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Significance of the Study – Examples and Writing Guide

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The significance of the study is a crucial section in research that explains the relevance and importance of the research topic. It outlines how the study contributes to the existing body of knowledge, benefits stakeholders, and addresses real-world problems. Writing a clear and compelling significance of the study ensures that readers and evaluators understand the value of your research.

This article provides examples, practical tips, and a step-by-step guide to effectively write the significance of the study.

Significance of the Study

The significance of the study is a brief section that highlights:

• Theoretical Contributions: How the study advances knowledge in the field.
• Practical Applications: The real-world implications and uses of the research findings.
• Beneficiaries: Who will benefit from the study (e.g., students, professionals, policymakers).

Example: In a study about mental health among teenagers, the significance might include providing data to improve school counseling services and contributing to mental health policy reforms.

Why is the Significance of the Study Important?

• Highlights Relevance: Demonstrates why the research is worth conducting.
• Engages Stakeholders: Attracts interest from those who can benefit from the findings.
• Enhances Credibility: Shows the study’s alignment with academic and practical needs.
• Guides Future Research: Lays the groundwork for further investigations.

How to Write the Significance of the Study

Follow these steps to craft an impactful significance of the study:

1. Identify the Research Problem

• Clearly state the issue your research addresses.
• Explain why this problem is important.
• Example: “Teenage mental health issues are increasing, yet many schools lack adequate counseling resources.”

2. Highlight the Research Gap

• Point out what is missing in the existing literature.
• Describe how your study fills this gap.
• Example: “While studies focus on adult mental health, there is limited research on school-based interventions for teenagers.”

3. Specify Contributions to Knowledge

• Explain how your findings will advance theoretical or academic understanding.
• Example: “This study provides new insights into the correlation between academic pressure and anxiety among teenagers.”

4. Explain Practical Applications

• Detail how the research findings can be applied in real-world settings.
• Example: “Findings will help schools develop effective counseling programs tailored to teenage needs.”

5. Identify Beneficiaries

• Highlight who will benefit from the study and how.
• Example: “Educators, mental health professionals, and policymakers can use this research to improve support systems for students.”

6. Use Clear and Concise Language

• Write in a straightforward manner to ensure accessibility to a broad audience.
• Avoid jargon or overly technical terms.

Examples of the Significance of the Study

Example 1: education research.

Title: The Impact of Digital Tools on Student Engagement in Online Learning Significance of the Study: This research aims to address the gap in understanding how digital tools influence student engagement in online learning environments. It contributes to the growing field of educational technology by identifying effective strategies for integrating digital tools in virtual classrooms. The findings will benefit educators, administrators, and policymakers by providing actionable insights to improve online learning experiences, especially in post-pandemic education systems.

Example 2: Healthcare Research

Title: Assessing the Effectiveness of Telemedicine in Rural Healthcare Delivery Significance of the Study: This study is significant as it evaluates the role of telemedicine in improving healthcare access in rural areas, where traditional healthcare services are often limited. By analyzing patient satisfaction and health outcomes, the research contributes to the growing body of evidence supporting telemedicine as a viable healthcare model. The findings will guide healthcare providers and policymakers in developing effective telehealth programs, reducing healthcare disparities in underserved communities.

Example 3: Environmental Science

Title: The Role of Urban Green Spaces in Reducing Air Pollution Significance of the Study: The study addresses the increasing issue of urban air pollution by investigating the effectiveness of green spaces in mitigating air quality problems. It bridges the gap in literature regarding the specific types of vegetation most effective at capturing pollutants. The findings will aid urban planners, environmental policymakers, and community organizations in designing greener cities, contributing to public health and environmental sustainability.

Tips for Writing an Effective Significance of the Study

• Understand Your Audience: Tailor the content to address the interests of academic and practical stakeholders.
• Focus on Impact: Emphasize how your research makes a difference, whether in advancing theory or solving practical problems.
• Be Specific: Avoid vague statements and provide concrete details about your contributions.
• Align with Objectives: Ensure the significance aligns with your research goals and questions.
• Use Realistic Claims: Avoid exaggerating the potential impact of your research.

Common Mistakes to Avoid

• Being Too General: Failing to specify contributions or beneficiaries reduces credibility.
• Overemphasis on Limitations: While acknowledging limitations is important, the significance section should focus on the study’s strengths.
• Using Technical Jargon: Make sure the section is understandable even to non-specialists.
• Ignoring Practical Relevance: Highlight how the findings can be applied, not just theoretical contributions.

Sample Template for Writing the Significance of the Study

Here’s a structured template to guide your writing:

1. Introduction:

• Briefly state the research topic and problem.
• Highlight its importance or urgency.

2. Research Gap:

• Explain what is missing in the existing literature.

3. Theoretical Contributions:

• Describe how the study advances knowledge or understanding in the field.

4. Practical Applications:

• Detail how findings will be applied in real-world scenarios.

5. Beneficiaries:

• Identify specific groups or individuals who will benefit from the research.

The significance of the study is a vital component of any research paper or thesis, as it communicates the value and impact of the work. By clearly outlining its theoretical contributions, practical applications, and potential beneficiaries, researchers can effectively justify the relevance of their study. Following a structured approach ensures that this section is compelling and aligns with the broader research objectives.

• Creswell, J. W. (2018). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches . Sage Publications.
• Kumar, R. (2019). Research Methodology: A Step-by-Step Guide for Beginners . Sage Publications.
• Punch, K. F. (2014). Introduction to Social Research: Quantitative and Qualitative Approaches . Sage Publications.
• Bryman, A. (2015). Social Research Methods . Oxford University Press.
• Bell, J., & Waters, S. (2018). Doing Your Research Project: A Guide for First-Time Researchers . McGraw-Hill Education.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Research education and training for nurses and allied health professionals: a systematic scoping review

Olivia king, kristen glenister, claire quilliam, anna wong shee, hannah beks.

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Received 2021 Oct 14; Accepted 2022 Apr 22; Collection date 2022.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Research capacity building (RCB) initiatives have gained steady momentum in health settings across the globe to reduce the gap between research evidence and health practice and policy. RCB strategies are typically multidimensional, comprising several initiatives targeted at different levels within health organisations. Research education and training is a mainstay strategy targeted at the individual level and yet, the evidence for research education in health settings is unclear. This review scopes the literature on research education programs for nurses and allied health professionals, delivered and evaluated in healthcare settings in high-income countries.

The review was conducted systematically in accordance with the Joanna Briggs Institute scoping review methodology. Eleven academic databases and numerous grey literature platforms were searched. Data were extracted from the included full texts in accordance with the aims of the scoping review. A narrative approach was used to synthesise findings. Program characteristics, approaches to program evaluation and the outcomes reported were extracted and summarised.

Database searches for peer-reviewed and grey literature yielded 12,457 unique records. Following abstract and title screening, 207 full texts were reviewed. Of these, 60 records were included. Nine additional records were identified on forward and backward citation searching for the included records, resulting in a total of 69 papers describing 68 research education programs.

Research education programs were implemented in fourteen different high-income countries over five decades. Programs were multifaceted, often encompassed experiential learning, with half including a mentoring component. Outcome measures largely reflected lower levels of Barr and colleagues’ modified Kirkpatrick educational outcomes typology (e.g., satisfaction, improved research knowledge and confidence), with few evaluated objectively using traditional research milestones (e.g., protocol completion, manuscript preparation, poster, conference presentation). Few programs were evaluated using organisational and practice outcomes. Overall, evaluation methods were poorly described.

Research education remains a key strategy to build research capacity for nurses and allied health professionals working in healthcare settings. Evaluation of research education programs needs to be rigorous and, although targeted at the individual, must consider longer-term and broader organisation-level outcomes and impacts. Examining this is critical to improving clinician-led health research and the translation of research into clinical practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-022-03406-7.

