Bridging the Gap to Independent Scientist Career Trajectory In Nursing
In the USA, postdoctoral preparation has developed over the past approximately 100 years in response to the need for additional research training (American Association of Universities [AAU], 1998). The Johns Hopkins University initiated postdoctoral preparation shortly after its founding in 1876 and the Rockefeller Foundation established formal postdoctoral fellowships for recent PhD graduates in the physical sciences at the beginning of the twentieth century.
Postdoctoral preparation grew modestly in the first half of the last century, but increased rapidly in the 1970s. The US federal government has supported predoctoral and postdoctoral preparation for nurses since 1955 (Hinshaw and Lucas, 1993). Postdoctoral preparation in nursing has a history that parallels that of doctoral education, but beginning at a later time.
Until there was a critical body of nurses prepared at the doctoral level, there was not great demand for postdoctoral training opportunities. In nursing, the first doctoral programs were initiated at Teachers College, Columbia University, in 1933 and at New York University in 1934 (Fisher and Habermann, 2000). By 2003, there were approximately 273 doctoral programs in nursing across the world (INDEN, 2003).
It is difficult to ascertain the number of nurses in postdoctoral study from a national or international perspective. The number of postdoctoral fellows reported in the annual American Association of Colleges of Nursing survey was 66 for 2002, a decrease from 70 in 2001 (Berlin, Stennett and Bednash, 2002– 2003). Initially, mentors for postdoctoral opportunities for nurses primarily were in other related disciplines, such as psychology, sociology, physiology, public health and education.
As a cadre of active nursing researchers was established, postdoctoral training within the nursing discipline became viable. Doctoral study is an intense experience that provides students basic preparation in knowledge development through a variety of research and theory development approaches. Additionally, students need to develop in-depth knowledge within a specific content area. Ideally, doctoral study would prepare scholars who are ready to launch independent research programs (Wood, 2002).
USA and other parts of the world. The British/European model of doctoral education is structured as a research mentorship with minimal coursework. Within the latter model, the focus is on research with less emphasis on building a knowledge base for the discipline (McKenna, 2000). Within either model, the doctoral program merely provides the foundation for developing as an independent researcher.
The key to success relies on the postdoctoral fellowship. Although many individuals can succeed without this additional preparation, most people would benefit from the additional preparation (Wood, 2002). For some disciplines, such as biochemistry and physics, the postdoctoral fellowship ‘has become the de facto terminal academic credential’ (AAU, 2003, p. 1). Postdoctoral training helps consolidate the academic skills and scholarly habits needed to prepare for a postdoctoral fellow’s long-term career plans.
It is a period in which researchers develop a ‘specialized, focused area of both substantive content and methodological strategies’ (Hinshaw and Lucas, 1993, p. 309). A postdoctoral training period helps the scholar to launch his or her long-term research focus before taking up the demands of academic teaching, service and tenure (Paul, 2000) and establish the basis of the research program before taking up the demands of academic teaching and service , in addition to research. It should be designed to help a person develop skills and research expertise in a specific area (Lowe et al, 1991 as cited in Paul, 2000). In addition, tangible outcomes can include publications and preparation of a proposal that can be submitted for funding.
Career Trajectories of Doctorly Prepared Nurses
Similar to other disciplines, nurses who have completed their doctorate pursue a number of career options. Most doctorly prepared nurses take positions in research-intensive and teaching-intensive academic institutions. Although a large number of academic positions are tenure-track ones, a growing number of doctorly prepared nurses are choosing to move into non-tenure positions such as primary research scientist or lecturer positions.
Generally, they are in high demand, unlike a number of other disciplines and they often have multiple offers of positions. The current faculty shortage in the USA has exacerbated this situation and new PhD graduates as well as experienced doctorally prepared faculty are in even higher demand than previously. In addition to faculty positions these individuals often hold responsible positions in the government, consulting firms, healthcare service organizations, and/or a professional association (in both the government and private sector).
However, the majority of these individuals will work as faculty members at universities throughout the country and worldwide. Academic career pathways can vary across the world, but typically begin as a senior lecturer or assistant professor, advancing to associate professor and full professor. These positions are awarded depending on the applicant’s research, teaching, and publications. As faculty members, they teach in the undergraduate, Master’s and doctoral programs, as well as develop their own research programs.
In Thailand, some doctorly prepared nurses work at the Ministry of Public Health in the office of planning, policy and in the nursing department. They are involved in establishing health policies and developing the strategies needed to improve the quality of nursing care. The career pathways relate to the position classification beginning with C7 and going through C10. These positions will be awarded depending on the clinical research.
In the USA, doctorly prepared nurses are recruited into government positions at all levels and across agencies. At the state level, nurses are often employed in departments of public health to plan, implement, and evaluate intervention programs, and to work on health policy. At the national level, the National Institutes of Health employs a number of nurses in both extramural and intramural programs across its various institutes. Their positions range from managing clinical studies to directing and staffing the National Institute of Nursing Research.
Other federal agencies, such as the Centers for Disease Control, employ doctorly prepared nurses in research and policy positions. In the USA, clinical research positions for doctorly prepared nurses were developed in the 1980s and became fairly common. However, as hospitals, especially academic health centers where clinical nurse researchers were more likely to be employed, experienced financial difficulties, many of these positions were eliminated.
Still other doctorly prepared nurses hold a variety of positions in healthcare institutions, including research and administrative positions. A growing number of nurse scientists are elected to combine research and practice in clinical faculty positions. Individuals in these positions, usually nontenure track, are expected to generate support for their positions through clinical practice and research grants.
Further, they may have some teaching and research mentoring responsibilities. In contrast, clinical research positions are not offered in Thai hospitals. However, the job description of the clinical nursing specialist in each hospital provides a cue that they have to conduct clinical research.
Although doctorly prepared nurses are in high demand and have considerable choices in selecting job options, those who assume faculty positions in research-intensive academic institutions often find that they are relatively disadvantaged in establishing a program of research and meeting tenure criteria compared to colleagues who have had a postdoctoral experience.
Successfully attaining tenure at research-intensive institutions requires that within five to seven years faculty need to have established a program of research that is nationally and internationally recognized and preferably is externally funded. Research productivity must be accompanied by dissemination of scholarship results through publications and presentations. All this is to be done in addition to teaching and service activities. McGivern (2003, p. 60) cites Kohler (1990) as describing faculty ‘not as professional researchers but as teachers who fit research into the small spaces of their career’.
Doctorly prepared nurses employed in service settings find that they need a repertoire of skills to assist with research needs of the institution with varied foci and may have limited time to focus on their own research. Postdoctoral preparation is one option available to nurse researchers to establish a research program and solidify their research skills.
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