BRIEF REPORT
Nurse practitioner faculty research: Results from the 2012 National Organization of Nurse Practitioner Faculties Survey Susan Weber Buchholz, PhD, ANP-BC, FAANP (Professor)1 , Joan Rosen Bloch, PhD, CRNP (Associate Professor)2 , David Westrin, MSN, AGNP-BC (Nurse Practitioner)3 , & Louis Fogg, PhD (Associate Professor)1 1
Rush University College of Nursing, Chicago, Illinois Doctoral Nursing Department, College of Nursing and Health Professions, School of Public Health, Drexel University, Philadelphia, Pennsylvania 3 Good Samaritan Medical Center, Brockton, Massachusetts 2
Keywords Research; nurse practitioners; education; Nursing Scholarship; Doctoral faculty; faculty practice. Correspondence Susan Weber Buchholz, PhD, ANP-BC, FAANP, Rush University College of Nursing, 600 S. Paulina Street, AAC 1030D, Chicago, IL 60612. Tel: 312-563-3590; Fax: 312-942-3043; E-mail: [email protected] Received: 29 October 2014; accepted: 8 February 2015 doi: 10.1002/2327-6924.12250
Abstract Purpose: To better understand the research capacity and productivity of nurse practitioner (NP) faculty, a study was conducted to describe the types of research that have been and are being completed by National Organization of Nurse Practitioner Faculties (NONPF) members. Data sources: A web-based survey was developed with input from members of the NONPF Research Special Interest Group and the NONPF Board. This 23-question survey included demographic, academic degree, NP population focus, and research-related questions. Three e-mails were sent to NONPF members over a 10-week period of time (late December 2012 to early February 2013). Conclusions: Respondents (N = 344) in the sample were Advanced Practice Registered Nurses with either a Masters, Doctor of Nursing Practice, DNS or PhD as their highest academic degree. Study results demonstrated that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. Implications for practice: Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research.
Introduction The evolution and institutionalization of the nurse practitioner (NP) role during the 20th century transformed nursing practice and education leading to increasing numbers of NPs assuming faculty positions (Ford, 2010). This movement to academia has provided numerous opportunities and incentives for NP faculty to engage in research (Hughes, Clarke, Sampson, Fairman, & SullivanMarx, 2010). Enhancing funding sources available to NP faculty was the 1993 creation of the National Institute of Nursing Research (NINR, 2010). These two historical events contributed to the transformation of nursing into a field that emphasizes both advanced clinical practice and rigorous scholarship. NP faculty are well positioned in academic settings to integrate research careers with current practice as they fulfill the tripartite faculty mission of teaching, scholarship, and service. The NINR’s current priorities for health
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promotion and symptom management research (NINR, 2013) are well suited for advancing the knowledge needed for NP practice. This is particularly applicable among the poorest urban and rural populations in the nation, often served by Nurse-Managed Centers (King, Hansen-Turton, & Hughes, 2010). In addition, the growing emphasis on translational research facilitates addressing practice-based research questions often encountered in NP practices (Broome, 2013; Hughes et al., 2010). Healthcare research is the cornerstone of evidencebased healthcare practices used worldwide. As a discipline, nursing has produced and continues to produce research at the highest level (NINR, 2013). NPs are in a unique position to conduct research because of their close proximity to academic institutions, patient care, and their vast experiences with multiple populations, health-related conditions, and research methodologies (Goolsby, 2011; Kleinpell & Goolsby, 2012).
Journal of the American Association of Nurse Practitioners 27 (2015) 664–670 C 2015 American Association of Nurse Practitioners
Nurse practitioner faculty research
S. W. Buchholz et al.
Recognizing and promoting original and translational research of National Organization of Nurse Practitioner Faculties (NONPF) members is in direct alignment with the NONPF organizational goal of promoting scholarship and enhancing NP faculty scholarship (NONPF, 2012). Research provides the pathway for discovery of knowledge that is ultimately applied to real-life healthcare and community settings. Increasing numbers of NPs are obtaining doctoral degrees and the work of these NPs adds to the body of nursing research as well as to the critical translation and dissemination of research to the point-ofcare. Therefore to better understand the research capacity, funding, and productivity of NP faculty, this study was proposed to describe the types of research that have been and are being completed by NONPF members.
Methods Design This descriptive study utilized a web-based survey to reach NONPF members. NONPF is the only organization specifically devoted to promoting quality NP education at the national and international levels (NONPF, 2014). Since its beginning in 1974, NONPF has evolved as the leading organization for NP faculty, achieving broad recognition for its leadership role in developing and maintaining NP educational resources and providing valuable resources for supporting the promotion and tenure of NP faculty.
Sample This was a convenience sample of NONPF members, recognizing that all NP faculty are not necessarily NONPF members. Inclusion criteria were: (a) faculty on NONPF’s master list of members during the period when the survey was electronically delivered, and (b) having an e-mail address. Three e-mails were sent to NONPF members (1575 potential subjects) over a 10-week period of time (late December 2012 to early February 2013). Of the 1575 e-mails that were sent out, 344 (22%, 344/1575) members participated in the survey.
