Why Pursue a Doctorate? Findings From a Study of Doctorally Prepared RNs in an Integrated Healthcare System.

OBJECTIVE: The aim of this study was to examine the motivations and perceptions of RNs with completed doctorates in an integrated healthcare system. BACKGROUND: Historically, PhD preparation was the primary doctorate available for nurses, preparing them to conduct research and hold leadership positions. The recent growth of Doctor of Nursing Practice (DNP) programs that focus on either advanced clinical practice or executive competencies has significant implications for the future of nursing in practice settings. METHODS: A 30-item survey was sent to all 93 RNs at a healthcare system who have completed doctorates. RESULTS: A response rate of 71% found DNPs outnumber PhDs 3 to 1. PhDs are significantly more likely to perceive concrete benefits associated with their degrees, and DNPs are more likely to report that their degrees have not made a difference in their jobs. CONCLUSIONS: Leaders in practice and education must collaborate to ensure that both DNPs and PhDs are engaged in positions that use their highest level of competence in any setting.

Beyond competence and retention: Developing a comprehensive evaluation framework for a rural primary care nurse practitioner residency program.

ABSTRACT: With the rise in nurse practitioner (NP) residency programs, evaluations have largely focused on retention and competency completion for residents. There is a need for expanded evaluation to ensure the sustainability of NP residency programs, to ensure timely adaptations to address resident satisfaction, and to solidify a long-term pathway of NPs well prepared for rural practice. We created a family nurse practitioner (FNP) residency program with a comprehensive evaluation framework to prepare residents for practice in rural settings. The evaluation framework was developed through collaborative engagement of an external evaluation team, program leadership, and clinical site representatives. The evaluation framework of the FNP residency program combined resident assessment and holistic program evaluation, using a rapid continuous quality improvement (QI) approach. The evaluation considered three distinct perspectives: the resident, the peer coach, and the clinical site. The rapid continuous QI approach allowed program leadership to respond swiftly to programmatic challenges, improve the residency program in response to residents' reported experiences, and emphasize sustainability for continued program impact, while assessing residents' learning and performance. The program's data-driven evaluation approach has demonstrated its success in meeting the goals of the Health Resources and Services Administration funding by increasing the number of primary care providers in rural settings. The program's expansion and continued success have further validated the efficacy of this evaluation framework in assessing, improving, and ensuring the sustainability of APRN residency programs. This article calls for the adoption of similar evaluation strategies in future residency programs to promote their long-term success and impact in rural health care settings.

Redefining Competencies for Nurse Anesthesia Education--Integrating Emotional Intelligence Assessment and Training into a Nurse Anesthesia DNP Program.

We present an overview of best practices for integrating emotional intelligence into a nurse anesthesia educational program. We first cover a brief history of the importance of emotional intelligence to the healthcare, nursing, and nurse anesthesia fields and then present the processes we undertook to integrate emotional intelligence holistically into our curriculum.

Optimizing Care for Military Women: The Value of the Dual-Certified Family and Women's Health Nurse Practitioner.

The number of women in the military has more than tripled over the past 50 years, increasing from 5% in the 1970s to 17% in 2023, making them essential for global health engagement and military operations. Provider competence and confidence are barriers to the consistent availability of preventive, gynecologic, and reproductive services for women across service locations and duty platforms. The Defense Health Board recommends standardizing services and improving the availability and scope of services for women at every point of care. In direct conflict with these recommendations, however, is a congressional call for a drawdown of medical forces, which creates a need for operationally trained clinicians with a broad skill set including comprehensive care for women. Advanced practice registered nurses, such as family and women's health nurse practitioners, are key assets to fill this gap on military medical health-care teams. At the request of the U.S. Air Force, the Graduate School of Nursing at the Uniformed Services University began offering a Women's Health Nurse Practitioner (WHNP) program in 2014. The WHNP curriculum was layered onto the existing Family Nurse Practitioner program so that Family Nurse Practitioner students receive enhanced education in women's health and WHNP students are prepared to meet the holistic, primary care needs of patients across the lifespan in addition to caring for women with obstetric and urogenital health concerns. This article highlights the value of dual-certified Family Nurse Practitioners and WHNPs in the military health-care system. These Uniformed Services University alumni are uniquely prepared to provide comprehensive primary and specialty care for female warfighters across the lifecycle from stable, well-resourced duty stations to austere, operational settings or deployment platforms.

