After the doctorate: a qualitative study investigating nursing research career development in Jordan

Career development of doctorally prepared nurses

AIM

To integrate research literature regarding careers, career development and factors influencing the career development of doctorally prepared nurses.

DESIGN

An integrative review.

DATA SOURCES

Medline, CINAHL and Embase were searched in June 2022 without time restrictions.

METHODS

Peer-reviewed empirical publications written in English with different types of study designs were included. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals using Joanna Briggs checklists. Data were extracted and analysed using a convergent integrated approach with thematic analysis. Themes were established within three categories based on the research questions: career, career development and factors influencing career development.

RESULTS

Twenty-two studies were included. Nine themes were identified. One theme regarding careers describes that doctorally prepared nurses need to prioritize work within different positions. The two themes focusing on career development described the need to determine career goals after the doctorate and further develop competencies. Six themes described factors influencing career development: 'Intrinsic motivation to improve health care and nursing education', 'Available support sources', 'Professional development programmes', 'Work-life balance', 'Organizational infrastructures for career advancement' and 'Competition and hostile treatment among colleagues'.

CONCLUSION

Limited knowledge of the careers and career development of doctorally prepared nurses was found. Doctorally prepared nurses need to balance work with various part-time positions. Careers and career development could be supported by the development of structures for career advancement as well as supportive working environments.

IMPACT

Doctorally prepared nurses with strong careers are important to health care and nursing as they generate and implement new knowledge into clinical practice and thereby support the improvement of (nursing) care and patient outcomes. This study provides considerations towards strengthening the careers of doctorally prepared nurses.

REPORTING METHOD

PRISMA.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Improved professional competencies and leadership in PhD-prepared nurses and doctoral students after participating in the cross-national and web-based Nurse-Lead program

BACKGROUND

Doctor of Philosophy (PhD)-prepared nurses are expected to exercise leadership in their various roles. Therefore, European nurse scholars developed a cross-national web-based Nursing Leadership and Mentoring Educational (Nurse-Lead) program.

PURPOSE

To evaluate changes in leadership practices, professional and research competencies as well as career development of PhD-prepared nurses and doctoral nursing students after participation in the Nurse-Lead program.

METHODS

A pre-post-test evaluation was conducted. Surveys addressed leadership, professional and research competencies, and career development. Quantitative data were analyzed with descriptive statistics and paired sample t-tests. Content analysis was used for qualitative data.

DISCUSSION

The 30 participants showed significant improvements in all leadership practices, professional competencies, and most research competencies. Participants reported increased confidence in decision-making, taking on new responsibilities, and becoming more visible within research teams.

CONCLUSION

Web-based, international leadership and mentoring programs are promising tools for the leadership and professional development of PhD-prepared nurses and doctoral nursing students.

The experiences of doctorally prepared nurses and doctoral nursing students with being mentored in the Nurse-Lead programme: A focus group study

AIM

to explore experiences of being mentored and the contribution of the mentoring to leadership and professional development of doctorally prepared nurses and doctoral nursing students participating in the Nurse-Lead programme.

BACKGROUND

Mentoring is considered important for career development of academic nurses. Doctorally prepared nurses need a wide range of professional competences to develop sustainable careers. Therefore, they may benefit from a larger network of mentors, outside their own organization, to support their professional development. Therefore, a web-based leadership and mentoring programme was developed - the Nurse Lead programme.

DESIGN

A descriptive study with semi-structured focus groups.

METHOD

Three focus groups were conducted during an on-site programme meeting in 2019 with twenty-one doctorally prepared nurses and doctoral nursing students. The interview guide included questions about mentoring relationships and meaning of mentoring for leadership and professional development. The interviews were thematically analysed.

RESULTS

Five themes were identified: "Preferred characteristics of mentors", "Developing trusting relationships", "Engagement of the mentors", "Becoming a proficient researcher and team leader" and "Becoming an empowered and confident professional".