Measure The 2012 NONPF Research SIG Survey was initially developed by input from Research Special Interest Group (SIG) members and by members of the NONPF Board. Members of the Research SIG are NONPF members with an interest and experience in research. The survey was then reviewed for face validity by seven NONPF members from across the nation, and recommended changes were made to the survey prior to dissemination. This 23-question (openand close-ended) survey included demographic (gender,
age group), academic (degree, NP population focus), and research-related questions. For this study, research was defined as the discovery of knowledge that is or can be applied to real-life healthcare settings. This broad definition was chosen to include both basic and applied clinical and/or population-based research as much as possible. Respondents were asked if they had conducted research within the last 10 years. If they had, they were asked if they had participated in qualitative, quantitative, clinical outcome, or other types of research (respondents were allowed to check all types of research that applied). We inquired if projects had been funded, and if so, by which sources, and total dollar amounts received. We also asked if research findings had been published and if so in which type of journals. Respondents were asked about their current research areas. They were also asked to list research conducted within the last 10 years, identifying their role and the project name (for up to six projects). Questions were additionally asked about conducting regional or national grant reviews and participating on Research Advisory Boards. A separate section, where respondents were asked to identify themselves by providing their name and e-mail if they so desired, addressed two questions. The first question asked respondents if they had experience conducting educational research, and if so, would they be willing to potentially assist NONPF with conducting such research. The second question asked respondents if they have had national funding and if so, would they be willing to provide one to three individual brief research consultations at an NONPF annual meeting. These questions were solely for the purpose of providing information for future development work related to faculty research at NONPF and are not reported in this article. Completion of this section did not compromise respondents’ anonymity.
Procedures This research project was approved by the NONPF Board and Institutional Review Board approval was received from Rush University. The survey was produced/uploaded into Survey Monkey. Three e-mails were sent to NONPF members over a 10-week period explaining the nature of the survey and providing a link to the survey instrument. It was estimated that the survey would take 15 min or less to complete, depending on the research involvement of the respondent. All e-mails were sent by NONPF administrative staff.
Analysis Data management, analysis, and interpretation of the data were conducted by two NP faculty researchers who 665
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have led multiple studies evolving from their practice as NPs. They were assisted in this process by a statistician and a graduate NP student. Data were exported from Survey Monkey directly into SPSS version 19.0. Extensive exploratory descriptive analyses were conducted to explore the distribution of the data for each variable and relationships between variables. This process included calculating measures of central tendency; means were calculated for continuous variables and frequency distributions for categorical variables. Relationships among the variables were assessed by constructing correlation matrices for continuous variables and contingency tables for categorical variables.
Results The respondents in this study were predominately female (95.8%; 317/331), mainly between the ages of 50 and 69 (73.2%; 240/328). Respondents in the sample were Advanced Practice Registered Nurses with greater than 40% reporting having a PhD in nursing (44.2%; 137/310). Additionally, 21.6% (67/310) of the sample reported having a Doctor of Nursing Practice (DNP). The specialty most highly represented was the Family/Across the Lifespan (62.8%; 172/326) (see Table 1). Among the NONPF members who responded to the survey, 85.2% (283/331) reported they had conducted research in the last 10 years. Although a wide variety of research designs were pursued, the most frequently reported by NP faculty was descriptive exploratory analyses (see Table 2). However, no specific trend was noted between the NP faculty specialty and the number of qualitative or quantitative methods that were used. Respondents cited conducting research in over 80 distinct areas. These ranged from important conventional areas (e.g., acute care, chronic care, educational research, family health, gerontological nursing, health disparities, pediatric nursing, program evaluation, psychiatric health, women’s health) to equally important but less studied or newer areas (e.g., bulling/incivility, clinical level business knowledge, environmental health, forensic topics, genomics, regulatory issues, transgender issues). Research was conducted in every specialty area of practice (see Table 3). The three clinical outcome areas that NP faculty were most interested in were patient health care, quality improvement, and population-based research (see Figure 1). Three large sources of funding were intramural, National Institutes of Health (NIH), and Sigma Theta Tau (see Figure 2). While 67 participants reported receiving intramural funding, 51 reported receiving NIH funding, and 49 reported receiving Sigma Theta Tau funding. The majority (65%) of NP faculty research is published, and most frequently disseminated in peer-reviewed nursing journals (see Figure 3). 666
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Table 1 General demographics of respondents Characteristic Gender Female Male Total Age 69 Total Highest academic degree Bachelors of Science in Nursing Masters of Science in Nursing Masters degree nonnursing Doctor of Nursing Practice (DNP) DrNP PhD in Nursing PhD nonnursing DNS/DNSc Total Nurse practitioner population focus Adult Acute Care Adult Primary Care Adult-Gerontology Acute Care Adult-Gerontology Primary Care Family/Across the Lifespan Gerontological Neonatal Pediatric Acute Care Pediatric Primary Care Psychiatric-Mental Health Women’s Health/Gender-Specific Total
N
Percentage
317 14 331
95.8 4.2
19 63 141 99 6 328
5.8 19.2 43.0 30.2 1.8
0 46 3 67 2 137 41 14 310
0 14.8 1 21.6 0.6 44.2 13.2 4.5
9 40 9 11 172 9 7 5 29 19 16 326
2.8 12.3 2.8 3.4 52.8 2.8 2.1 1.5 8.9 5.8 4.9
Research interests were broad, and represented the full spectrum of clinical practice areas, however nursing education and educational research represented the largest categories (27.5% and 25.6%, respectively). Nearly 93% of NONPF faculty researchers reported being a principal investigator, over one fourth, have participated in regional or national grant reviews (26.5%), and 16.5% have participated on Research Advisory Boards.
