Nurses Taking the Lead: A Look Back to Move Forward.

In recognition of the Year of the Nurse and Midwife, the 2020 annual conference of the Association for Leadership Science in Nursing (ALSN) celebrated A Look Back to Move Forward in recognition of the 50th anniversary of ALSN. The ALSN began as the Council of Graduate Education for Administrative Nursing (CGEAN) in 1970. Today, ALSN maintains the goals of shaping graduate education and research to inform nursing leadership practice.

Making explicit the development of PhD-prepared nurses to steward the discipline.

Leadership is a core curricular element of PhD programs in nursing. Our PhD faculty began a dialogue about being a leader, a steward of the discipline. We asked ourselves: (a) What expertise do PhD prepared nurse needs to begin to steward the discipline? (b) How do faculty engage PhD nursing students to assume responsibility for stewarding the discipline? Lastly, (c) How do we work with PhD nursing students to create their vision for how their work contributes to stewarding the discipline, from doctoral coursework throughout their career? We support the need for PhD graduates to have the skills to generate knowledge, conserve that which is important, and transform by disseminating new knowledge to a broad audience. Examples of nurses stewarding the discipline when pioneering research, critiquing traditional approaches to inquiry or trends in nursing practice, and developing policy, are highlighted along with examples of how PhD nursing students begin to steward the discipline.

Inconsistency in Faculty and Student Perceptions of DNP and PhD Leader Scholarly Activity.

OBJECTIVE: We aimed to quantify faculty and student perceptions of scholarly activities for doctor of nursing practice (DNP) and PhD leaders. BACKGROUND: The American Association of Colleges of Nursing describes DNP as a practice-focused degree and PhD as a research-focused degree. In 2016, the Council on Graduate Education for Administration in Nursing (now Association for Leadership Science in Nursing) published in the Journal of Nursing Administration sample practice objectives for DNP and research objectives for PhD leaders. METHODS: Using the published objectives, we surveyed faculty and students to quantify congruence with the publication and consistency within groups. The data informed intraprofessional education constructed using action research. RESULTS: There was low congruence between faculty and student responses with the article. PhD faculty had the least, and PhD students, the greatest, consistency in survey responses. CONCLUSIONS: Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.

Exploring telehealth in the graduate curriculum.

BACKGROUND: With an increase in patient demand and a decrease in healthcare professionals, telehealth is able to provide needed services to patients, but appropriate training in telehealth is crucial for providers to deliver excellent patient care. METHOD: Nurse researchers developed a quality improvement project targeting telehealth in the graduate nursing curriculum. A two-part evidence-based curriculum was developed for graduate family nurse practitioner (FNP) students. Part one consisted of a lecture that focused on increasing students' knowledge, and part two enhanced skills through simulation. RESULTS: Data were collected through qualitative and quantitative surveys. The qualitative data were analyzed for themes and statistical analysis of the quantitative data was completed (t-scores and descriptive statistics). Results showed that FNP students perceived the telehealth curriculum as educational and recommend it be continued for future FNP cohorts. CONCLUSION: Using evidence-based practice and telehealth experts graduate nursing programs should introduce the telehealth curriculum for FNP students through in class lecture and simulation.

An Assessment of Lesbian, Gay, Bisexual, and Transgender Health Competencies Among Bachelors-Prepared Registered Nurses in Graduate-Level Study.

PURPOSE: To assess graduate nursing students' lesbian, gay, bisexual, and transgender (LGBT)-specific health competencies. METHOD: Using a cross-sectional design, a 13-item multiple response survey, derived from The Joint Commission guidelines and LGBT health competencies proposed by the Association of American Medical Colleges, was administered online to 116 registered nurses enrolled in graduate study. Survey items assessed nurses' knowledge of LGBT health, professionalism, provision of patient care, communication skills, care environment, gaps in learning, and systems-based practice. Descriptive analyses were used to summarize frequencies and proportions of study variables. RESULTS: Respondent nurses' knowledge about health, prevalent conditions, and social factors that influence LGBT health was somewhat limited. Respondents did not rate their knowledge about LGBT health high (µ = 3.11 [1.1], median = 3) and did not feel qualified to educate other colleagues about LGBT health issues (µ = 2.43 [1.26], median = 2). But 58% (n = 65) indicated that they felt comfortable performing prostate exams on transgender female patients (born with male genitalia); 62% (n = 70) felt comfortable doing pap smears for transgender male patients (born with female genitalia). Sixty nurses (52%) stated that they would advocate reforms within existing health care institutions to improve the care of LGBT patients. Cultural competency training was offered in some health care settings and environmental indications of inclusivity were inconsistent. CONCLUSIONS: LGBT health competence among graduate nursing students was limited. There is a need to reevaluate LGBT health-related content in nursing curricula as well as robust assessment of competence in LGBT health.