Keywords: Research education, Research capacity building, Evidence-based practice, Health settings

Introduction

The translation of research evidence into health practice and policy relies on healthcare organisations and systems having sufficient research capacity and capability [ 1 – 3 ]. Health organisation executives and policymakers globally, recognise the need to invest in research capacity building (RCB) initiatives and interventions that are delivered in healthcare settings [ 2 – 4 ]. RCB strategies encompass a range of initiatives designed to promote individual, team and organisation research skills, competence and to influence attitudes towards research [ 2 , 5 – 7 ]. Initiatives designed to build individual and organisational research capacity may include education and training programs, funding for embedded researchers (e.g., fellowships, scholarships) and other research support roles (e.g., research librarians, knowledge-brokers), strategic collaborations with academic partners and developing research infrastructure [ 2 , 6 , 8 ]. RCB strategies often comprise a combination of the aforementioned approaches [ 8 ] and notably, research education and training programs are a sustaining feature of many [ 2 , 3 , 6 , 8 – 11 ]. This is likely related to the insufficient coverage of research in undergraduate health curricula and the need for supplementary education to fill research knowledge and skill gaps, particularly for non-medically trained healthcare professionals. Medically trained healthcare professionals typically have a greater inclination toward and engagement in research than their nurse and allied health counterparts [ 4 , 8 , 12 , 13 ]. Given that nursing and allied health form the majority of the health workforce [ 14 , 15 ], there is increasing interest in RCB strategies that target nurses and allied health professionals to enhance the delivery of evidence-informed care across all healthcare settings and services [ 8 , 16 – 18 ]. Allied health comprises a range of autonomous healthcare professions including physiotherapy, social work, podiatry, and occupational therapy [ 16 ].

This review was commissioned by an academic health science centre in Australia, to inform the research education and training component of its health organisation RCB strategy. Given the typically multidimensional nature of RCB strategies, their functions and impacts at the various levels are inextricably related [ 2 , 5 ]. This makes the discernment between research education and training interventions and other elements of strategies a fraught endeavour. For example, embedded researchers may form part of a broader organisational RCB strategy, and in the scope of their work, may perform an ad hoc education function (e.g., through their interactions with novice researchers) [ 11 , 19 ]. Aligning with the purpose of this work, this review defines research education and training programs as organised initiatives or interventions that are either discrete (e.g., standalone workshops or research days) or longer in their duration (e.g., research courses or a series of workshops or lectures) wherein curriculum is developed and shared with multiple individuals or participants, with a view to develop and apply research skills [ 2 , 5 ]. Healthcare settings are considered those wherein the provision of healthcare is considered core business (e.g., hospitals, community-based health services, cancer care services, family medicine clinics) and is therefore the setting in which research evidence needs to be applied or translated to reduce the gap between research knowledge and practice [ 2 , 20 ].

An initial search of Cochrane Database of Systematic Reviews, Joanna Briggs Institute’s Evidence Synthesis, PROSPERO, and Google Scholar for reviews of research education and training programs delivered in health settings, yielded no existing or planned reviews. On further cursory review of the RCB and research education literature, and concomitant discussions with four content experts (i.e., educators, academic and clinician researchers concerned with research capacity building), it became apparent that research education programs take different forms, occur in pockets within health organisations across health districts and regions, are not always formally evaluated, and often fail to account for adult learning principles and theories. The decision to conduct a scoping review, rather than a conventional systematic review, was based on three key factors: 1) the heterogeneity evident in research education program characteristics; 2) the absence of an existing synthesis of evidence for research education programs delivered in health settings [ 5 ]; and 3) the need to identify the gaps in knowledge about these programs.

This systematic scoping review sought to scope the research education and training programs delivered to nurses and allied health professionals working in health settings and the evidence supporting these approaches. The specific review objectives were to describe the:

Types of research education programs delivered in health settings in high-income countries

Theoretical or pedagogical principles that underly the programs

Approaches to research education program evaluation

Types of outcomes reported

This review used the Joanna Briggs Institute’s (JBI) scoping review methodology. As per the JBI methodology, search terms were developed for Population, Concept and Context (PCC). The review question, objectives, inclusion/exclusion criteria and search strategies were developed and documented in advance (Additional File  1 Scoping Review Protocol). The review is reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews (Additional File  2 PRISMA-ScR checklist [ 21 ]).

Search strategy

The researchers identified a set of key papers based on their knowledge of contemporary research education programs and in consultation with four content experts from two high-income countries. They used these papers to identify the key search terms. In consultation with the research librarians (SH and HS, see acknowledgements), the research team conducted preliminary scoping searches to test the search terms and strategy (between 3 March – 10 March 2022). These searches informed decisions about final search terms. A tailored search strategy was developed for each academic database (Additional file  3 Search Strategy).

Academic databases searched included PubMed, Ovid MEDLINE, Embase, CINAHL, VOCEDPlus, PEDro, Scopus, ERIC, Informit Health Database, JBI, and Google Scholar. Selected grey literature platforms as determined by our knowledge of relevant websites and organisations, were searched. Where larger search yields were observed (e.g., via Google and Google Scholar), the first 250 items were reviewed, only (Additional file  4 Grey literature search). The final research database searches were conducted between 12 and 15 March 2022 by a researcher with extensive systematic literature searching experience (Author 2) in consultation with a research librarian. Grey literature searches were conducted on 17 March 2022. Searches of the reference lists of included records and forward citation searches were undertaken.

Inclusion criteria and exclusion criteria

Literature was selected according to defined inclusion and exclusion criteria developed using the PCC framework (see Table  1 ). Research education or capacity building programs delivered to qualified health professionals, working in health settings (excluding programs delivered as part of tertiary study) in high-income countries (HIC) as defined by the Organisation for Economic Co-operation and Development (OECD), were included [ 22 ]. The decision to include studies published in HICs only was made with a view to introduce a level of homogeneity around the broader resource contexts of the study populations [ 23 , 24 ]. No date limits applied, and all types of literature published up to 17 March 2022 were included. Literature published in English only was included, due to resource limitations.

Inclusion and exclusion criteria

a Health professionals were not limited to those that are accredited or registered, but rather included any health worker that was situated in a healthcare setting

b Evaluation was considered if there was an informal or formal approach to measuring and describing the outcomes and/or impacts of the program, to determine whether it met its objectives

Study selection, quality appraisal and data extraction

Citations were imported into Covidence (Veritas Health Innovation, Melbourne, Australia) for screening. Titles and abstracts were independently screened by two reviewers initially, with conflicts resolved by a third (independent) reviewer. Similarly, full texts were reviewed by two researchers and the reasons for exclusion were noted (Additional file  5 Excluded studies). Data was extracted from the included texts by five researchers. Formal quality appraisal is not typically undertaken as part of scoping review methodology and was not undertaken for the papers included in this review [ 25 ].

Data extracted were tabulated and results were synthesized using a descriptive approach guided by the review objectives as per a scoping review methodology. Outcomes measured and reported in the papers were mapped to the modified Kirkpatrick’s educational outcomes typology [ 26 , 27 ]. Recognising the complex interactions between individuals, research education programs, organisational and other factors, and the various outcomes produced [ 2 ], the modified Kirkpatrick’s typology gives rise to the identification of outcome measures at multiple levels or within these inter-related domains [ 26 ].

Of the 207 citations considered for full text screening, 60 met the inclusion criteria and nine additional papers were located through a citation search of the initial set (Fig.  1 PRISMA Flow Diagram) [ 28 ].

PRISMA Flow Diagram

Research education program characteristics

When, where and to whom research education programs were delivered

A total of 69 papers, describing 68 research education and training programs were reviewed. The implementation of the programs spanned five decades, with almost half ( n =  33) implemented in the most recent decade. Research education programs were delivered in the United States of America ( n =  22), Australia ( n =  20), the United Kingdom ( n =  9), Canada ( n =  5), Denmark ( n =  2), Qatar ( n =  2), and one each in Argentina, Finland, Japan, Italy, Singapore, Sweden, Spain, and The Netherlands. The geographical distribution of programs by country is presented in Fig.  2 . Research education programs were targeted and delivered to different healthcare professional groups. Programs were delivered most frequently to nurses and midwives ( n =  35), then mixed professional groups ( n =  18), allied health ( n =  13), and pharmacists ( n =  2). The characteristics of included programs are provided in Table  2 .