CONCLUSION

Mentoring supported the leadership and professional development of doctorally prepared nurses and doctoral nursing students. Participants were engaged in rewarding mentoring trajectories. The results indicate that a similar approach could be followed when developing mentoring programmes in the future.

Leadership of PhD-prepared nurses working in hospitals and its influence on career development: A qualitative study

AIMS AND OBJECTIVES

To explore leadership experiences and the influence of leadership on career development of PhD-prepared nurses working in hospitals.

BACKGROUND

The Doctor of Philosophy (PhD) represents the highest level of education for a career in research and scholarship. PhD-prepared nurses have an important role in advancing the nursing discipline by conducting and implementing research finding. Given the rapidly changing health care environment, there is a clear need for PhD-prepared nurses with strong leadership competences. Currently, there is a dearth of studies exploring leadership of PhD-prepared nurses working in hospitals.

DESIGN

A descriptive qualitative study.

METHOD

A purposive sample with PhD-prepared nurses employed at clinical departments was used. Twelve interviews were conducted with participants from seven hospitals. Perceptions towards leadership, leadership experiences, leadership barriers and the influence of leadership on career development were discussed. Interviews were thematically analysed. Reporting followed the COREQ guidelines.

RESULTS

Three themes addressing leadership experiences were found: (1) "Leadership is needed for career development" describes how participants took initiative and received support from colleagues and mentors; (2) "Practicing leadership behaviours" describes leadership behaviours and feelings associated with leadership and (3) "Leadership influenced by the hospital setting" describes the working environment including struggling nursing research cultures and infrastructures with limited positions, managerial support and opportunities for collaboration.

CONCLUSION

Although participants showed leadership to advance their careers, barriers related to working environment were found. Stakeholders should invest into opportunities to develop and utilise leadership competences and development of strong nursing research cultures and infrastructures with sustainable career frameworks and positions.

RELEVANCE FOR CLINICAL PRACTICE

There is a need for ongoing efforts to build strong leadership competences as well as nursing research cultures and infrastructures with career pathways and suitable positions for PhD-prepared nurses within hospitals to empower them to strengthen nursing.

Bridging the gap between research and clinical care: strategies to increase staff awareness and engagement in clinical research

Background

Research active hospitals have better patient outcomes and improvements in healthcare are associated with greater staff engagement in research. However, barriers to research activity include inadequate knowledge/training and perceptions that research is a specialist activity. Nursing is an academic discipline but the infrastructure supporting nursing research worldwide is variable and sustaining clinical academic careers remains challenging. The National Institute of Health Research 70@70 Senior Nurse Research Leader programme provides dedicated time to increase clinical academic opportunities and foster a research culture across England; we describe initiatives developed by one National Institute of Health Research 70@70 leader to increase clinical staff engagement in research.

Aim

The purpose of this work was to develop initiatives to facilitate clinical research opportunities and bridge the gap between clinical care and research.

Methods

New strategies were developed in one health service to increase clinical staff engagement in research activity. This included: (a) Chief Nurse Research Fellows: clinical staff undertaking bespoke research training to identify local clinical research priorities, (b) an exemplar nurse-led Embedding Research In Care unit to pioneer innovation, evaluation and research participation supported by a research facilitator and (c) a Clinical Academic Network for nursing, midwifery and allied healthcare professionals to aid collaborative working.

Results

The first cohort of Chief Nurse Research Fellows have successfully completed a bespoke training programme and, with mentoring, developed projects to tackle clinical problems. The Embedding Research In Care unit initiative was configured and the first Embedding Research In Care unit has been awarded. A Clinical Academic Network group of 25+ nurses, midwives and allied health professionals was established and provides peer support and mentoring.

Conclusions

This multi-faceted approach has successfully supported research training/engagement, enabled career development and identified nurses/midwives with potential to undertake clinical academic careers. A range of strategies, such as those described in this paper, are required to successfully bridge the gap between clinical care and research and provide additional opportunities for clinical staff to become engaged in a research active career.