Discussion The overall findings reveal an extensive research capacity among the membership of NONPF. Eighty-five percent of the respondents were active in research in the past 10 years. The breadth of research areas that NONPF faculty members have studied is extensive, and ranges from research topics that NPs commonly study, to those areas that are studied less frequently or are emerging research
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Implications for future NP faculty research
Table 2 Types of research designs used by NP faculty Research design
Percent
Number
Ethnography Focus group Grounded theory Narrative inquiry Participatory action Phenomenology
5.8 25.9 8.8 13.1 9.5 16.5
19 85 29 43 31 54
Descriptive/exploratory Cohort/case control Pre-experimental Quasi-experimental Experimental Secondary data analysis
63.7 7.6 4.3 21.0 9.5 18.6
209 25 14 69 31 61
Patient health care Population based Systems management Quality improvement Comparative effectiveness research
26.2 17.1 5.5 20.1 3.4
86 56 18 66 11
Systematic review Meta-analysis
17.1 3.4
56 11 328
Qualitative research
Quantitative research
Outcomes research
Other research designs
Total
Table 3 Areas of respondent specialty where research was conducted in the last 10 years Specialty area of practice Adult Acute Care Adult Primary Care Adult-Gerontology Acute Care Adult-Gerontology Primary Care Family/Across the Lifespan Gerontological Neonatal Pediatric Acute Care Pediatric Primary Care Psychiatric-Mental Health Women’s Health/Gender-Specific Total
Number
Percent of the total of specific specialty
6 33 9 8 149 4 4 4 25 19 15 276
66.7 84.6 100.0 80.0 86.6 44.4 57.1 80.0 86.2 100.0 93.8 85.2
topics. Equally impressive, multiple studies were funded not only by intramural support, but also by federal and foundation funding. In addition, participants reported that generally they published their findings. It is interesting to note that many NONPF researchers have experience in using qualitative methods. For the NONPF researchers who conducted quantitative research, the majority used descriptive and/or exploratory designs, although more rigorous designs were certainly present.
Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research. Therefore, it is important for NP faculty to seek out adequate resources to conduct research, including allotted workload assignment time, statistical assistance, support staff, and other resources as needed, in order to ensure the ongoing success of NP faculty research. In addition, for junior NP faculty, seeking out mentoring from senior NP faculty and other accomplished healthcare researchers can be very effective in finding guidance needed to lay the groundwork for successful programs of research (Chase et al., 2013). Mentoring junior NP faculty in their research programs will help to insure that NP faculty research continues to remain strong into the future. When conducting quantitative research, NP faculty often used descriptive and/or exploratory methods. While descriptive and exploratory research provides an excellent foundation for further research, in order for quantitative research findings to be used to change practice, more rigorous designs are required. Describing a problem is critical, but only a part of providing the type of research needed to change clinical outcomes. NP faculty that are not as experienced with conducting experimental studies need to seek out other NP faculty and healthcare researchers who are experienced in more complex methodologies, in order to provide guidance and expertise for their research work. NP faculty engaged in conducting research used different types of qualitative methodologies. Because of this demonstrated qualitative research experience, there is the potential for using mixed methods more effectively. There is a growing national interest for mixed-methods research designs in health research, especially for translational research (NIH, 2014). Funding agencies such as PatientCentered Outcomes Research Institute (PCORI), highly value the input of research that is guided by patients (PCORI, 2014). Qualitative methods are often used to gain this perspective from the patient, along with mixed methods. There is a significant need for NP faculty to engage in novel and creative research approaches that incorporate both qualitative and quantitative methodologies. NP faculty researchers are assets to interdisciplinary research teams, offering the perspectives of being both clinicians and experienced researchers. However, in order to move successful healthcare research findings forward, NP faculty need to be knowledgeable on how best to translate national health research and practice agendas into pertinent and fundable interdisciplinary scholarship. Ongoing familiarity with the NIH, Centers for Disease 667
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Figure 1 Type of clinical outcome research conducted by NONPF respondents. Note. PHC, patient health care; QI, quality improvement; PB, population based; SM, systems management; CER, comparative effectiveness research.