Geographical distribution of research education programs. This image was generated by the authors via Microsoft Excel using the Map function

a PEAK program is described in [ 72 ] and the evaluation is reported in linked paper [ 102 ]

How research education programs were formatted and delivered

Research education programs were delivered in several different formats and over different types of durations. Some were delivered as standalone single study days, workshops or sessions [ 29 – 34 ], and others as a series of several short sessions or workshops [ 35 – 45 ]. The majority of papers described integrated research education courses of either a short duration, (i.e., one to 4 months) [ 46 – 65 ], medium duration (i.e., five to 11 months) [ 9 , 66 – 76 ], or longer-duration (i.e., 1 year or longer) [ 77 – 94 ].

Programs almost always included a didactic element (e.g., lectures, seminars), delivered by an experienced academic or clinician-researcher (researcher with a primary healthcare qualification; [ 95 ]) or an individual with content expertise (e.g., biostatistician [ 48 ], librarian [ 33 , 57 , 66 ], ethics committee member [ 57 ] or data manager [ 42 ]). Most of the programs were multifaceted and included a mix of didactic teaching as well as either group discussion, online teaching (e.g., teleconferences or modules), or the practical application of theoretical principles between education sessions. Several were described as single mode research education programs (e.g., seminars, lectures, or online modules only) [ 29 – 31 , 33 , 37 – 39 , 46 , 48 , 49 , 53 – 55 , 87 ]. Timing was described as an important consideration in several papers, with an emphasis on minimising impact on participants’ working day or clinical duties. For example, by holding sessions early (8 am) prior to the working day [ 9 , 51 ] or on weekends [ 32 , 63 , 71 ].

Features and content of research education programs

The curricula or research education content described in the papers reflected the aims of the programs. Program aims were broadly categorised according to the level of intended participants’ research engagement: research use or consumption ( n =  28) and research activity ( n =  31) [ 96 ]. Where the program content focused on searching, retrieving, and appraising research literature, and considering in the context of clinical practice (i.e., evidence-based practice), this was considered engagement at the research user or consumer level. Slightly more programs were concerned with developing research skills to engage in and conduct research activity. These programs included content related to research methods, data collection and analysis techniques, protocol development and ethics application [ 31 , 35 , 37 , 39 , 42 , 43 , 48 , 49 , 52 , 53 , 57 , 59 , 63 , 64 , 67 , 68 , 73 , 77 – 85 , 90 – 92 ]. Seven programs were orientated toward developing participants’ skills for research dissemination, typically writing for publication [ 9 , 32 , 33 , 47 , 51 , 74 ] or preparing research posters and seminars [ 88 ]. It was assumed that the participants in the programs concerned with writing for publication had already undertaken a research activity and needed further education and support to formally disseminate their findings. Two programs were specifically focused on developing participants’ skills to complete a systematic review [ 46 , 76 ]. Three programs included content directly related to implementing research in practice [ 60 , 80 , 86 ].

Fourteen programs required that participants had overt support from their manager to participate (e.g., written approval or direct selection of participants) [ 46 , 51 , 58 , 62 , 75 , 79 – 81 , 83 , 85 , 91 – 94 ]. Two papers described participants’ departments being actively supportive of their participation in the research education program [ 59 , 86 ]. One paper referred to managers’ positive role modelling by engaging in the research education program [ 39 ] and another described the criteria used to determine the suitability of participants based on their context (i.e., supportive managers who were interested in research and willing to release participating staff for half day each week) [ 88 ]. Five papers described manager or leadership support as being a key enabler to participants engaging in the education program [ 56 , 60 , 75 , 89 , 91 ] and four papers referred explicitly to the lack of organisational, managerial, or collegial support as key limitations to, or a negative influence on participants’ learning experience [ 49 , 77 , 84 , 88 ].

Nine papers described the integration of opportunities to acknowledge the achievements of program participants. Opportunities were described as formal events held at the conclusion of the program to celebrate the participants’ completion [ 58 , 66 , 80 , 83 ], recognition via staff communications or at an organisation-wide event [ 37 ], opening participants’ project presentations to a wider healthcare organisation audience [ 92 ], or by managers providing opportunities for participating staff to present their work to colleagues [ 81 , 82 ]. One program included the acknowledgment of contact hours for nurse participants to attain continuing professional development points for their professional registration [ 54 ] and another referred to participants’ “recognition and exposure” within and beyond their organisation, as a participant-reported benefit (46, e–145).

Theories and pedagogical principles

Understanding how people learn effectively is fundamental to the design of any educational program. Thus, the second aim of this review was to determine what pedagogies (teaching methods) were employed for adult learners undertaking research education and training. Few of the studies ( n =  13) included in this review explicitly stated which pedagogical strategies informed the design and delivery of the education programs. However, where possible we extracted pedagogical strategies that appear to be present (see Table 2 ).

Education programs generally included a mix of active and passive learning strategies. Active learning can be defined as an activity which engages students as participants in the learning process whereas with passive learning, students receive information from the instructor but have little active involvement [ 97 ]. Passive forms of learning or didactic approaches that were employed included seminars, lectures, reading, and exams. Five programs were described with respect to the didactic learning component only, with no reference or implication of any underlying pedagogy or learning theory [ 39 , 45 , 48 , 49 , 53 ].

Commonly, education programs included some form of experiential learning. Experiential learning, or “learning by doing” is a type of active learning whereby students apply knowledge to real-world situations and then reflect on the process and experience [ 98 ]. Examples of experiential learning described in the education programs include simulations, role-play, preparation of research protocols, grant proposals, manuscripts, and appraisal of research. Lack of experiential learning, or “practical experience”, was described as a limitation in one paper [ 38 ]. Quizzes were utilised in two programs [ 42 , 66 ] to reinforce participants’ learning.

Social cognitive theories of learning, such as self-efficacy theory [ 99 ], were explicitly mentioned in seven studies [ 31 , 47 , 54 , 56 , 61 , 71 , 72 ]. Self-efficacy theory posits that a person’s belief in their capabilities provide the foundation for performance and accomplishment. If a person has low self-efficacy (little belief in their capabilities) and fear related to the task at hand, they will likely avoid that task for fear of failure. Education programs using a self-efficacy framework focused on increasing participants self-efficacy through coaching, support, social modelling, and mastery experiences. Five studies referred to Roger’s Diffusion of Innovation theory [ 37 , 50 , 60 , 68 , 71 ], which posits that identifying and working with highly motivated individuals is an efficient way to promote the adoption of new behaviours and practices more widely [ 8 ].

Two studies were informed by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model which is based on cognitive-behavioural theory and control theory, and therefore designed to address barriers to desired behaviours and practice [ 65 , 100 ]. Other programs described drew on the transtheoretical model of organisational change [ 62 ], Donald Ely’s conditions for change [ 37 ], the knowledge to action framework [ 52 ] and the Promoting Action on Research Implementation in Health Services (PARiHS) Framework [ 72 ].

Mentoring was a feature of more than half of the programs ( n =  37). This is where novice researchers were paired with an experienced researcher, typically to support their application and practice of the knowledge gleaned through their education or training [ 101 ]. In three papers describing programs that did not include mentoring, this was identified as a critical element for future research education programs [ 37 , 78 , 92 ]. Several evaluations of programs that included mentoring illustrated that it was required throughout the life of the program and beyond [ 9 , 32 , 67 , 68 , 73 , 81 , 84 ]. Harding et al. [ 46 ] found that mentors as well as mentees, benefited from the research education program, in terms of their own learning and motivation.

Social theories of learning, or collaborative learning approaches, were also frequently utilised ( n =  40). Collaborative learning approaches are based on the notion that learning is a social activity at its core, shaped by context and community. Such approaches promote socialisation and require learners to collaborate as a group to solve problems, complete tasks, or understand new concepts. Collaborative approaches utilised included journal clubs [ 38 , 50 , 54 , 69 , 70 , 87 ], writing groups [ 32 , 51 ], classroom discussions [ 33 , 36 , 72 , 76 , 80 , 94 ], interactive group workshops or activities [ 29 , 31 , 46 , 47 , 56 , 75 , 82 , 84 , 86 , 93 ], and development of team research projects [ 78 , 79 ]. These approaches were often reported to enhance cultural support with participants networking, sharing resources, and celebrating successes together. One program employed a self-guided learning approach through the use of computer-based learning modules [ 55 ].

