribution among the groups increased. This was one of the first studies to use social networks as a source of information and also to analyze relationships between doctoral students and faculty.

Research in nursing education allows for the sharing of best practices in the delivery of nursing education and types of programs that produce graduates ready for practice in the health care system. Scholarship, translational science, and research findings contribute to the profession’s advocacy for higher education for nursing to meet the health care needs of the populace and to assume leadership roles in the health care delivery system. Research helps to identify the types of educational programs best suited to levels of responsibility in the health care system and the role of nursing.

CURRENT RESEARCH IN THE LITERATURE ON CURRICULUM DEVELOPMENT AND EVALUATION

Curriculum Development and Revision

Throughout the update of this textbook the author and contributors reviewed the literature for classic and current research and studies in curriculum development in nursing. Many of these studies focused on one program and can serve as pilots for further research to be generalized across types and levels of program and geographical areas. Table 19.1 lists some of the references reviewed in this text that relate to curriculum development. As one can see, additional research-based studies are needed that can inform faculty as they consider revising existing curricula or developing new programs.

424TABLE 19.1 STUDIES THAT APPLY TO CURRICULUM DEVELOPMENT

Table 19.2 summarizes studies that were found to be related to curriculum and program evaluation research and provides recommendation for further study. Few studies were found that applied directly to nursing education program evaluation, indicating the need for testing of evaluation models, especially in light of the emphasis on the measurement of program outcomes and student learning outcomes. Nursing may need to borrow from other disciplines to find and adapt evaluation models appropriate to nursing education and to compare models, theories, and concepts in evaluation as they apply to nursing.

TABLE 19.2 STUDIES THAT APPLY TO PROGRAM AND CURRICULUM EVALUATION

Stay updated, free articles. Join our Telegram channel

Join