Developing leadership in postdoctoral nurses: A longitudinal mixed-methods study

BACKGROUND

Postdoctoral nurses have an important role in advancing nursing by generating knowledge and building networks in research, practice, and education which requires effective leadership. Therefore, the Leadership Mentoring in Nursing Research programme for postdoctoral nurses was developed.

PURPOSE

This study was to evaluate expectations, experiences, and perceived influence of the leadership mentoring programme on leadership and professional development, professional identity, and research productivity of postdoctoral nurses.

METHODS

A longitudinal mixed-method study with a concurrent triangulation design was used with data collected through semistructured interviews and online surveys.

FINDINGS

The leadership mentoring programme was found to be valuable by the participants who described strengthened leadership and professional development and development of professional identities. Participants showed increased research productivity and many moved to new/higher positions.

DISCUSSION

The leadership mentoring programme was found to enhance the leadership and professional development of postdoctoral nurses and support them in their academic careers.

Enablers and barriers to progressing a clinical academic career in nursing, midwifery and allied health professions: A cross-sectional survey

AIMS AND OBJECTIVES

This study aimed to understand the routes by which nurses, midwives and allied health professionals (NMAHPs) pursue and sustain a research career and the enablers and barriers to career progression.

BACKGROUND

Robust evidence is central to practice and professional decision making of NMAHPs, with generation and translation of research arguably best led by those clinically active. Whilst countries like the UK and USA have fellowship schemes to support research career development, anecdotal reports suggest barriers exist in translating these opportunities into sustainable clinical academic careers.

DESIGN

Online survey.

METHODS

An online questionnaire addressing career choices, facilitators/barriers and support was emailed to 1074 past applicants (doctoral and post-doctoral) to National Institute of Health Research fellowship schemes (awarded and rejected) in England between March and May 2017; 231 responded (25.6%). Study reporting adheres to STROBE checklist.

RESULTS

Overall, 134 doctoral and 96 post-doctoral applicants participated; two-thirds were from allied health professions. Most were early in their research career. Interest in research was most frequently sparked by interaction with people in research positions. Nearly half had their first research experience during their BSc project; though less often for nurses/midwives/health visitors (37.5%) than other NMAHPs (51.6%). The award of a fellowship resulted in higher likelihood of being research-active (doctoral level). Nearly three quarters pursuing a clinical academic career indicated 'clearer career paths' and 'greater integration across clinical and academic departments' were desirable. Most common barriers related to research roles, availability of positions and funding.

CONCLUSIONS

Fellowship schemes are important to NMAHPs' research careers, but there are serious challenges to establishing and sustaining a career.

RELEVANCE TO CLINICAL PRACTICE

Lack of a clear model of career progression, at national and local level, and barriers to creating joint posts impacts on capacity of clinical academics to strengthen integration of research with practice.

Embedding post-doctoral clinical academic careers in practice: The St Bartholomew's Hospital model

AIMS AND OBJECTIVES

In order to retain and develop pre-doctoral and doctoral staff, we sought to establish and implement a model for supporting postdoctoral clinical academic careers at our hospital.

BACKGROUND

Doctorally-prepared nurses can raise clinical practice standards, but there is a deficit of career opportunities and post-doctoral positions. This will inevitably impact delivering the evidence for improving patient outcomes and service delivery. It is therefore imperative that post-doctoral nursing and allied professional post-doctoral clinical academic career opportunities are developed and embedded in practice.

DESIGN

We describe the development and implementation of a model to provide and embed post-doctoral clinical academic roles at our hospital.

METHODS

A multidisciplinary group devised the model which was approved by the Hospital Executive Board.

RESULTS

The model includes having a bespoke plan for each individual, planning the post-doctoral role at time of PhD planning, providing 1 day a week protected research time for a minimum of 12 months after PhD completion, having an appropriate honorary academic contract at a partner University, and providing integrated clinical and academic supervision throughout. Other key components include senior clinical and Executive Board support and an existing vibrant research culture at our organisation.