Approaches to program evaluation

Less than half of the included papers accurately and comprehensively described the methodology and methods used to evaluate the research education program [ 9 , 30 , 38 , 46 , 54 – 56 , 60 – 63 , 65 , 69 – 71 , 75 , 77 , 79 , 82 , 84 – 86 , 89 , 100 , 102 ]. The remaining papers either referred to the data collection techniques used without describing the overarching approach or methodology. Therefore, in Table  3 rather than referring to the approach to program evaluation as quantitative, qualitative or mixed methods, reference is made to the data collection techniques (e.g., surveys, interviews, facilitator reflections, audit of research outputs).

Research education program evaluation and outcomes reported

Most programs were evaluated using surveys ( n =  51), some of these in combination with other outcome measures. More than half of the program evaluations ( n =  38) used pre- and post-intervention surveys. Other evaluation methods included interviews, focus groups, attendance rates, and outcomes audits (e.g., ethics applications, manuscripts submitted for peer review or published, grant applications, grants awarded, or adherence to evidence-based guidelines). Twelve evaluation studies included a control group [ 36 , 38 , 51 , 60 , 65 , 68 – 70 , 77 , 79 , 86 , 100 ]. Three evaluations were informal and did not explicitly draw on evaluation data but rather on general feedback, authors’ own reflections and observations, including observed research progress [ 35 , 37 , 94 ]. Evaluation of the longer-term outcomes were described in seven papers, where surveys were undertaken or outcomes were otherwise measured between one and 5 years after the programs were completed [ 44 , 51 , 76 , 84 , 85 , 89 , 93 ].

Outcomes measured and described

Program outcome measures were mapped to Barr et al.’s modified Kirkpatrick educational outcomes typology [ 27 ]. The typology categorises educational outcomes reported according to their level of impact. The outcomes levels range from individual learner-level outcomes through to the impact of educational program on their organisation and healthcare consumer outcomes. See Table  4 below for descriptions of the outcome levels and the corresponding citations.

Evaluation outcomes according to Barr et al.’s modified Kirkpatrick typology

Almost all program evaluations included a mix of outcome measure types or levels. In addition to the modified Kirkpatrick level outcomes, other types of outcomes and impacts were measured and reported. Program participant engagement was measured and reported with reference to interest and uptake, attendance, and drop-out rates in five evaluations [ 48 , 54 , 74 , 78 , 87 ]. Twelve program evaluations explored participants’ experiences or perspectives of barriers to engaging in research in their health setting [ 34 , 36 , 49 , 56 , 71 , 77 , 81 , 82 , 84 , 86 , 88 , 89 ] and four evaluations included program cost calculations [ 51 , 60 , 83 , 90 ]. One evaluation measured group cohesion, participant (nurse) productivity and nursing staff retention [ 100 ].

Programs that were evaluated over a longer period demonstrated a high success rate with respect to manuscript publication [ 34 , 51 , 76 ], longer term development of research skills, experience, and engagement [ 44 , 84 , 89 ], and highlighted the value of mentoring to participants’ enduring engagement with research and to their development of research confidence and leadership skills [ 84 ]. One evaluation study included administrative leaders [ 89 ], one included training participants’ managers [ 93 ], however none included senior executives or healthcare consumers.

To the authors’ knowledge, this is the first systematic scoping review of the research education literature. The findings of the review support existing evidence of the continued relevance of research education and training to RCB endeavours [ 2 , 16 ]. Indeed, research education appears to be a mainstay RCB strategy over the last five decades. This review sought to explore the features or characteristics of research education and training programs delivered to nurses and allied health professionals working in health settings in HICs, the pedagogical principles or learning theories underpinning the programs, how programs were evaluated, and the types of outcomes reported.

Common features and approaches to the delivery of research education were identified. Some common pedagogical features of research education programs: multifaceted delivery to allow for flexibility in engaging with the program and content [ 5 , 103 ], experiential learning [ 2 , 103 ] and social or collaborative learning principles [ 103 ]. These underpinning principles were implied more frequently than they were explicitly stated. The integration of mentoring to reinforce the knowledge gleaned through research education programs appears to be a critical element and a key component of contemporary research education and capacity building [ 2 , 3 , 104 ].

This review also highlights some differences in the programs, particularly in terms of duration, which varied from single sessions or workshops to three-year programs. The curricula or educational content tended to reflect the aims of the programs which mapped to two different levels of engagement with research: research use or consumption and research activity. Some programs were specifically focused on advanced research skills, namely writing for publication, which is a particularly challenging aspect of the research process for clinicians [ 7 , 51 ].

Findings indicate that organisational context and support are pivotal to the cultivation of and completion of research activity [ 2 , 6 , 7 , 49 , 77 , 84 , 88 , 105 ]. Although this review focused specifically on papers describing research education programs targeting individual-level research capacity, there were several organisation-related factors that were integrated into the programs. Middle or executive level manager support for program participants was evident in numerous papers either through explicit support or permission, or positive role modelling. This resonates with the findings of existing evidence related to organisational factors enabling research [ 7 , 106 , 107 ]. Schmidt and colleagues [ 106 ] have previously highlighted a lack of managerial support for research training participants and their projects, as a factor influencing withdrawal. Several programs incorporated events or other opportunities for participants to present their work or to be otherwise recognised [ 37 , 46 , 54 , 66 , 80 – 83 ]. This facilitated organisation-level acknowledgement and celebration of individuals’ research activity and achievement, reinforcing organisational support for research [ 2 ].

This scoping review highlights some evidence of the impact of research education beyond the individual participants, and on their colleagues and organisations more broadly. This broader impact can be attributed to participants actively sharing their new knowledge and skills with their colleagues and teams [ 108 ]. Roger’s Diffusion of Innovation Theory can also underpin RCB strategies that are targeted at the individual level and explain how and why they have a broader impact on organisational research capacity and culture [ 104 ].

Research education program outcome measures tend to reflect lower levels of Kirkpatrick’s modified typology, with comparatively few studies reporting organisation-level impacts and none reporting health consumer outcomes. Although it is recognised that measuring and demonstrating direct links between RCB initiatives and health consumer outcomes is difficult [ 109 ], RCB initiatives including research training typically aim to promote the delivery of evidence-informed care, which in turn improves health consumer outcomes [ 110 ]. Some program evaluations included self-reported measures by participants that did not engage in the research education program, providing for comparisons between groups. Senior and executive managers, and healthcare consumers, however, were not involved in any evaluations reported. This limits knowledge of the outcomes and impacts beyond the individual participant level. Moreover, the program evaluation methods were generally poorly described. This is somewhat paradoxical, given the subject matter, however it is not a problem unique to research education and capacity building. Indeed poor evaluation is a widespread problem evident in multiple key healthcare areas such as Aboriginal Health in Australia [ 111 ] supportive care services for vulnerable populations [ 112 ], and in continuing education for healthcare professionals [ 113 ]. Factors contributing to poor program evaluation likely include time constraints, inaccessible data, and inadequate evaluation capacity and skills, as described in other scoping reviews of health and health professions education programs [ 111 – 113 ].

Although it is encouraging to see broadening interest in RCB initiatives for the nursing and allied health professions including research education, investment in rigorous, carefully planned, broadly targeted and long-term evaluation is required. This will ensure that research education programs maximise the outcomes for individuals and organisations and the most crucial impact on health consumer outcomes can be measured.

Strengths and methodological limitations

The strengths of this scoping review are the adherence to an established and systematic approach and the wide and comprehensive search including 11 research databases, multiple grey literature databases and search engines. The methodological and content expertise within the research team, including expertise in scoping review, systematic review, realist review methodologies and research education and capacity building strategies strengthened the rigour of the review. Moreover, the consultation with content experts during the development of the search strategy ensured the review was well-informed and shaped to meet the needs of those concerned with RCB.

