Case Studies Doctoral Education in Nursing Opportunities and Dynamics
The expectation for careers in academia and/or research is born out in one of the cases. The potential for conducting research and generating new knowledge, supervising the research work of others, and serving in leadership positions that contribute to senior management agendas is a realistic aspiration for the doctoral graduate. These career plans may be achieved through a range of avenues as unique opportunities become available. While the opportunities and the avenues of preparation will vary from country to country, the potential positions seem limited only by the interests and motivation of the doctorly prepared nurses.
Agenda for Doctoral Nursing Education
The issues and challenges in doctoral education in general, and nursing in particular, seem to have some universal themes. While the educational approaches and opportunities will vary in different educational and social systems , there appears to be a common agenda that could be addressed globally for the benefit of nursing and healthcare. The critical next steps offered for consideration are as follows:
1 Development of a global database for doctoral nursing education. While there is a comprehensive listing of nursing doctoral education programs internationally, developed and maintained by the International Network for Doctoral Education in Nursing (INDEN, 2003), there are very limited data available on the number of graduates produced by these programs, the variety of curricular approaches employed, and the types of positions that graduates fulfill.
Data on the number of graduates and their post-graduation positions vary considerably throughout the international community. These types of data are essential for development of an evidence-based approach to assessing how well these programs are doing in preparing graduates for their professional roles and responsibilities.
Such a database would provide opportunities for cross-national comparisons of programs and assessments of their effectiveness in preparing graduates for various roles. It would assist in examining the success of these programs as well as the attrition they experience, the costs and benefits to society and the healthcare systems that depend on these graduates. It would also provide an opportunity for assessing the perspectives of stakeholders, including the graduates themselves.
2 Infuse current nursing doctoral curricula with recommendations already available about doctoral education. As discussed previously, a number of core competencies have already been identified as essential for today’s doctoral graduate. These include the types of knowledge and skills for doctorly prepared individuals to function effectively in a variety of organizational contexts across the spectrum of educational, governmental and corporate settings.
The competencies identified by the Re-envisioning the PhD Project are applicable to all disciplines, including nursing. An excellent example is found at the Graduate School at the University of Texas. This institution offers a series of cross-disciplinary seminars for students in all disciplines throughout their doctoral programs around the theme of ‘intellectual entrepreneurship.
These interdisciplinary learning experiences teach students how to take risks, seize opportunities, discover knowledge through research questions that have direct relevance to pressing problems people face in their social milieu, use innovative strategies to solve complex problems in diverse social realms, collaborate and assume roles as citizen-scholars.
Other topics include social ethics, issues related to technology, and integrity in leadership roles (Cherwitz and Sullivan, 2002). All doctoral students, including those in nursing, would benefit from this kind of learning as they also acquire discipline-specific competencies and methods.
3 Development of global partnerships in nursing education. Collaborative efforts among nursing doctoral programs through the development of partnerships would provide powerful learning opportunities in this rapidly changing environment.
Doctoral education is in various stages of development in different countries and learning from each other’s successes and failures would be efficient and cost-effective. Some of these partnerships and collaborative models have already begun for curricular and mentoring purposes and these could be replicated and expanded. Their experiences can inform others at earlier stages of development.
Little seems to be known about how effective programs are in preparing graduates for their future roles, particularly in the international community (Carty et al, 2002). Since all social systems are challenged today to provide quality services in an environment of diminishing resources, partnerships can provide a mechanism for dialogue and strategic initiatives to address the needed competencies for doctoral nursing graduates today.
Case Study Profiles of Doctorly Prepared Nurses
Example 1
After completing a Diploma of Nursing in her own country in 1988 Graduate 1 was employed as a registered nurse in an emergency department and a medical ward for two years and then as a school nurse in a rural area for one year, before applying to undertake a Bachelor of Health Science in Nursing conversion program in Australia. After graduating with this degree, she enrolled in Master of Nursing by research at the same Australian university. As an overseas nurse she underwent an accreditation process in Australia so that she could practice part time while completing her studies.
She found employment as an overseas student assistant in the university’s international student office during the next two years. She then returned to her own country and worked for two years as a lecturer in emergency medicine and emergency care skills at a health college. However, her ultimate goal was to obtain a PhD in the field of mental health nursing because of her interest in nurse-patient-family interaction. It was also an expectation in her country that an academic career required doctoral level preparation.
She accepted the offer of an Australian university PhD scholarship in 1998 and undertook a naturalistic inquiry of the relationships between family caregivers of people with a mental illness and community mental health nurses. Her supervisors encouraged her to publish and present at conferences during the candidature, which assisted in obtaining a research position prior to graduating.
During the candidature she worked as a part-time tutor of nursing students in the faculty and also as a workshop facilitator in problem-based learning within a dedicated problem-based learning center at the university. Developing these skills provided opportunities to facilitate workshops in this approach to learning in her home county and in Australia, and to assist student learning through translation support. She was awarded the degree in 2002.
Having observed the breadth of research potential in Australia, available only through a long period of apprenticeship in her own country, she decided to seek permanent residency in Australia and establish herself as a researcher. She has held a full-time research position in a health service-based research unit since 2001 and is a research associate with a linked university.
These positions provide broad-ranging opportunities to conduct research in the field of aged care, coordinate and manage multidisciplinary research projects, mentor research students and health staff in research, contribute to health service planning and policy development, and network with health staff, consumers and researchers in this specialty field.
While the PhD provided her with the necessary knowledge and skills to undertake in-depth qualitative research, this position has offered new opportunities for a wide range of research processes and areas of inquiry through mentoring. She received a research award within the first year of taking up this position and has been successful in achieving research grants and publications.
The PhD, combined with her research training in this new position, provides her with a possible future in the university sector, in a range of health organizations, government departments or in the field of health policy and planning in the nongovernment sector. Whatever opportunities present, she will have the necessary background for success.
Example # 2
After completing an undergraduate degree in business administration at a university in the USA in 1988, Nurse 2 worked for a large management consulting firm. He has assisted organizations in the human services industry to find more efficient ways to design and deliver their services in the challenged economic environment. As organizations were rapidly downsizing, these consultations were intended to increase efficiency without compromising the quality or quantity of services provided.
As he worked across these organizations, he became increasingly interested in the pressing human needs these organizations were struggling with and decided that he, too, wanted to be more involved in the direct delivery of meeting these pressing social needs, In 1995, he enrolled in an accelerated baccalaureate nursing program which recognized his previous university education and his background in the business world.
The curriculum provided nursing preparation in 14 months, focusing only on the courses needed for professional nursing practice and not requiring any repetition of previous coursework he had completed. Upon graduation he worked in a critical care unit for two years in a large academic health center . Experiencing the major issues that nurses faced in hospital-based practice, he yearned to apply his previous management skills in ways that could redesign nursing practice and deliver services of better quality and efficiency.
I have decided to enroll in a post-baccalaureate doctoral program in nursing that emphasized nursing systems administration and research. He completed the program in 2000 and worked for a large healthcare consulting firm that focused on quality improvement and evidence-based practice in the delivery of healthcare services. In 2003, he left that organization and developed his own consulting firm.
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