CONCLUSIONS

The St Bartholomew's Hospital model, focusing on individualised posts integrating clinical and academic roles to address service needs, offers a novel approach to supporting post-doctoral clinical academic careers in a clinical setting.

RELEVANCE TO CLINICAL PRACTICE

Since doctorally-prepared nurses can raise clinical practice standards we developed a sustainable infrastructure to increase our postdoctoral nursing and allied professional workforce. This model could provide a framework for other hospitals to embed postdoctoral clinical academic careers in practice.

The Leadership Mentoring in Nursing Research Program for Postdoctoral Nurses: A Development Paper

PURPOSE

The Dutch Nursing Science Faculties developed the Leadership Mentoring in Nursing Research program, which aims to increase the cadre of nurse scientists, strengthen nursing research within universities, and improve the career development of postdoctoral nurses. The purpose of this article was to describe the development of the leadership and mentoring program to foster its replication and to present a formative program evaluation.

DESIGN

The leadership mentoring program was developed using a three-step procedure: a systematic review of the literature on successful leadership programs was conducted; theoretical underpinnings were identified and input; and feedback was solicited from national and international experts and changes made, resulting in the final program, which was executed from February 2016-2018.

FINDINGS

A 2-year leadership and mentoring program for postdoctoral nurses working in research was developed and executed. Ten fellows completed the program and worked on their leadership development, developed their own research programs, and established research collaborations. Formative evaluations showed that the fellows highly valued the program sessions. We have learned several key lessons on how to structure, implement, and evaluate the leadership and mentoring program.

CONCLUSIONS

Through the leadership and mentoring program, the fellows are immersed in concerted leadership development focusing on the academic leadership role. Formative evaluations showed that the program was valued by the fellows and that several key lessons were learned.

CLINICAL RELEVANCE

Through the leadership and mentoring program, 10 postdoctoral nurses strengthened their leadership in research and will further develop their role in healthcare research, clinical practice, and education.

Double nursing degree: potentialities and challenges of an international student academic experience

Objective To share the experience of a Double Nursing degree promoted between the Nursing School of the Universidade de São Paulo and the Health Sciences Institute of the Universidade Católica Portuguesa, reflecting on the potentialities and challenges of this opportunity for graduate students. Method This is an experience report presented in chronological order and of a descriptive nature. The double degree in Nursing was accomplished over a period of 6 months in a different institution from the institution of origin. Results Among the activities developed during the Double Degree are: participating in examining boards, congresses, seminars, courses, meetings, lectures, colloquium, classes, research groups and technical visits to health services. A table presents and describes the main benefits of the experience experienced by the authors. Conclusion When well-planned and well-developed, a double degree can promote personal, cultural and professional development of the students, favoring internationalization and contributing to the qualification of graduate programs.

"We're at a watershed": The positioning of PhD nurses in clinical practice

AIM

The aim of this study was to explore different perspectives on the positioning (i.e. the perceived rights and duties) of PhD nurses and how they contribute to clinical nursing practice.

BACKGROUND

The number of PhD nurses is growing worldwide, but we only have little knowledge of what is expected of PhD nurses and what their actual impact is in the clinic.

DESIGN

The findings of this article stem from a qualitative, explorative interview study.

METHODS

Semi-structured interviews were carried out with six PhD nurses, nine nurse colleagues and six clinical nurse leaders. Data collection took place from April - June 2016 in Central Denmark Region. Data were analysed using positioning theory.

FINDINGS

The PhD nurses were positioned as responsible for implementing evidence-based practice in the clinic and in nursing culture as such. Emphasis was put on the importance of PhD nurses staying close to the clinic to do practice-based research of immediate effect for patient care.

CONCLUSION

The study reveals several positive effects of PhD nurses in the clinic but also problematizes the many and diverse duties they are expected to carry out.

Developing nursing research in the United Arab Emirates: a narrative review

AIM

This article identified, critically analysed and synthesized the literature on international nursing and midwifery research capacity building and standards.