Nonetheless, this review is limited by several factors. Research education, training, and RCB more broadly are poorly defined concepts [ 2 ], as such, it is acknowledged that the search strategy was developed in such a way that it may not have resulted in the retrieval of all relevant literature. This is acceptable, given the scoping review aimed to provide an overview of the breadth and depth of the literature and used content expertise to balance the comprehensiveness of the review with the capacity to answer research questions [ 114 ]. It is, however, recommended that the findings of this review inform a more focused and systematic review of the literature.

It is well-established that research education and training alone, do not sufficiently influence research capacity and capability at an individual or organisational level [ 1 , 7 ]. Indeed, barriers to nurse and allied health-led research include time constraints, demanding clinical workloads, enduring workforce shortages, a lack of organisational support and research culture, funding, and inadequate research knowledge and skills, persist [ 7 , 12 , 39 , 47 , 115 ]. These factors were not analysed as part of the review. The explicit focus on research education meant that some RCB strategies with education as a component may have been missed.

The authorship team were situated in Australia, with limited knowledge of other, complementary search engines internationally and lacked the resources to execute extensive international grey literature searches. These limited grey literature searches introduce a level of publication bias. Publications in languages other than English were excluded for reasons related to feasibility and limited resourcing. Through engagement with content experts early in the review, it was noted that many education programs are not formally documented, evaluated, or published in peer-reviewed or grey literature and therefore not accessible to others outside the organisation. This means that the review of published literature may not entirely represent research education programs in health settings.

Research education is a cornerstone RCB strategy for nurses and allied health professionals working in health settings. Education is typically aimed at enhancing individual clinician-level RCB however, there is some evidence that the outcomes of individual-level research education can influence organisational research capacity and culture. Moreover, strategies targeted at the organisational level can be integrated into research education programs. Mentoring, experiential, and collaborative learning have gained recognition as key features of research education programs and facilitate the application of new knowledge and skills in practice. Evaluation continues to focus on lower levels of educational impact or traditional research outputs; there is need for greater attention to organisational culture, longer-term capacity building outcomes and health consumer impacts. Approaches to the evaluation of research education programs should incorporate the experiences and perspectives of managers, executives, health consumers and other stakeholders concerned with research capacity and the delivery of evidence-informed care. This will ensure that RCB strategies and initiatives with greater impact at the individual and organisational level can be supported and that the impact of such initiatives can be measured at the population health level.

Acknowledgements

The authors acknowledge and sincerely thank Sarah Hayman and Helen Skoglund, Research Librarians at Barwon Health for their invaluable contributions to developing the literature search strategy, conducting the scoping and initial literature searches and retrieval process. They also thank the expert panel for their invaluable contributions in shaping the review.

Authors’ information (optional)

Olivia King (PhD) is Manager of Research Capability Building for Western Alliance.

Emma West is a PhD scholarship holder and research assistant at Deakin University and Program Officer, Research Capability Building for Western Alliance.

Sarah Lee is a PhD candidate at the Monash Centre for Scholarship in Health Education at Monash University.

Kristen Glenister (PhD) is a Senior Research Fellow (Rural Chronic Ill Health) for the Department of Rural Health, University of Melbourne and funded by the Rural Health Multidisciplinary Training program (Australian Government).

Claire Quilliam (PhD) is a Rural Nursing and Allied Health Research Fellow at The University of Melbourne and funded by the Rural Health Multidisciplinary Training program (Australian Government).

Anna Wong Shee (PhD) is Associate Professor Allied Health at Grampians Health and Deakin University.

Hannah Beks (MPH) is an Associate Research Fellow with Deakin Rural Health and funded by the Rural Health Multidisciplinary Training program (Australian Government).

Abbreviations

Evidence based practice

Joanna Briggs Institute

High-income countries

Organisation for Economic Co-operation and Development

Population, Concept and Context

Preferred Reporting Items for Systematic reviews and Meta-Analyses

PRISMA extension for scoping reviews

Research capacity building

Randomised control trial

Authors’ contributions

The first three authors (OK, EW, SL) conceived the research idea. Five authors (OK, EW, SL, AWS, and HB) contributed to the title and abstract screening, and review of full texts. Five authors (OK, EW, SL, KG and CQ) contributed to the extraction of data from papers. The first author (OK) drafted the manuscript. The last author (HB) provided methodological expertise and guidance. All authors contributed to the development of the manuscript, read, and approved the final version.

The authors thank Western Alliance for funding the initial stages of this review and co-funding the publication of this paper with Deakin Rural Health.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its supplementary information files.

Declarations

Ethics approval and consent to participate.

Barwon Health’s Research Ethics, Governance and Integrity Office conferred ethics approval for the engagement of the expert panel (Ref. 19/164). Written informed consent was obtained for all expert panel participants. All methods were conducted in accordance with the Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Why Nursing Research Matters

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• 1 Author Affiliation: Director, Magnet Recognition Program®, American Nurses Credentialing Center, Silver Spring, Maryland.
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• DOI: 10.1097/NNA.0000000000001005

Increasingly, nursing research is considered essential to the achievement of high-quality patient care and outcomes. In this month's Magnet® Perspectives column, we examine the origins of nursing research, its role in creating the Magnet Recognition Program®, and why a culture of clinical inquiry matters for nurses. This column explores how Magnet hospitals have built upon the foundation of seminal research to advance contemporary standards that address some of the challenges faced by healthcare organizations around the world. We offer strategies for nursing leaders to develop robust research-oriented programs in their organizations.

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Nursing Research -Introduction, Importance, Types, and Challenges

Nursing Research -Introduction, Importance, Types of Nursing Research Designs, Challenges in Nursing Research.Steps in Conducting Nursing Research

Table of Contents

Nursing Research -Introduction

Nursing research is an essential component of the nursing profession that promotes evidence-based practice, informs clinical decision-making, and contributes to improving patient outcomes. Nursing research is a systematic process of inquiry that seeks to answer questions related to nursing practice, education, administration, and policy. In this article, we will explore the importance of nursing research, the types of research designs, and the steps involved in conducting nursing research.

Importance of Nursing Research

Nursing research is essential to improve patient care, enhance nursing practice, and advance the nursing profession. By conducting research, nurses can identify the best practices that promote patient safety, reduce healthcare costs, and improve the quality of care. Nurses can also use research findings to guide clinical decision-making and develop evidence-based nursing interventions.

Nursing research also contributes to the development of nursing science, which helps to establish the unique role of nursing in the healthcare system. It also supports the development of nursing theories, which guide nursing practice, education, and administration. Nursing research also informs health policies that impact patient care, healthcare systems, and nursing practice.

Types of Nursing Research Designs

There are several types of nursing research designs, including quantitative, qualitative, and mixed-methods research. Each design has its unique strengths and weaknesses and is appropriate for different research questions.

1. Quantitative Research

Quantitative research involves the collection of numerical data, which is analyzed using statistical methods. This type of research design is used to test hypotheses, identify cause-and-effect relationships, and measure the frequency and prevalence of phenomena. Examples of quantitative research include randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies.

2. Qualitative Research

Qualitative research involves the collection of non-numerical data, such as words, images, and behaviors. This type of research design is used to explore complex phenomena, understand the meaning and experiences of people, and develop theories. Examples of qualitative research include phenomenology, grounded theory, ethnography, and narrative inquiry.

3. Mixed-Methods Research

Mixed-methods research involves the use of both quantitative and qualitative research designs to address research questions. This type of research design is used to provide a more comprehensive understanding of phenomena, validate findings from one method with another, and enhance the generalizability of research findings.

Steps in Conducting Nursing Research

The process of conducting nursing research involves several steps, including formulating a research question, conducting a literature review, designing the study, collecting data, analyzing data, and disseminating findings.

1. Formulating a Research Question

The first step in conducting nursing research is to formulate a research question. The research question should be relevant to nursing practice, education, or administration and should be answerable through research. The research question should be clear, concise, and specific.

2. Conducting a Literature Review

The second step in conducting nursing research is to conduct a literature review. The literature review involves a systematic search of published research studies related to the research question. The literature review helps to identify knowledge gaps, establish the significance of the research question, and inform the research design.

