Training scientists in the nursing informatics research agenda
Article Outline
The skills and competencies needed by health care professionals in the 21st century, as envisioned by the Institute of Medicine (IOM), include the ability to: provide patient-centered care, work in interdisciplinary teams, practice from a sound evidence base, and use informatics to improve the delivery and quality of care.1 To realize this vision within the discipline of nursing, a critical need exists for nurse researchers who can envision, devise, implement, and evaluate information technologies that facilitate patient outcomes. Research and research training in nursing informatics is essential to fulfill nursing’s participation in the initiatives addressed in the National Institutes for Health Roadmap for Medical Research.2 Nurse scientists trained in nursing informatics research have the capacity to provide leadership in designing and using new technology and in developing new tools—2 strategies identified in the National Institute for Nursing (NINR) Strategic Plan for advancing nursing science.3 Nursing informatics (NI) practice is essentially interdisciplinary, and NI scholars demonstrate advanced skills in collaboration, integration, and incorporation of multiple strategies to ask and answer complex questions. There is need for both basic research in nursing informatics as well as integrating nursing informatics strategies into research programs that address all 4 of the current areas of research emphasis: (1) promoting health and preventing disease; (2) improving quality of life; (3) eliminating health disparities; and (4) setting directions for end-of-life research.3
Additionally, the current nursing shortage will not be solved by labor force development alone; rather, its safe resolution waits a rebalancing of the human and technological resources deployed to support patient care. It is only through research in nursing informatics that knowledge-management strategies can be developed that capitalize on emerging informatics developments while preserving the professional dimensions of nursing and nursing science.4 Situating nursing informatics training within PhD programs in nursing will insure the development of nursing informatics scholars socialized within the discipline.
Our nation’s existing approach to training nurse informatics scholars is costly, suboptimal, and has a very low output of research-productive scholars. For over 15 years, nurses who sought research training in nursing informatics had only 2 options: an apprenticeship model of training with one of the few nurse informatics scholars at a PhD granting institution, or training within a Medical Informatics PhD program. At best, the apprenticeship model produces 2–3 graduates a year nationally. Most of the leading medical informatics training programs exist in schools of medicine in universities that lack doctoral programs in nursing (eg, Harvard, Stanford, and Rice). Columbia University stands as a notable exception in that there exists a strong doctoral program in nursing whose faculty members enjoy a close affiliation with a research-intensive medical informatics faculty. However, even Columbia has a very small cadre of research-productive nursing informatics scholars, and their areas of expertise do not cover all important components of the domain of nursing informatics.
Yet, one of the challenges faced in creating doctoral and post-doctoral programs in nursing informatics arises from the small numbers of research-productive nurse informaticians. Schools of nursing are fortunate to count even one nurse informatics researcher among their ranks, and many leading schools of nursing lack even a single faculty member with expertise in nursing informatics. Establishing a sustainable research program and concomitant training environment with, at best, a single peer within the School of Nursing is daunting, even for an outstanding scholar. The nursing informatics community nationally enjoys a long history of peer support and collaboration across institutions, and it is out of this “invisible college” that the impetus to develop a novel, cross-institutional training program that links nurse informatics scholars from several schools in a combined effort that supports research training has occurred. Thus, a new model for pre- and post-doctoral nursing informatics education to address the serious shortage of nurse scientists in this highly specialized field has been established. This novel arrangement links the nursing and informatics faculties at 6 Schools of Nursing (Indiana University, University of Illinois at Chicago, University of Iowa, University of Michigan, University of Minnesota, and University of Wisconsin-Madison) in a collaborative research training program through an existing cross-university infrastructure. The Committee for Institutional Cooperation (CIC) is a consortium of 12 research universities in 8 Midwestern states with the mission “to advance academic excellence by sharing resources and promoting and coordinating collaborative activities across the member universities.”5 The CIC Nursing and Health Informatics Consortium has developed an innovative shared curriculum that includes collaborative courses and involves doctoral students and faculty from participating institutions using videoconferencing and Web-based technology. The outcomes of this unique collaboration include jointly authored publications and scientific presentations. Moreover, the focused discussions and intensity of the combined expertise from multiple faculty members enriches student development of research ideas. Unexpected benefits accrued to faculty. In many ways, participation in the course yielded some elements of the sabbatical experience—the rich opportunity to have regular, deeply scientific scholarly exchange among faculty colleagues.
In summary, this innovative model for educating a cadre of well-qualified nursing informatics scholars is effective. Having cooperative tuition and credit-transfer agreements is essential, as well as the technical capacity for collaboration. Future priorities include extending the programming throughout CIC nursing institutions, expanding to include non-CIC institutions, and establishing collaborative research projects.6
References
- In: Greiner AC, Knebel E editor. Health Professional Education: A Bridge to Quality. Washington, DC: National Academy Press; 2003;
- Office of Portfolio Analysis and Strategic Initiatives, National Institutes of Health. Roadmap for Medical Research. Available at: http://nihroadmap.nih.gov/. Accessed November 29, 2006.
- . Changing Practice, Changing Lives: NINR Strategic Plan. Washington, DC: National Institute for Nursing Research, National Institutes of Health; 2006;
- Guideposts to the future—An agenda for nursing informatics. J Am Med Info Assoc. 2007;19–24
- Committee on Institutional Collaboration. About CIC. Available at: http://www.cic.uiuc.edu/AboutCIC.shtml. Accessed on December 30, 2006.
- . Building informatics capacity through a virtual university consortium. In: Weaver C, Delaney CW, Weber P, Carr R editor. Nursing and Informatics for the 21st Century: An International Look at Practice, Trends, and the Future. Chicago, IL: Health Information Management Systems Society; 2006;
PII: S0029-6554(07)00037-1
doi:10.1016/j.outlook.2007.01.010