Figure 2 Source of research funding of NONPF respondents. Note. NIH, National Institutes of Health; STT, Sigma Theta Tau; HRSA, Health Resources and Services Administration; CF, Community Foundations; RWJF, Robert Wood Johnson Foundation; AANP, American Association of Nurse Practitioners; ANF, American Nurses Foundation; IG, Industrial Grant; AACN, American Association of Colleges of Nursing; MNRS, Midwest Nursing Research Society; CDC, Centers for Disease Control and Prevention; AHRQ, Agency for Healthcare Research and Quality; KF, Kellogg Foundation.
Control and Prevention, Health Services and Resources Administration and Agency for Healthcare Research and Quality is necessary. Understanding key interdisciplinary health and healthcare issues is critical in assuring that NP faculty scholarship will be congruent with the areas of inquiry supported by national initiatives and agendas. There is potential to create synergistic research among NP faculty across the country pushing forward nursing science 668
that will translate to improved health for patients, families and communities, and the nation. Generating new knowledge is important for our nursing profession as well as the health of the American people; it also provides important scholarship venues for NP faculty. It is critically important for NP faculty to bring together their energies and talents with productive research teams capable of filling important gaps in knowledge.
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Figure 3 Largest grant and publication information of NONPF respondents. Note. Nursing PRJ, nursing peer-reviewed journal; interdisciplinary PRJ, interdisciplinary peer-reviewed journal; medical PRJ, medical peer-reviewed journal.
Limitations The sample may be biased. The relatively small number of NP faculty who filled out this survey on NP research may in fact be more likely to have conducted research themselves. Using survey methodology can structure responses that are conventional, which may not have actually fit the type of research being conducted by the NONPF members. Given the type of questions that were asked, it was not determined if research was conducted as sole projects, or if these research studies were embedded within research trajectories. It was also not determined if research projects reported were done as a fulfillment of the DNP or PhD degree requirements. Level and type of collaboration with other NP faculty was not determined, which could have resulted in studies being reported more than once. Yet, the results of this survey documented impressive research capacity among a convenience sample of NONPF members who responded to the survey.
Conclusions This study demonstrates that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. NP faculty in this study reported that they conduct research using qualitative and quantitative methods. NP faculty research could be strengthened by using more rigorous analytic methods, mixed-methods designs, and multisite studies. This study demonstrates that NP faculty have the research qualities that are needed when continuing to seek out opportu-
nities to work with interdisciplinary research teams. The qualities of the NP faculty profession that are so useful in clinical and academic settings are the same characteristics that will continue to make NP faculty research even more valuable.
Acknowledgments The authors wish to thank the NONPF Board for their facilitation in delivering the survey, the members of the NONPF Research SIG for their contributions to survey preparation and interpretation of results, NONPF members Susan Kelly-Weeder, PhD, FNP-BC, Chin Hwa (Gina) Dahlem, PhD, FNP-C, and Mary Kamienski, PhD, APRN for their thoughtful critique, and Edith V. Ocampo, MS, for assistance with data preparation.
References Broome, M. E. (2013). The continuum of translational research: Special issue from the council for the advancement of nursing science. Nursing Outlook, 61(4), 193–194. doi:10.1016/j.outlook.2013.05.007 Chase, J. A., Topp, R., Smith, C. E., Cohen, M. Z., Fahrenwald, N., Zerwic, J. J., . . . Conn, V. S. (2013). Time management strategies for research productivity. Western Journal of Nursing Research, 35(2), 155–176. doi:10.1177/0193945912451163 Ford, L. (2010). Foreword In E. M. Sullivan-Marx, D. O. McGivern, J. A. Fairman, & S. A. Greenberg (Eds.), Nurse practitioners: The evolution and future of advanced practice (5th ed., pp. xvii–xviii). New York, NY: Springer Publishing Company. Goolsby, M. J. (2011). 2009–2010 AANP national nurse practitioner sample survey: An overview. Journal of the American Academy of Nurse Practitioners, 23(5), 266–268. doi:10.1111/j.1745-7599.2011.00611.x Hughes, F., Clarke, S., Sampson, D. A., Fairman, J. A., & Sullivan-Marx, E. M. (2010). Research in support of nurse practitioners. In E. M. Sullivan-Marx, D. O. McGivern, J. A. Fairman, & S. A. Greenberg (Eds.), Nurse practitioners:
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The evolution and future of advanced practice (5th ed., pp. 65–92). New York, NY: Springer Publishing Company. King, E. S., Hansen-Turton, T., & Hughes, F. (2010). Nurse-managed health centers. In E. M. Sullivan-Marx, D. O. McGivern, J. A. Fairman, & S. A. Greenberg (Eds.), Nurse practitioners: The evolution and future of advanced practice (5th ed., pp. 183–198). New York, NY: Springer Publishing Company. Kleinpell, R. & Goolsby, M. J. (2012). American academy of nurse practitioners national nurse practitioner sample survey: Focus on acute care. Journal of the American Academy of Nurse Practitioners, 24(12), 690–694. doi:10.1111/j.1745-7599.2012.00777.x National Institute of Nursing Research (NINR). (2010). NINR: Bringing science to life. Retrieved from http://history.nih.gov/research/downloads/NINR History Book 508.pdf