3. Designing the Study

The third step in conducting nursing research is to design the study. The research design should be appropriate for the research question and should include a description of the study population, data collection methods, data analysis methods, and ethical considerations.

4. Collecting Data

The fourth step in conducting nursing research is to collect data. Data collection methods may include surveys, interviews, observations, or secondary data sources. Data collection methods should be standardized to ensure data quality and should comply with ethical standards.

5. Analyzing Data

The fifth step in conducting nursing research is to analyze the data. Data analysis methods may include statistical analysis, content analysis, or thematic analysis. Data analysis should be appropriate for the research design and research question.

6. Disseminating Findings

The final step in conducting nursing research is to disseminate the findings. Dissemination involves sharing the research findings with the nursing community and other stakeholders. Dissemination methods may include publication in peer-reviewed journals, presentations at conferences, or sharing findings with policymakers and healthcare organizations. Dissemination should be tailored to the target audience and should emphasize the significance and implications of the research findings.

Challenges in Nursing Research

Nursing research faces several challenges, including funding, time constraints, access to participants, and ethical considerations. Funding is a major challenge for nursing research, as it requires resources to conduct high-quality research studies. Time constraints also pose a challenge for nursing research, as nurses often have competing demands on their time, such as patient care responsibilities.

Access to participants is also a challenge for nursing research, as nurses may have limited access to certain patient populations or healthcare settings. Ethical considerations are also an important challenge in nursing research, as research studies must comply with ethical principles, protect human subjects, and maintain confidentiality and privacy.

Conclusion – Nursing Research

Nursing research is an essential component of the nursing profession that promotes evidence-based practice, informs clinical decision-making, and contributes to improving patient outcomes. Nursing research can use different research designs, such as quantitative, qualitative, and mixed-methods research, and requires several steps, including formulating a research question, conducting a literature review, designing the study, collecting data, analyzing data, and disseminating findings. Despite the challenges that nursing research faces, it remains a critical component of the nursing profession and contributes to the development of nursing science, knowledge, and practice.

Please note that this article is for informational purposes only and should not substitute professional medical advice.

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National Research Council (US) Committee for Monitoring the Nation's Changing Needs for Biomedical, Behavioral, and Clinical Personnel. Advancing the Nation's Health Needs: NIH Research Training Programs. Washington (DC): National Academies Press (US); 2005.

Advancing the Nation's Health Needs: NIH Research Training Programs.

• Hardcopy Version at National Academies Press

6 Nursing Research

Research training in nursing prepares investigators who are a part of the larger health sciences workforce. Study questions are raised from the nursing perspective but contribute to knowledge in general. For scientists in the discipline of nursing, the ultimate intent of the knowledge generated through research is to provide information for guiding nursing practice; assessing the health care environment, enhancing patient, family, and community outcomes; and shaping health policy.

The science of nursing is characterized by three themes of inquiry that relate to the function of intact humans: (1) principles and laws that govern life processes, well-being, and optimum function during illness and health; (2) patterns of human behavior in interaction with the environment in critical life situations; and (3) processes by which positive changes in health status are affected. 1 Thus, within the health sciences, nursing studies integrate biobehavioral responses of humans. The science of nursing can also be classified as translational research because it advances clinical knowledge and has the directional aims of improved health care and human health status. 2 As stated in a classic policy paper, research for nursing focuses on ameliorating the consequences of disease, managing the symptoms of illnesses and treatments of disease, facilitating individuals and families coping or adapting to their disease, and dealing in large part with promoting healthy lifestyles for individuals of all ages and under different backgrounds and disease conditions. 3 In addition, nursing research focuses on enhancing or redesigning the environment in which health care occurs in terms of the factors that influence patient, family, and community outcomes.

Focusing on ameliorating the consequences of illnesses or their treatment is the intent of many research programs conducted in nursing. For example, a new protocol for endotracheal suctioning has been tested and implemented in a number of hospital critical care units. Endotracheal suctioning is a frequently performed procedure that can have serious consequences if not done correctly. Another example in the area of symptom management is understanding the factors that influence common problems such as pain. In one study that focused on developing a longer-acting pain medication, investigators found that gender is a major factor in whether drugs are effective, with women responding well to seldom-used kappa-opioid drugs while men have little benefit from such drugs.

Another major area for research in nursing is facilitating individuals and families as they cope or adapt to long-term chronic disease. An excellent example of this area of study is a self-help program developed for Spanish-speaking people with arthritis. For many years, Hispanics with arthritis did not have many educational resources for how to cope with or adapt to their illness. Two investigators at Stanford University's medical center have now developed and tested for effectiveness a self-management program with accompanying exercise and relaxation tapes. This self-help program is being considered for nationwide dissemination by the National Arthritis Foundation.

Research in nursing also has a strong focus on health promotion and risk reduction. The intent is to promote healthy lifestyles for individuals of all ages and backgrounds and with various disease conditions. One example is a school-based program now adapted by most North Carolina schools that is a tested health promotion program in exercise and diet for young children at risk for cardiovascular disease. The research results from this school-based intervention program are impressive; the young people's total cholesterol levels and measurements of body fat were significantly reduced following the education and exercise interventions, and their fitness levels, physical activity, and knowledge about cardiovascular disease risk factors improved. 4

Together, influencing, redesigning, and shaping the environment for patients, families, and communities is another major area of study in nursing. For example, over 80 studies have shown the influence of nursing surveillance and presence on positive patient outcomes. 5 The shortage of nurses, a critical factor, in a health care environment has been demonstrated to increase patient mortality and morbidity. 6 Other studies show the benefit of home visits by nurses in improving the health and quality of life of low-income mothers and children. 7

Research in nursing is often referred to as “nursing science” or “nursing research,” which has led some to confuse it with the nursing profession. This terminology exists at the National Institutes of Health (NIH) in the name of the National Institute for Nursing Research (NINR); however, the funding from NINR supports scientific research relevant to the science of nursing, and the investigators may be nurses or nonnurses. Nursing science is a knowledge structure that is separate from the profession and clinical practice of nursing. 8 Furthermore, the term “nurse-scientist” is not reserved for graduates of Ph.D. programs in nursing; it refers to any scientist conducting research in the disciplinary field of nursing. For example, highly trained nurses under the supervision of a principal investigator could conduct the bulk of the work in a clinical trial.

Research training for nurses, as for other biomedical and behavioral researchers, needs to occur within strong research-intensive universities and schools of nursing. Important characteristics of these training environments include an interdisciplinary cadre of researchers and a strong group of nursing research colleagues who are senior scientists in the sense of consistent extramural review and funding of their investigative programs and obvious productivity in terms of publications and presentations. These elements are essential to the environment required for excellence in research training.

The NINR has traditionally placed a greater emphasis on research training in relationship to the relative size of the institute's budget than is evident with NIH in general. This is due to the current stage of development of nursing research and the need for greater numbers both as investigators and academic faculty. At least 8 percent of NINR funds go to research training, which is roughly twice the percentage invested by other institutes. 9 This commitment has been consistent for a number of years. This committee's Nursing Research Panel members commend the wisdom of this tradition and encourage its continuation.

This chapter focuses on the following two areas that are of major concern to the discipline: (1) changing the career trajectory of research training for nurse-scientists to include earlier and more rapid progression through the educational programs to and through doctoral and postdoctoral study as well as increasing the number of individuals seeking doctoral education and faculty roles, and (2) enhancing postdoctoral and career development opportunities in creative ways.

• CHANGING THE CAREER TRAJECTORY FOR NURSE-SCIENTISTS

The following three major factors motivate the critical need to change the career trajectory for nurse-researchers: (1) enhancing the productivity of nurse-researchers to build strong, sustained research programs generating knowledge for nursing and health practice as well as shaping health policy; (2) responding to the shortage of nursing faculty and the advancing age of current nurse-investigators, and (3) emphasizing the need for strong research training of nurse-investigators in research-extensive and research-intensive universities with equally strong interdisciplinary research opportunities.