An Individualized, Holistic Approach to Supporting New Graduate Nurses.

New graduate nurses bring unique strengths and opportunities for growth to transition to practice. This article describes strategies organizations can use to foster an individualized and holistic approach to clinical competency and well-being development. [J Contin Educ Nurs. 2023;54(11):492-494.].

The motivational factors and the perceived effects of attaining higher education among post-diploma graduate nurses and midwives in Kumasi, Ghana: A cross-sectional study.

BACKGROUND: Globally, there has been increased demand for higher education in nursing and midwifery to support evidence-based practice. It is believed that higher education in nursing leads to improved quality of care. The motivation for pursuing higher education, the choice of institution for learning and the effects of higher education programs have not been given much attention in research literature in Ghanaq OBJECTIVE: To assess the motivating factors, reasons for the choice of institution and the perceived effects of attaining higher educational qualifications among post-diploma graduate nurses and midwives. STUDY DESIGN: Descriptive cross-sectional study. SETTING: Kumasi. PARTICIPANTS: Convenience and snowball sampling were used to select 523 nurses and midwives who had pursued higher education after their Diploma in Nursing or Midwifery education. METHOD: A researcher-developed questionnaire was used to collect data on motivation, choice of institution and perceived effects of higher education by nurses and midwives. Data were analyzed through descriptive statistics, Pearson correlation and linear regression at 0.05 significance level. RESULTS: The greatest motivation for higher education by nurses/midwives was to improve clinical judgment. Academic quality and reputation of the institution were the main reasons for the choice of institution (n = 458, 92.7 %). There were weak but positive significant correlations between the perceived effects of higher nursing and midwifery education and pressure from the workplace (r = 0.204, p < .001), and increasing new demands from clients (r = 0.284, p < .001). Increasing demands from clients (ß = 0.203, p < .001) and improving social status (ß = 0.264, p < .001) were the motivating factors that influenced the perceived effects of higher nursing and midwifery education. CONCLUSION: The desire for improved professionalism and increased expertise are the reasons nurses and midwives seek higher education. Health managers should support nurses and midwives to attain higher education to improve the quality of care.

Simulation-based learning in palliative care in postgraduate nursing education: a scoping review.

BACKGROUND: Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education. METHODS: The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Meth 8(1):19-32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework. RESULTS: This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one's ability to communicate during emotionally challenging situations; and impact and relevance to one's own clinical practice. CONCLUSIONS: The use of SBL in palliative care in postgraduate nursing education seems to enhance students' understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students' confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students' experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.

Inclusivity in Graduate Nursing Education: A Scoping Review.

BACKGROUND: Advancing inclusivity in graduate nursing education is paramount for preparing diverse nursing leaders to mobilize change within health care and educational systems. This scoping review examined inclusivity in graduate nursing education. METHOD: CINAHL, Medline, and ERIC databases were searched for studies published in English since 2011. Key journals and reference lists of included studies were hand searched. Included studies focused on inclusivity in the context of graduate nursing education. RESULTS: Data from 31 included studies are presented. Most of the studies (n = 22) aimed to cultivate inclusivity among students, primarily through cultural competence training. A few studies enacted inclusivity through program-level strategies (n = 4) or explored the lived experiences of diverse students (n = 5). CONCLUSION: Future research and education initiatives should advance a more holistic, intersectional approach to cultivating inclusivity, as well as emphasize enacting inclusivity through strategies to transform the learning environment. [J Nurs Educ. 2022;61(12):679-692.].

The Impact of Mindfulness on Stress and Burnout of New Graduate Nurses as a Component of a Nurse Residency Program.

OBJECTIVE: This evidence-based practice project assessed the impact of integrating mindfulness training into an existing nurse residency program. BACKGROUND: Stress and burnout are endemic in healthcare. The transition to practice is associated with stress and anxiety for newly graduated nurses. Evidence supports mindfulness-based interventions to mitigate stress and burnout and improve the workplace environment and patient outcomes. METHODS: This project employed a pre/post design to measure burnout, stress, and mindfulness, comparing means and standard deviations between intervention and comparison nurse residency cohorts. Mindfulness training was integrated at 4 points within the 1st 6 months of the residency program. RESULTS: The intervention cohort reported significantly less burnout and stress and more mindfulness at 6 months than the comparison group. CONCLUSIONS: Mindfulness training can be feasibly integrated into an existing nurse residency program to decrease stress and burnout for new graduate nurses during the transition to practice.