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National Institute of Nursing Research (NINR). (2013). Mission and strategic plan. Retrieved from http://www.ninr.nih.gov/aboutninr/ninr-mission-andstrategic-plan National Institutes of Health (NIH). (2014). Best practices for mixed methods research in the health sciences. Retrieved from http://obssr.od.nih.gov/mixed methods research/ National Organization of Nurse Practitioner Faculties (NONPF). (2012). History and goals. Retrieved from http://www.nonpf.org/?page=1 National Organization of Nurse Practitioner Faculties (NONPF). (2014). Home page. Retrieved from http://www.nonpf.org/default.asp? Patient-Centered Outcomes Research Institute (PCORI). (2014). Mission and vision. Retrieved from http://www.pcori.org/about-us/mission-andvision/
Nurse practitioner faculty research: Results from the 2012 National Organization of Nurse Practitioner Faculties Survey Susan Weber Buchholz, PhD, ANP-BC, FAANP (Professor)1 , Joan Rosen Bloch, PhD, CRNP (Associate Professor)2 , David Westrin, MSN, AGNP-BC (Nurse Practitioner)3 , & Louis Fogg, PhD (Associate Professor)1 1
Rush University College of Nursing, Chicago, Illinois Doctoral Nursing Department, College of Nursing and Health Professions, School of Public Health, Drexel University, Philadelphia, Pennsylvania 3 Good Samaritan Medical Center, Brockton, Massachusetts 2
Keywords Research; nurse practitioners; education; Nursing Scholarship; Doctoral faculty; faculty practice. Correspondence Susan Weber Buchholz, PhD, ANP-BC, FAANP, Rush University College of Nursing, 600 S. Paulina Street, AAC 1030D, Chicago, IL 60612. Tel: 312-563-3590; Fax: 312-942-3043; E-mail: [email protected] Received: 29 October 2014; accepted: 8 February 2015 doi: 10.1002/2327-6924.12250
Abstract Purpose: To better understand the research capacity and productivity of nurse practitioner (NP) faculty, a study was conducted to describe the types of research that have been and are being completed by National Organization of Nurse Practitioner Faculties (NONPF) members. Data sources: A web-based survey was developed with input from members of the NONPF Research Special Interest Group and the NONPF Board. This 23-question survey included demographic, academic degree, NP population focus, and research-related questions. Three e-mails were sent to NONPF members over a 10-week period of time (late December 2012 to early February 2013). Conclusions: Respondents (N = 344) in the sample were Advanced Practice Registered Nurses with either a Masters, Doctor of Nursing Practice, DNS or PhD as their highest academic degree. Study results demonstrated that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. Implications for practice: Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research.
Introduction The evolution and institutionalization of the nurse practitioner (NP) role during the 20th century transformed nursing practice and education leading to increasing numbers of NPs assuming faculty positions (Ford, 2010). This movement to academia has provided numerous opportunities and incentives for NP faculty to engage in research (Hughes, Clarke, Sampson, Fairman, & SullivanMarx, 2010). Enhancing funding sources available to NP faculty was the 1993 creation of the National Institute of Nursing Research (NINR, 2010). These two historical events contributed to the transformation of nursing into a field that emphasizes both advanced clinical practice and rigorous scholarship. NP faculty are well positioned in academic settings to integrate research careers with current practice as they fulfill the tripartite faculty mission of teaching, scholarship, and service. The NINR’s current priorities for health
664
promotion and symptom management research (NINR, 2013) are well suited for advancing the knowledge needed for NP practice. This is particularly applicable among the poorest urban and rural populations in the nation, often served by Nurse-Managed Centers (King, Hansen-Turton, & Hughes, 2010). In addition, the growing emphasis on translational research facilitates addressing practice-based research questions often encountered in NP practices (Broome, 2013; Hughes et al., 2010). Healthcare research is the cornerstone of evidencebased healthcare practices used worldwide. As a discipline, nursing has produced and continues to produce research at the highest level (NINR, 2013). NPs are in a unique position to conduct research because of their close proximity to academic institutions, patient care, and their vast experiences with multiple populations, health-related conditions, and research methodologies (Goolsby, 2011; Kleinpell & Goolsby, 2012).
Journal of the American Association of Nurse Practitioners 27 (2015) 664–670 C 2015 American Association of Nurse Practitioners
Nurse practitioner faculty research
S. W. Buchholz et al.
Recognizing and promoting original and translational research of National Organization of Nurse Practitioner Faculties (NONPF) members is in direct alignment with the NONPF organizational goal of promoting scholarship and enhancing NP faculty scholarship (NONPF, 2012). Research provides the pathway for discovery of knowledge that is ultimately applied to real-life healthcare and community settings. Increasing numbers of NPs are obtaining doctoral degrees and the work of these NPs adds to the body of nursing research as well as to the critical translation and dissemination of research to the point-ofcare. Therefore to better understand the research capacity, funding, and productivity of NP faculty, this study was proposed to describe the types of research that have been and are being completed by NONPF members.