• ENHANCING SUSTAINED PRODUCTIVITY FOR NURSE-SCIENTISTS

Nurse-scientists play a critical role in the conduct of research and the generation of new knowledge that can serve as the evidence base for practice and improvement of patient health outcomes. However, nurses delay entering Ph.D. programs. There is particular concern because of inherent limitations in the number of years of potential scientific productivity. Starting assistant professors in other scientific fields typically have a research career trajectory of 30 to 40 years in duration. The average age of an assistant professor in nursing is 50.2 years. Hinshaw reasons that for a faculty member who enters the nursing academic workforce at the age of 50 and retires at 65, this productive period will be only 15 years for developing research programs and contributing to science for nursing and health practice in general. 10 Thus, nurse-investigators tend to have a short career span. This limitation severely constrains the growth of nursing research and thus knowledge for nursing practice.

The median time elapsed between entry into a master's program to completion of a doctorate in nursing is approximately 15.9 years compared to 8.5 years in other disciplines. 11 In addition to having a long period of graduate training, the time has increased by 3 years since 1990, and there are no signs of the trend being reversed. Because there are many factors that reinforce the late entry of nurses into Ph.D. programs, there is a need to create incentives to change the career path. The challenge of promoting earlier entry into science careers was discussed by this panel. Of several proposals considered, there was strong support for one that would encourage and support education trajectories with fewer interruptions. To facilitate this, there needs to be greater awareness of nursing as a scientific discipline. Once students enter undergraduate programs in nursing, those students with interests in science should be identified early and encouraged to consider doctoral education. Exposure to nurse-scientists during the undergraduate program would also entice students to consider research as a primary focus in nursing. A few programs of this type exist, such as the Early-Entry Option in the school of nursing at the University of Wisconsin, Madison. In this program highly talented undergraduates are moved directly into the Ph.D. program.

A “fast tracking” of undergraduates into doctoral programs also necessitates dispelling myths related to the need for clinical practice prior to graduate school entry. There is a need to evaluate the requirement of the master's degree for individuals interested in an academic career with an emphasis on research. The lengthening of most master's programs due to certification requirements for advanced-practice roles has resulted in two plus years for master's program completion, which further delays entry into doctoral education.

In addition, the average number of years registered in a doctoral program is longer for nursing than for other fields. On average, it takes 8.3 years for nursing Ph.D. students to complete their degrees compared to 6.8 years for all research program doctoral students. 12 This is due in part to the fact that the majority of doctoral nursing students are part-time students. As of 2002, there were 81 research-focused doctoral programs in nursing with a total of 3,168 enrollees; 55 percent of enrollees were part-time students. This accounts for the low percentage of graduates; 12.8 percent of enrollees graduate each year. 13

Nursing developed both its Ph.D. and its D.N.Sc. 14 programs to build on the master's degree in nursing as well as to accommodate breaks between degrees for clinical practice. Early reliance on the master's degree is understandable in that it was nursing's highest degree for many years before the establishment of a significant number of research doctoral programs. As doctoral programs were developed, they built on the master's content, which at the time was predominantly research and theory focused. Over time the master's programs have changed to become primarily preparation for advanced clinical practice, yet nursing continues to require the master's degree for entry into doctoral study in most programs. Currently, very few doctoral programs in nursing admit baccalaureate graduates directly into the program, and for those that do, the master's degree is usually required as a progression step. This requirement for entry into the Ph.D. program makes the group of advanced nurse-practitioners, rather than baccalaureate students, the major pool from which applicants are recruited into research. This is problematic in that this practitioner pool has the same demographic characteristics as the profession and thus is older in average age and more limited in diversity compared to applicants for science Ph.D. programs in general. Incorporation of the clinical/professional content from the master's degree as foundational to the Ph.D. in nursing also encourages faculty to recruit and teach only nurses. Currently there are only a few doctorate programs in nursing that admit nonnurses.

Even though there are other fields that require a master's degree as a requirement for earning the professional research doctorate, such as the M.P.H. for the Dr.P.H., the master's degree has a completely different meaning relative to the science Ph.D. degree. The master's degree is usually awarded as a “consolation prize” for students who are unable to complete the requirements for the science Ph.D. By making the master's degree a requirement for its Ph.D. program, nursing has created confusion as to the meaning of the degree outside the nursing profession.

In considering strategies for increasing the number and length of productive research years for scientists in nursing, it is important to distinguish between the educational needs and goals of nursing as a practice profession that requires practitioners with clinical expertise from nursing as an academic discipline and science that requires independent researchers and scientists to build the body of knowledge. 15 To improve the productivity and research focus of the Ph.D. in nursing, doctoral programs need to be reengineered to admit directly from baccalaureate programs, to admit nonnurses, to decrease the number of years from high school to Ph.D. graduation, and to expand the interdisciplinary scope of the program and the research. The need for doctorally prepared practitioners and clinical faculty would be met if nursing could develop a new nonresearch clinical doctorate, similar to the M.D. and Pharm.D. in medicine and pharmacy, respectively. The concept of a nonresearch clinical doctorate in nursing is controversial, but some programs of this type exist.

Nursing should be encouraged to reengineer some of its doctorate programs to exclusively meet the goal of producing scientists and researchers who are the most capable in terms of skills and projected career life, to meet the needs of nursing as a science and for the development of its research-based disciplinary knowledge. Doctorate programs currently require core coursework in theoretical systems, philosophy of science, qualitative and quantitative methods, and statistical/data analysis techniques. What is different from other science degrees is the amount of advanced practice usually required prior to the doctoral program. Some educational depth in a clinical area or in practice is important for the study of clinical questions, but how much is the issue.

There is no clear research career trajectory evident among scientists in nursing today. The common thread is that they entered their doctoral programs later than most other scientists and have not benefited from postdoctoral education. This is because most nurses enter doctoral programs following receipt of the clinical master's degree, also often with many years of clinical experience, and their primary socialization has been as practitioners. As such, they bring with them rich experiences that may help shape the focus of their inquiry. However, they also carry with them enormous burdens relating to their readiness for entering rigorous science training, their interest in continuing training following their predoctoral experience, and their long-term capacity for developing a research career. In addition, when nurses complete their doctoral training, most move directly into an academic career. There they frequently encounter settings in which the demands for teaching and lack of pervasive research programs, socialization, and further mentoring make continuing progress as a scientist difficult.

There is evidence to suggest that a successful career in science is the result of a number of key factors across the life span. These factors include inspiration and “connection” to science and the field; involvement in the enterprise of discovery and science; knowledge, skill, and leadership development; opportunities for coaching, role modeling, and mentoring; a scientific community with peer engagement, assessment, support, and critique; an intensive research environment; and adequate support for research in all of its phases. With these factors in mind, each stage of nursing from precollege, undergraduate, predoctoral, and postdoctoral to the career scientist can build strategies to enhance the career path.

The development of future scientists begins very early in the educational experiences of young people. These include education in school but also beyond. This begins with exposing students interested in nursing at the precollege level to both the profession and nursing science. Undergraduate development of scientists moves individuals from a more general interest in and connection to science to actually beginning to embark on a career in science. The context should be designed to support both the acquisition of a solid academic foundation for further study, a clear notion of pathways for becoming a scientist, and educational experiences that move the student into actual conduct of research. Predoctoral training should begin before the doctoral student starts a course of study. The student's program should assure a very strong match between the research interests of the student and the capacity of the program and faculty. Programs should be fundamentally grounded in a commitment to and processes that support the development of scientists. The postdoctoral phase is the point at which one's own science career should begin to take hold and the intrinsic rewards of science and discovery drive the work of the postdoctoral fellow. Ultimately, the career scientist is at the stage of developing and maintaining his/her program of research. For academic scientists this is the point at which mentoree becomes mentor and teacher, based on the program of research. It is also the point at which the scientist should become an active member of the academic community.