A comparative study of PhD and DNP nurses in an integrated health care system.

BACKGROUND: A vast literature exists on doctorally-prepared RNs in academia, but little is known about those in practice settings. PURPOSE: The purpose of this study was to explore demographic, educational, and employment characteristics, as well as practice patterns and professional accomplishments of doctorally-prepared RNs in one practice setting. METHODS: Survey of approximately 100 doctorally-prepared RNs in an integrated health system were surveyed. DISCUSSION: Doctors of Nursing Practice (DNPs) outnumber PhDs three to one in the institution. Several statistically significant differences exist between them: DNPs are younger and most likely hold advanced practice nursing positions; PhDs are 10 years older and more likely hold administrative or leadership positions. Little evidence exists that neither nurses nor administrators understand the skills and knowledge that doctorally-prepared RNs bring to the organization. This is particularly true for DNPs who predominantly hold clinical positions also held by master's-prepared RNs. CONCLUSION: Advocates for continued growth of DNPs in academia and practice should partner more closely to clarify the skills and talents that doctorally-prepared nurses bring to clinical settings.

The experiences of new graduate nurses and midwives going through a virtual interview recruitment process during the COVID-19 crisis: a cross-sectional study.

BACKGROUND: The annual recruitment of new graduate nurses and midwives is key to recruiting large numbers of staff with the right attitude, skills and knowledge who are the best fit for the organisation. Virtual interviews were undertaken in 2020 due to the surge worldwide in the COVID-19 crisis. This study evaluates those virtual interviews and explores the sustainability of the model. METHODS: A cross-sectional study was conducted at a large health organisation in New South Wales, Australia. Data were collected over 3 weeks using two online surveys, one for interviewees (n = 512) and the other for interviewers (n = 68). Quantitative data were analysed using descriptive statistics and frequency distributions, and additional free-text comments were analysed using content analysis. RESULTS: Response rates were 55% (n = 280) interviewees and 54% (n = 37) for interviewers. The majority of interviewees (58%, n = 184) and interviewers (78%, n = 29) stated the interview was seamless or very seamless and 55% (n = 156) of interviewees and 73% (n = 27) of interviewers agreed interviewees conveyed themselves well during interviews. Over half of interviewees (65%, n = 182) and interviewers (51%, n = 18) agreed the virtual interview was fair or very fair for interviewee performance, regardless of age, race, or socio-economic status. However, many expressed a need for better internet access, equipment, and support, and a longer interview time to personally connect. Both new graduate interviewees (60%) and interviewers (75%) agreed virtual interviews are a suitable model for future use. However, some respondents indicated they preferred face-to-face interviews. CONCLUSIONS: The use of virtual interviews to select new graduates is considered acceptable, cost-effective and sustainable, as well as fair by the majority of participants. Study findings inform policy development, future planning, support the use of flexible selection practices and provide other health care professionals with a virtual recruitment model to consider when developing strategies to grow their future health workforce.

St. Luke's International University and University of North Carolina at Chapel Hill collaboration project to develop the first DNP program in Japan.

We report an international collaborative project to develop the first Doctor of Nursing Practice (DNP) program in Japan. We described the development and implementation of the first DNP program at the St. Luke's International University in Tokyo and the collaboration with the University of North Carolina at Chapel Hill in the United States. Faculty perceptions in both parties gradually evolved from the traditional perspective of international collaboration to the transitional and the beginning of the holistic partnership perspectives. The collaboration resulted in an innovative DNP program that directly addressed the gap between nursing education programs and Japan's clinical needs. The collaborative project cultivated a holistic international partnership. Rather than reporting a manual for international collaboration, we present our reflections and outcomes as narratives that others could use to achieve a holistic global partnership.

Learning to be a doctoral supervisor: Experiences and views of nurse supervisors of higher degree research students.

AIMS AND OBJECTIVES: Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like. BACKGROUND: Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence. DESIGN: Qualitative storytelling, semi-structured interviews were conducted via a videoconferencing programme, audio-recorded and thematically analysed with twenty-one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines. RESULTS: Thematic analysis revealed four themes: 'I had a great mentor': the importance of mentorship and role modelling; 'Sometimes it's just trial and error': learning through experience; 'It's like tick a box': strengths and limitations of formal supervisor training; and 'The training should be more holistic': what should be in supervisor training. CONCLUSIONS: We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline-based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training. RELEVANCE TO CLINICAL PRACTICE: Further development of clinical nursing is inextricably linked to quality nurse-led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence-informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing.