BACKGROUND

The United Arab Emirates is heavily dependent up on expatriate nurses. Only 4% of nurses working within the country are Emirati. The nation is therefore committed to developing nurses and nursing as a profession.

INTRODUCTION

The United Arab Emirates' Nursing and Midwifery Council was formed in 2009 and initially focused on regulation, education and specialization. This review was undertaken to inform the work of the Council's newly established Scientific Research Sub-Committee.

METHODS

A rapid narrative review was conducted using the Cumulative Index of Nursing and Allied Health Literature database, key words, Boolean operators, parameters and a journal-specific search. An inclusion/exclusion criterion was identified.

RESULTS

The search provided 332 articles with 45 included in the final review. The literature on nursing research 'standards' and 'capacity building' is diverse and inconsistent across continents and in approaches.

DISCUSSION

Nursing research has evolved to varying degrees across the globe. Nevertheless, irrespective of the locale, there are similar problems encountered in growing research, for example nursing faculty shortage, lack of collaborative research, funding. There are also specific challenges in the Middle East and North Africa region.

LIMITATIONS

The review was constrained by time and access.

CONCLUSION AND IMPLICATIONS FOR NURSING POLICY

There are specific challenges for the United Arab Emirates. However, the country is well placed to learn from the experiences of colleagues elsewhere. Time and commitment is required to build the solid foundations necessary to ensure robust, sustained growth. Identifying research capacity as both a process and outcome at the outset may also assist. Further, it may be prudent to consider initiating a Gulf Coast Countries' collaborative approach to building research capacity to harness scare resources and create a larger critical mass.

Leadership mentoring in nursing research, career development and scholarly productivity: A systematic review

BACKGROUND

Although nursing has been an academic discipline for decades, the infrastructure for nursing research in many countries is still fragile and struggling. Postdoctoral nurses have difficulties developing sustaining careers in nursing research due to lack of career opportunities. Considerable research has been conducted on leadership and mentoring in various areas of nursing. We aimed to systematically review the literature investigating leadership programs and mentoring for postdoctoral nurse researchers, as well as the influence of leadership and mentoring on research productivity, research career development, leadership knowledge and skills, the nurses' health and well-being, staff relationships, work culture and collaboration, salaries and postdoctoral nurses' experiences.

METHODS

A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted. The electronic databases PubMed, CINAHL and EMBASE were searched without time limits for eligible studies up to January 2016. Reference lists of included articles were also searched manually and authors were contacted to inquire about other relevant papers. Two authors independently assessed eligibility of studies for inclusion. Titles and abstracts were matched with the inclusion criteria: studies investigating leadership and mentoring programs for postdoctoral nurses and leadership and mentoring influencing research productivity, and career development; and leadership knowledge and skills and other outcomes. The quality of the studies was appraised using the Centre for Evidence-Based Medicine for surveys, the Critical Appraisal Skill Program Qualitative Appraisal Checklist for qualitative studies, and a critical appraisal list for mixed methods studies. Any disagreements were resolved by consensus. Data were extracted by two reviewers.

FINDINGS

We screened 1775 titles and abstracts, resulting in 15 studies, which included quantitative, descriptive, qualitative and mixed methods designs and involved 3855 postdoctoral nurses. Two studies presenting mentoring programs for postdoctoral nurses were identified. Other studies investigated the influence of mentoring on various outcomes. The findings showed a positive influence of mentoring on research productivity, including increase in publications and grant writing and research career development, improved leadership skills and knowledge. Furthermore, mentoring positively influenced nurses' health and well-being, staff relationships, work culture and collaboration. Postdoctoral nurses' experience of mentoring, mentorship, leadership and peer-support is essential in supporting ongoing research activity.

CONCLUSION

Although there is a lack of studies with robust designs investigating leadership and mentoring programs, our results document some evidence of mentoring's influence on research productivity, career development and other outcomes of postdoctoral nurses.