Methods Design This descriptive study utilized a web-based survey to reach NONPF members. NONPF is the only organization specifically devoted to promoting quality NP education at the national and international levels (NONPF, 2014). Since its beginning in 1974, NONPF has evolved as the leading organization for NP faculty, achieving broad recognition for its leadership role in developing and maintaining NP educational resources and providing valuable resources for supporting the promotion and tenure of NP faculty.
Sample This was a convenience sample of NONPF members, recognizing that all NP faculty are not necessarily NONPF members. Inclusion criteria were: (a) faculty on NONPF’s master list of members during the period when the survey was electronically delivered, and (b) having an e-mail address. Three e-mails were sent to NONPF members (1575 potential subjects) over a 10-week period of time (late December 2012 to early February 2013). Of the 1575 e-mails that were sent out, 344 (22%, 344/1575) members participated in the survey.
Measure The 2012 NONPF Research SIG Survey was initially developed by input from Research Special Interest Group (SIG) members and by members of the NONPF Board. Members of the Research SIG are NONPF members with an interest and experience in research. The survey was then reviewed for face validity by seven NONPF members from across the nation, and recommended changes were made to the survey prior to dissemination. This 23-question (openand close-ended) survey included demographic (gender,
age group), academic (degree, NP population focus), and research-related questions. For this study, research was defined as the discovery of knowledge that is or can be applied to real-life healthcare settings. This broad definition was chosen to include both basic and applied clinical and/or population-based research as much as possible. Respondents were asked if they had conducted research within the last 10 years. If they had, they were asked if they had participated in qualitative, quantitative, clinical outcome, or other types of research (respondents were allowed to check all types of research that applied). We inquired if projects had been funded, and if so, by which sources, and total dollar amounts received. We also asked if research findings had been published and if so in which type of journals. Respondents were asked about their current research areas. They were also asked to list research conducted within the last 10 years, identifying their role and the project name (for up to six projects). Questions were additionally asked about conducting regional or national grant reviews and participating on Research Advisory Boards. A separate section, where respondents were asked to identify themselves by providing their name and e-mail if they so desired, addressed two questions. The first question asked respondents if they had experience conducting educational research, and if so, would they be willing to potentially assist NONPF with conducting such research. The second question asked respondents if they have had national funding and if so, would they be willing to provide one to three individual brief research consultations at an NONPF annual meeting. These questions were solely for the purpose of providing information for future development work related to faculty research at NONPF and are not reported in this article. Completion of this section did not compromise respondents’ anonymity.
Procedures This research project was approved by the NONPF Board and Institutional Review Board approval was received from Rush University. The survey was produced/uploaded into Survey Monkey. Three e-mails were sent to NONPF members over a 10-week period explaining the nature of the survey and providing a link to the survey instrument. It was estimated that the survey would take 15 min or less to complete, depending on the research involvement of the respondent. All e-mails were sent by NONPF administrative staff.
Analysis Data management, analysis, and interpretation of the data were conducted by two NP faculty researchers who 665
Nurse practitioner faculty research
have led multiple studies evolving from their practice as NPs. They were assisted in this process by a statistician and a graduate NP student. Data were exported from Survey Monkey directly into SPSS version 19.0. Extensive exploratory descriptive analyses were conducted to explore the distribution of the data for each variable and relationships between variables. This process included calculating measures of central tendency; means were calculated for continuous variables and frequency distributions for categorical variables. Relationships among the variables were assessed by constructing correlation matrices for continuous variables and contingency tables for categorical variables.