• RESPONDING TO THE SHORTAGE OF NURSE-INVESTIGATORS

It has been well established that there is both a current shortage and a projected continued shortage of nursing faculty, especially those who are scientists and researchers. At this time, approximately 50 percent of faculty that teach in nursing baccalaureate programs are doctorally prepared. This represents a marked increase from the late 1970s, when only 15 percent were. This 50 percent level was achieved in 1999 but has not increased since then despite a large increase in the number of doctoral degree programs available to nurses during the same time period (e.g., in 2002 there were 81 research-focused programs). Two factors that likely contribute to this stalemate are (1) the relatively constant number of doctoral degrees earned each year, despite the increase in the number of programs, as shown in Table 6-1 , and (2) the older age of graduates, as evidenced by an increase in the average age of assistant professors from 45 to 49.6 years for the period 1996 to 1999. In 2002 the average age of doctorally prepared faculty was 53.3, compared to 50.2 in 1999 and 2000. 16 These statistics suggest that the doctorally prepared faculty is aging, and because the percentage of faculty members with doctorates is not increasing, it does not appear that younger replacements are being put in place. Thus, this older group of doctorally prepared faculty members in nursing is likely to retire from the academic workforce over the next few years, leaving nursing programs with too few faculty members to conduct research and educate the next generation of scientists.

Nursing Doctorates from U.S. Institutions, 1991–2003 .

The need to dramatically increase, even double, the number of nurse-scientists is acute, especially at earlier points in their careers. A recent Special Survey of Vacant Faculty Positions conducted by the American Association of Colleges of Nursing indicated that 59.8 percent of the vacancies require an earned doctoral degree. 17 Training opportunities are available, including predoctoral and postdoctoral fellowship programs offered primarily by the NINR. The number of applicants for these awards has remained relatively stable over time, consistent with the flat doctoral graduation rate for nursing. It is important to provide research training incentives that increase the number of nurses selecting a research career and at a much earlier point in their professional development.

• EMPHASIZING RESEARCH-INTENSIVE TRAINING ENVIRONMENTS

Strong, research-intensive environments are critical in both the general universities and the schools of nursing for doctoral, postdoctoral, and career development preparation. Such environments provide the experience of being immersed in scientific inquiry with mentors and the intellectual cohort of investigators required for the preparation of nurse-researchers. Research-intensive environments also promote crucial interdisciplinary research opportunities. Nursing research confronts complex questions. Thus it needs to involve multiple perspectives and bodies of interdisciplinary expertise.

To date, scientific training for nurses and others committed to nursing research has utilized a variety of National Research Service Awards (NRSAs) and Career Development K awards. These research training awards are funded by the NINR. The individual predoctoral awards (F31) have been slowly increasing, with very limited numbers of individual postdoctoral awards (F32) evident. The NRSA institutional awards (T32) have grown considerably over time, with 43 such awards made between 1986 and 2002 and 27 operational in 2003. Within the T32s, 65 postdoctoral trainees and 93 predoctoral awards were anticipated for 2003. For the individual NRSA awards there were five postdoctoral awards (F32) and 100 predoctoral awards (F31) for 2003 (see Figure 6-1 ).

Training positions at the postdoctoral and predoctoral levels. SOURCE: National Institute for Nursing Research Budget Office.

The level of scientific productivity differs among the NRSA mechanisms for the individuals and institutions funded by the NINR. Analysis of the funding record for successfully acquiring either research (R) or career (K) development awards later in the career shows a pattern similar to that of the total NIH research training programs. NINR trainees and fellows funded on individual NRSAs are more apt to successfully acquire R and K awards (see Table 6-2 ) at a later date.

Analysis of Pre- and Postdoctoral Fellows with Subsequent Funding .

The difference is sizable, with predoctoral awards being 17 percent of the individual awards (F31) and 5 percent of the T32 predoctoral positions. The pattern is similar with a greater difference for the postdoctoral fellows—38 percent for the F32 and 18 percent of the T32 positions. However, productivity in terms of publications shows the opposite pattern (see Figure 6-2 ).

Publications, T32 versus non-T32. SOURCE: Outcome analysis by National Institute for Nursing Research at NIH.

The 2 years 1997 and 1999 illustrate a consistent pattern of higher publications for trainees and fellows on the T32 awards. In 1997 and 1999, 158 and 154 publications resulted from trainees and fellows on the institutional T32 awards versus 66 and 23, respectively, for doctoral students holding the individual F awards.

Both institutional and individual research training awards under the NRSA program should continue. The individual awards build strong scientific capability and independence when working with a research-active mentor. With the T32 institutional awards, the cadre of strong senior researchers forming a scientific community is valuable in terms of mentoring and publications. The individual predoctoral awards (F31) can be used for a variable length of study. The NINR/NIH is encouraged to allocate three to four years per award in order to support full-time, consistent progression for research training.

The lower productivity of trainers and fellows, who have been funded on the institutional NRSAs (T32) and later obtain R01 and K awards, is of concern. The research training offered through T32 mechanisms needs to be strengthened in the following manner:

• T32 awards should be placed in research-intensive universities with strong interdisciplinary opportunities and research funding, and research interdisciplinary activities should be a critical aspect of the initial NRSA application and annual reports.
• The T32 awards should be allocated only to schools with research-intensive environments, including a cadre of senior investigators with extramurally funded research or research track records and research infrastructures that support research and research training.
• The application process for T32 positions as predoctoral trainees or postdoctoral fellows should be more formalized, with specific proposals submitted in relationship to their research and the match with faculty at the institution made explicit.
• Trainees and fellows on a T32 award position should provide evidence of the interdisciplinary strength that is part of their program of study.
• Criteria for selection of T32 fellows and trainees should be based on a consistent, full-time plan for research training and long-term potential for contribution to science and nursing.
• The monitoring and tracking of trainees and fellows should be formalized, with changes in research plans or mentor(s) filed as part of the annual report.

A small but growing cadre of nurse-investigators is supported in their research development by K awards. In addition to the awards from NINR, other institutes and centers also support nursing research through the K mechanisms, since elements of nursing research are intrinsic to other fields. These awards are usually awarded to nurse-scientists in their early or midcareer stages when they are shifting the substantive or methodological focus of their research. NINR has primarily used the following four types of career awards: K01, Mentored Research Scientist Development Award; Minority K01, Mentored Research Scientist Development Award for Minority Investigators; K22, Career Transition Award, and K23, Mentored Patient-Oriented Research Career Development Award; and K24, Mid-Career Investigator Award in Patient-Oriented Research. 18

These awards could be important in advancing both career development and science development. Unfortunately, there is limited information regarding the outcomes of these awards, including successful research grants and publications by awardees.

In summary, three major factors influence the recommendation to change the research training career trajectory pattern for nurse-scientists: the need to enhance the productivity of each investigator's study for nursing practice and for shaping health policy; increasing the numbers of nurse-investigators to respond to the investigator and faculty shortage; and emphasizing the need for research training within strong research-intensive environments.

• RECOMMENDATION

Recommendation 6-1: The committee recommends that a new T32 program be established that focuses on rapid progression into research careers. Criteria might include predoctoral trainees who are within 8 years of high school graduation, not requiring a master's degree before commencing with a Ph.D., and postdoctoral trainees who are within 2 years of their Ph.D.

This new program would produce strong research personnel and lengthen the research careers of the trainees. These grants should be placed in research-intensive universities with strong interdisciplinary opportunities and research funding, including a cadre of well-established senior investigators.

Donaldson, S. K. and D. M. Crowley. 1978 .

Sung, N. S., et al. 2003 .

American Nurses Association. 1985 .

National Institute for Nursing Research. 2003 .

Aiken, L. H., et al. 2002 .

National Institute of Nursing Research. 2003 . op. cit.

Donaldson and Crowley. 1978 . op. cit.

Grady, P. A. 2003 .

Hinshaw, A. S. 2001 .

National Opinion Research Center. 2001 .

American Association of Colleges of Nursing. 2003b .

American Association of Colleges of Nursing. 2003a .

McEwen, M., and G. Bechtel. 2000 .

Donaldson and Crowley. 1973. op. cit.

American Association on Colleges of Nursing. 2004 .

Grady. 2003 . op. cit.

See Appendix B for a complete explanation of awards.

• Cite this Page National Research Council (US) Committee for Monitoring the Nation's Changing Needs for Biomedical, Behavioral, and Clinical Personnel. Advancing the Nation's Health Needs: NIH Research Training Programs. Washington (DC): National Academies Press (US); 2005. 6, Nursing Research.
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