DNP or PhD as a Credential for Nurse Faculty: Choices and Consequences.

With the inception of the Doctor of Nursing Practice (DNP) as the designated practice doctorate in nursing and ultimate acceptance of the DNP as a terminal degree in nursing by professional nursing organizations, questions have arisen about the implications for faculty appointment in the teaching-learning in nursing. Following a brief discussion of the background of the DNP and recent trends in academic nursing programs, a challenge is presented to nurse faculty and administrators to consider carefully the illuminated critical issues and concerns in planning for the future of teaching-learning in nursing.

Strategies for progression in a PhD nursing program within a transition model.

BACKGROUND: There is a need for interventions to improve the PhD pipeline for nursing program enrollment. PhD nursing students who have navigated the program successfully are in a strategic position to help by sharing their stories. Several strategies for successful completion of a PhD program and some common expected barriers have been documented in the literature. METHOD: The authors used personal reflections from their first and second years of study in a PhD nursing program to identify strategies to progress through a program. The personal reflections were analyzed by their student cohort and a faculty advisor using the Bridges' Transition Model as a theoretical framework. The cohort members included five females and one male, ages 29-48, attending a PhD nursing program in the Southeastern, US. RESULTS: The following strategies were identified from the personal reflections: seeking and offering support within your cohort; establishing a relationship with mentors; identifying and using a reference manager; mastering time management; soaking up statistics; and focusing on your focus. The strategies listed above occurred within the ending and/or neutral zone phases of the Bridges' Transition Model. CONCLUSION: It is important to note the early phases of transition and need for success strategies in these specific phases of transition. PhD nursing students are in a strategic position to positively influence the PhD pipeline by providing personal reflections that inform future PhD nursing students as well as PhD nursing programs.

Determining nurse practitioner core competencies using a Delphi approach.

BACKGROUND: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined. PURPOSE: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and the American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies (AACN, 2017a) because these documents are the competencies-accredited NP programs commonly used in curriculum development. The primary aim of this study was to refine and reduce redundancy of these competencies; a secondary aim was to ensure that the final competencies were clear and measurable. METHODS: A Delphi approach was used to reach consensus among an expert panel who reviewed the core competencies via an online questionnaire. Descriptive statistics were used to calculate median and interquartile ranges; content analysis was conducted with qualitative data. RESULTS: Consensus was reached after 3 rounds and resulted in 49 final core competencies. IMPLICATIONS FOR PRACTICE: This study provides the NP community with a manageable list of relevant, clear, and measurable competencies that faculty members can use to implement CBE in their programs.

Pleasure-suffering duality in stricto sensu graduate programs in nursing: between bridges and walls.

OBJECTIVES: to understand the pleasure-suffering duality experienced by students in stricto sensu Graduate Program in Nursing. METHODS: qualitative, integrated single-case study based on the Psychodynamics of Work. The setting was the stricto sensu Graduate Program in Nursing in Brazil. Two Graduate Programs were chosen. Data collection took place between May 2017 and April 2018, with 23 students, through interviews guided by semi-structured script and Documentary Analysis. Content Analysis was carried out. RESULTS: two analysis units emerged: Situations generating pleasure: bridges built by the Graduate Program and Situations generating suffering: walls of the Graduate Program. They were discussed in two dimensions - organizational and socio-professional relations. FINAL CONSIDERATIONS: the results can contribute to the planning of actions capable of potentiating the creation of "bridges" that lead to reach of pleasure in the Graduate Program. It impels the confrontation of suffering-generating situations for the student.