"Connecting the dots" - The transfer of bioscience knowledge by new graduate nurses to the clinical setting: A qualitative study.

BACKGROUND: Little is known regarding the transfer of bioscience knowledge gained during undergraduate nursing studies into clinical practice. OBJECTIVE: To explore the experiences of new registered nurses in applying bioscience concepts in their day-to-day nursing practice. DESIGN: Descriptive qualitative design. PARTICIPANTS: Fifteen recently graduated registered nurses (RNs) who were working in acute care settings participated in the study. METHODS: Semi-structured, face-to-face individual interviews were conducted. Interview data were audio-recorded and thematically analysed. RESULTS: Four themes were identified from the qualitative interviews. The first and second themes demonstrated nurses' realisation of the relevance of theoretical bioscience knowledge learnt within the classroom to their practice and how this evidence-based knowledge translated into confidence in decisions made. The third and fourth themes revealed the impact bioscience knowledge had on RNs' relationships with patients and family members, which was viewed as providing compassionate care. CONCLUSIONS: The application of knowledge in biosciences gained during their undergraduate years, provided the basis for RNs to trust in their own clinical judgment and to speak with conviction. 'Connecting the dots' between bioscience knowledge and clinical practice provided the platform for RNs to gain and build trust with their patients. The practical utility of bioscience knowledge in everyday practice allowed RNs to contextualise their nursing care regimen and tailor holistic nursing care delivery to individual patient needs.

Habitus profissional como expressão da identidade das enfermeiras obstétricas: configurações identitárias a partir da inserção no campo laboral / Professional habitus as an expression of the identity of obstetric nurses: identity configurations from the insertion in the labor field

Trata-se de uma pesquisa exploratória, descritiva com abordagem qualitativa, cujo objeto de estudo é identidade profissional das enfermeiras obstétricas. Este estudo teve por objetivo descrever as disposições incorporadas pelas enfermeiras obstétricas e seus nexos com a formação e com o vivido no mundo do trabalho, analisar os atos de pertencimento e a percepção dos atos de atribuição da identidade profissional das enfermeiras obstétricas e discutir as configurações identitárias das enfermeiras obstétricas segundo a perspectiva de Claude Dubar. Após a aprovação pelo Comitê de Ética, através do Parecer sob o número CAAE 18055319.0.0000.5282, foram realizadas 13 entrevistas semiestruturadas mediante a orientação de um roteiro. Foi realizada análise de conteúdo categorial temática, seguindo as três etapas de Bardin (2011): pré-análise, exploração do material e interpretação. Os dados obtidos foram agrupados em três categorias e recortados em Unidades de Registro (URs): "Disposições incorporadas pelas enfermeiras durante seu processo de socialização", "Atos de pertencimento e atos de atribuição" e "Configurações identitárias apresentadas pelas enfermeiras obstétricas". Os resultados da primeira categoria apontaram que no decorrer da socialização primária, as disposições incorporadas pelas participantes que influenciaram na escolha pela profissão foram: a autonomia financeira através do estudo; a disciplina; cuidar e respeitar o próximo. Além disso, ao ingressarem na especialização, adquiriram novos capitais somados aos pré-existentes, como: domínio do setor, noção de gênero, cuidados com a gestante, educação em saúde, práticas integrativas, empatia e respeito, escuta ativa, singularidade dos sujeitos e olhar integral. Os resultados da segunda categoria mostraram que as enfermeiras obstétricas se veem como mulheres batalhadoras que cuidam do lar e dos filhos, que amam a profissão, defendem o fisiológico e acreditam no parto normal sem intervenções, que tem empatia, que empoderam as mulheres, que veem a integralidade e a singularidade do indivíduo sem expressar julgamentos, que detém muito conhecimento e são anjos da guarda invisíveis. Os resultados da terceira categoria evidenciaram que as enfermeiras obstétricas apresentam traços compatíveis com as configurações identitárias negociatórias por dominarem saberes profissionais, manterem colaboração com a instituição e por reconstruírem a identidade de forma boa para ambos, e afinitária por não manifestarem pertencimento a empresa, terem certeza que valem mais que o cargo que ocupam e buscarem consolidar projetos pessoais alheios aos da instituição. Conclui-se que a socialização primária das enfermeiras obstétricas influenciou na escolha profissional e no modo como elas se vêem e acreditam ser vistas. Além disso, por estarem inseridas num campo laboral que não é compatível com sua identidade real, tendem, com o passar do tempo, a romper com o campo e procurar um novo espaço onde se sintam mais reconhecidas ou podem também permanecer no campo e sofrer desgaste psíquico, afetando assim sua saúde.