Results The respondents in this study were predominately female (95.8%; 317/331), mainly between the ages of 50 and 69 (73.2%; 240/328). Respondents in the sample were Advanced Practice Registered Nurses with greater than 40% reporting having a PhD in nursing (44.2%; 137/310). Additionally, 21.6% (67/310) of the sample reported having a Doctor of Nursing Practice (DNP). The specialty most highly represented was the Family/Across the Lifespan (62.8%; 172/326) (see Table 1). Among the NONPF members who responded to the survey, 85.2% (283/331) reported they had conducted research in the last 10 years. Although a wide variety of research designs were pursued, the most frequently reported by NP faculty was descriptive exploratory analyses (see Table 2). However, no specific trend was noted between the NP faculty specialty and the number of qualitative or quantitative methods that were used. Respondents cited conducting research in over 80 distinct areas. These ranged from important conventional areas (e.g., acute care, chronic care, educational research, family health, gerontological nursing, health disparities, pediatric nursing, program evaluation, psychiatric health, women’s health) to equally important but less studied or newer areas (e.g., bulling/incivility, clinical level business knowledge, environmental health, forensic topics, genomics, regulatory issues, transgender issues). Research was conducted in every specialty area of practice (see Table 3). The three clinical outcome areas that NP faculty were most interested in were patient health care, quality improvement, and population-based research (see Figure 1). Three large sources of funding were intramural, National Institutes of Health (NIH), and Sigma Theta Tau (see Figure 2). While 67 participants reported receiving intramural funding, 51 reported receiving NIH funding, and 49 reported receiving Sigma Theta Tau funding. The majority (65%) of NP faculty research is published, and most frequently disseminated in peer-reviewed nursing journals (see Figure 3). 666
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Table 1 General demographics of respondents Characteristic Gender Female Male Total Age 69 Total Highest academic degree Bachelors of Science in Nursing Masters of Science in Nursing Masters degree nonnursing Doctor of Nursing Practice (DNP) DrNP PhD in Nursing PhD nonnursing DNS/DNSc Total Nurse practitioner population focus Adult Acute Care Adult Primary Care Adult-Gerontology Acute Care Adult-Gerontology Primary Care Family/Across the Lifespan Gerontological Neonatal Pediatric Acute Care Pediatric Primary Care Psychiatric-Mental Health Women’s Health/Gender-Specific Total
N
Percentage
317 14 331
95.8 4.2
19 63 141 99 6 328
5.8 19.2 43.0 30.2 1.8
0 46 3 67 2 137 41 14 310
0 14.8 1 21.6 0.6 44.2 13.2 4.5
9 40 9 11 172 9 7 5 29 19 16 326
2.8 12.3 2.8 3.4 52.8 2.8 2.1 1.5 8.9 5.8 4.9
Research interests were broad, and represented the full spectrum of clinical practice areas, however nursing education and educational research represented the largest categories (27.5% and 25.6%, respectively). Nearly 93% of NONPF faculty researchers reported being a principal investigator, over one fourth, have participated in regional or national grant reviews (26.5%), and 16.5% have participated on Research Advisory Boards.
Discussion The overall findings reveal an extensive research capacity among the membership of NONPF. Eighty-five percent of the respondents were active in research in the past 10 years. The breadth of research areas that NONPF faculty members have studied is extensive, and ranges from research topics that NPs commonly study, to those areas that are studied less frequently or are emerging research
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Implications for future NP faculty research
Table 2 Types of research designs used by NP faculty Research design
Percent
Number
Ethnography Focus group Grounded theory Narrative inquiry Participatory action Phenomenology
5.8 25.9 8.8 13.1 9.5 16.5
19 85 29 43 31 54
Descriptive/exploratory Cohort/case control Pre-experimental Quasi-experimental Experimental Secondary data analysis
63.7 7.6 4.3 21.0 9.5 18.6
209 25 14 69 31 61
Patient health care Population based Systems management Quality improvement Comparative effectiveness research
26.2 17.1 5.5 20.1 3.4
86 56 18 66 11
Systematic review Meta-analysis
17.1 3.4
56 11 328
Qualitative research
Quantitative research
Outcomes research
Other research designs
Total
Table 3 Areas of respondent specialty where research was conducted in the last 10 years Specialty area of practice Adult Acute Care Adult Primary Care Adult-Gerontology Acute Care Adult-Gerontology Primary Care Family/Across the Lifespan Gerontological Neonatal Pediatric Acute Care Pediatric Primary Care Psychiatric-Mental Health Women’s Health/Gender-Specific Total
Number
Percent of the total of specific specialty
6 33 9 8 149 4 4 4 25 19 15 276
66.7 84.6 100.0 80.0 86.6 44.4 57.1 80.0 86.2 100.0 93.8 85.2
topics. Equally impressive, multiple studies were funded not only by intramural support, but also by federal and foundation funding. In addition, participants reported that generally they published their findings. It is interesting to note that many NONPF researchers have experience in using qualitative methods. For the NONPF researchers who conducted quantitative research, the majority used descriptive and/or exploratory designs, although more rigorous designs were certainly present.
Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research. Therefore, it is important for NP faculty to seek out adequate resources to conduct research, including allotted workload assignment time, statistical assistance, support staff, and other resources as needed, in order to ensure the ongoing success of NP faculty research. In addition, for junior NP faculty, seeking out mentoring from senior NP faculty and other accomplished healthcare researchers can be very effective in finding guidance needed to lay the groundwork for successful programs of research (Chase et al., 2013). Mentoring junior NP faculty in their research programs will help to insure that NP faculty research continues to remain strong into the future. When conducting quantitative research, NP faculty often used descriptive and/or exploratory methods. While descriptive and exploratory research provides an excellent foundation for further research, in order for quantitative research findings to be used to change practice, more rigorous designs are required. Describing a problem is critical, but only a part of providing the type of research needed to change clinical outcomes. NP faculty that are not as experienced with conducting experimental studies need to seek out other NP faculty and healthcare researchers who are experienced in more complex methodologies, in order to provide guidance and expertise for their research work. NP faculty engaged in conducting research used different types of qualitative methodologies. Because of this demonstrated qualitative research experience, there is the potential for using mixed methods more effectively. There is a growing national interest for mixed-methods research designs in health research, especially for translational research (NIH, 2014). Funding agencies such as PatientCentered Outcomes Research Institute (PCORI), highly value the input of research that is guided by patients (PCORI, 2014). Qualitative methods are often used to gain this perspective from the patient, along with mixed methods. There is a significant need for NP faculty to engage in novel and creative research approaches that incorporate both qualitative and quantitative methodologies. NP faculty researchers are assets to interdisciplinary research teams, offering the perspectives of being both clinicians and experienced researchers. However, in order to move successful healthcare research findings forward, NP faculty need to be knowledgeable on how best to translate national health research and practice agendas into pertinent and fundable interdisciplinary scholarship. Ongoing familiarity with the NIH, Centers for Disease 667
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Figure 1 Type of clinical outcome research conducted by NONPF respondents. Note. PHC, patient health care; QI, quality improvement; PB, population based; SM, systems management; CER, comparative effectiveness research.
Figure 2 Source of research funding of NONPF respondents. Note. NIH, National Institutes of Health; STT, Sigma Theta Tau; HRSA, Health Resources and Services Administration; CF, Community Foundations; RWJF, Robert Wood Johnson Foundation; AANP, American Association of Nurse Practitioners; ANF, American Nurses Foundation; IG, Industrial Grant; AACN, American Association of Colleges of Nursing; MNRS, Midwest Nursing Research Society; CDC, Centers for Disease Control and Prevention; AHRQ, Agency for Healthcare Research and Quality; KF, Kellogg Foundation.
Control and Prevention, Health Services and Resources Administration and Agency for Healthcare Research and Quality is necessary. Understanding key interdisciplinary health and healthcare issues is critical in assuring that NP faculty scholarship will be congruent with the areas of inquiry supported by national initiatives and agendas. There is potential to create synergistic research among NP faculty across the country pushing forward nursing science 668
that will translate to improved health for patients, families and communities, and the nation. Generating new knowledge is important for our nursing profession as well as the health of the American people; it also provides important scholarship venues for NP faculty. It is critically important for NP faculty to bring together their energies and talents with productive research teams capable of filling important gaps in knowledge.
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Figure 3 Largest grant and publication information of NONPF respondents. Note. Nursing PRJ, nursing peer-reviewed journal; interdisciplinary PRJ, interdisciplinary peer-reviewed journal; medical PRJ, medical peer-reviewed journal.
Limitations The sample may be biased. The relatively small number of NP faculty who filled out this survey on NP research may in fact be more likely to have conducted research themselves. Using survey methodology can structure responses that are conventional, which may not have actually fit the type of research being conducted by the NONPF members. Given the type of questions that were asked, it was not determined if research was conducted as sole projects, or if these research studies were embedded within research trajectories. It was also not determined if research projects reported were done as a fulfillment of the DNP or PhD degree requirements. Level and type of collaboration with other NP faculty was not determined, which could have resulted in studies being reported more than once. Yet, the results of this survey documented impressive research capacity among a convenience sample of NONPF members who responded to the survey.
Conclusions This study demonstrates that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. NP faculty in this study reported that they conduct research using qualitative and quantitative methods. NP faculty research could be strengthened by using more rigorous analytic methods, mixed-methods designs, and multisite studies. This study demonstrates that NP faculty have the research qualities that are needed when continuing to seek out opportu-
nities to work with interdisciplinary research teams. The qualities of the NP faculty profession that are so useful in clinical and academic settings are the same characteristics that will continue to make NP faculty research even more valuable.
Acknowledgments The authors wish to thank the NONPF Board for their facilitation in delivering the survey, the members of the NONPF Research SIG for their contributions to survey preparation and interpretation of results, NONPF members Susan Kelly-Weeder, PhD, FNP-BC, Chin Hwa (Gina) Dahlem, PhD, FNP-C, and Mary Kamienski, PhD, APRN for their thoughtful critique, and Edith V. Ocampo, MS, for assistance with data preparation.
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National Institute of Nursing Research (NINR). (2013). Mission and strategic plan. Retrieved from http://www.ninr.nih.gov/aboutninr/ninr-mission-andstrategic-plan National Institutes of Health (NIH). (2014). Best practices for mixed methods research in the health sciences. Retrieved from http://obssr.od.nih.gov/mixed methods research/ National Organization of Nurse Practitioner Faculties (NONPF). (2012). History and goals. Retrieved from http://www.nonpf.org/?page=1 National Organization of Nurse Practitioner Faculties (NONPF). (2014). Home page. Retrieved from http://www.nonpf.org/default.asp? Patient-Centered Outcomes Research Institute (PCORI). (2014). Mission and vision. Retrieved from http://www.pcori.org/about-us/mission-andvision/