Conflicts Within the Discipline of Nursing: Is There a Looming Paradigm War?

This paper presents a view of the current sources of potential conflicts in the academic discipline of nursing. It suggests that these conflicts could lead, in the Kuhnian sense, to a paradigm war. The differing paradigms underlying the education and traditions of the PhD prepared nurse scientist/researcher/scholar and the DNP prepared nurse practitioner are a challenge for the discipline. DNP programs are swelling and faculty are needed to teach in these programs, and their position with regard to the usual rank and tenure structures of academe are not yet clear. Concern arises when the tenured PhD nurse scientist faculty numbers drop as the DNP faculty numbers increase. The body of nursing science is threatened as fewer students enter PhD programs and faculty retire. The DNP faculty paradigm does not provide for the rigor and preparation need to carry forward the disciplinary scientific knowledge mission. Rather than a fruitless war between the two paradigms, ways are suggested to fully embrace the differences as important to nursing, and to increase the number of PhD prepared nurse scientists.

Low-cost thoracentesis simulation for nurse practitioner students.

The fast-paced hospital setting is not routinely a conducive environment for practicing procedural skills. Simulation learning can provide an opportunity for learners to achieve accuracy, confidence, and competence when performing the thoracentesis procedure. The cost associated with many commercial-brand manikins and the additional supplies needed to teach thoracentesis is expensive. However, thoracentesis is a skill many nurse practitioners (NPs) need to learn. The use of a whole, unstuffed turkey purchased at a supermarket to simulate a thoracentesis is a way in which NP students can safely practice this skill. Nurse practitioner students perform assessment skills on another student, whereas students perform the thoracentesis procedure on this turkey carcass. Nurse educators can teach NP students to safely, accurately, and efficiently perform a thoracentesis procedure using a low-cost simulator. Nurse educators can teach NP students how to perform a thoracentesis using a turkey carcass at a relatively low cost with a high yield.

Integration of Informatics Content in Baccalaureate and Graduate Nursing Education: An Updated Status Report.

BACKGROUND: The American Association of Colleges of Nursing identified informatics and health care technology as an essential component of baccalaureate, master's, and doctoral education, but schools still struggle to effectively deliver this core knowledge. PURPOSE: The purpose of this study was to provide an update of the 2013 status report on the integration of informatics in nursing education. METHOD: The top twenty-five 2018 US News & World Report Best Online Nursing Programs were reviewed for courses with technology, computers, informatics, statistics, or research in the title. FINDINGS: Sixty-seven percent of the schools with master's programs and more than 80% of the DNP programs included at least 1 informatics course. Schools with online BSN courses had about the same number of programs with informatics courses as the 2013 report. CONCLUSION: While there was some improvement in the number of informatics courses in the programs reviewed, faculty need support to overcome barriers to teaching informatics.

Teaching Online Graduate Nursing Students Cultural Diversity From an Ethnic and Nonethnic Perspective.

Introduction: Nursing programs requiring a short-term cultural diversity immersion experience can impose financial, family, and work schedule hardships for graduate students. This study aimed to measure changes in cultural practice, awareness, sensitivity, and behaviors before and after completing an online cultural diversity course without travel. Methodology: A quasi-experimental pretest/posttest design collected data from a convenience sample of graduate nursing students (n = 37) enrolled in a 16-week online course using the Cultural Competency Assessment (CAS/CCB), Culturally Congruent Care for Advanced Nursing Course Objectives (CCCAN-CLO) and Teaching/Assignment Inventory tools. Results: There was a statistically significant increase in graduate nursing students' cultural competency postcourse scores: CAS, t(36) = -5.16, p < .001; CCB, t(36) = -5.42, p < .001; CCCAN-CLO, t(36) = -6.21, p < .001. Students identified conducting cultural interviews and online discussions as the most effective teaching strategies and assignments for learning cultural diversity content. Conclusion: Effective approaches for teaching graduate nursing students' cultural diversity for practice are available for online learners.