It is an exploratory, descriptive research with a qualitative approach, whose object of study is the professional identity of obstetric nurses. This study aimed to describe the provisions incorporated by obstetric nurses and their links with training and with what they have experienced in the world of work, analyze the acts of belonging and the perception of acts of attribution of the professional identity of obstetric nurses and discuss the identity configurations obstetric nurses from the perspective of Claude Dubar. After approval by the Ethics Committee, through the Opinion under the number CAAE 18055319.0.0000.5282, 13 semi-structured interviews were conducted through the guidance of a script. Thematic categorical content analysis was carried out, following the three stages of Bardin (2011): pre-analysis, material exploration and interpretation. The data obtained were grouped into three categories and cut into Registration Units (URs): "Provisions incorporated by nurses during their socialization process" with 42 URs, "Acts of belonging and acts of attribution" with 61 URs and "Identity configurations presented by obstetric nurses "with 37 RUs. The results of the first category showed that during the course of primary socialization, the provisions incorporated by the participants that influenced the choice of the profession were: financial autonomy through the study; the discipline; take care and respect others. In addition, when they entered the specialization, they acquired new capital added to the pre-existing ones, such as: administration, domain of the sector, notion of gender, care for pregnant women, health education, integrative practices, empathy and respect, active listening, singularity of subjects and integral look. The results of the second category showed that obstetric nurses see themselves as hardworking women who care for the home and children, who love the profession, defend the physiological and believe in normal childbirth without interventions, who have empathy, who empower women, who see the integrality and uniqueness of the individual without expressing judgments, who have a lot of knowledge and are invisible guardian angels. The results of the third category showed that the obstetric nurses were divided into two groups and showed traits compatible with the negotiating identity configurations for dominating professional knowledge, maintaining reciprocal collaboration with the institution and reconstructing the identity in a good way for themselves and for the institution, and affinity for not expressing belonging to the company, making sure that they are worth more than the position they occupy and for seeking to consolidate personal projects unrelated to those of the institution. It is concluded that a primary socialization of obstetric nurses influenced the professional choice and how they see themselves and believe to be seen. In addition, as they are inserted in a labor field that is not compatible with their real identity, they tend to spend time breaking off with the field and looking for a new space where they feel more recognized or they can also remain in the field and suffer psychological distress thus affecting their health.

Preparing the clinicians of tomorrow: Weaving integrated care across doctor of nursing practice education.

In today's changing landscape of health care, integrated health care is essential for best patient outcomes. The number of people with psychiatric conditions in the United States today is staggering, but only half of these people will receive treatment for their condition. By effectively integrating psychiatric and primary health care patients can be connected to appropriate and necessary services that meet the Triple Aim of enhancing patient experience of care while achieving population health goals in a cost-effective manner. Incorporating integrated health care experiences in a DNP program can position future practice leaders to take on these challenges. Guided by DNP essentials and the National Organization of Nurse Practitioner Faculty competencies, integrated health care concepts were weaved across the DNP curriculum. Including robust academic experiences treating mental health conditions in primary care and integrated settings can increase the confidence and effectiveness of clinicians who identify, manage, and refer patients with mental health concerns. Increasing the number of doctorally prepared nurses who are educated in integrated health care helps improve clinical outcomes while transforming the health care landscape.

[Academisation of the Midwifery Profession (Part 2): Risks - and How they can Be Avoided as Best as Possible in the Degree Programs]. / Akademisierung des Hebammenberufs (Teil 2): Risiken ­ und wie sie in den Studiengängen bestmöglich vermieden werden können.

The full academisation of midwifery training, which thus far has been given in technical colleges, is now beginning in Germany and poses a great challenge for both the German federal states and the universities. Against this background, the aim of this article is to identify possible risks arising from the full academisation of training and the revision of the Midwifery Act and to show possible solution strategies to promote the implementation of study programmes.