Gerontological nurse researchers are in a position to determine evidence-based, efficacious, and cost-effective health care for older adults. With the population of older adults expected to double by the year 2030 (Kinsella & Velkoff, 2001), there is a critical need to prepare undergraduate and graduate nursing students to take active roles in gerontological nursing research. Baccalaureate-prepared nurses can be effective in using evidence-based practice for older adults, while doctorally prepared nurses can discover new knowledge to determine best practices to improve health outcomes. Furthermore, engaging students in research experiences provides opportunities to cultivate gerontological scholars and leaders who will then serve to mentor future generations.
However, as pointed out by Hawranik and Thorpe (2008), educators today are faced with multiple challenges such as large numbers of students, faculty shortages, and the demands of the tripartite role (teaching, scholarship, and service). Students, on the other hand, report being intimidated by research (Mandleco & Schwartz, 2002) and lack understanding of the applicability of research to clinical practice and policy (Newton, McKenna, Gilmour, & Fawcett, 2010). These issues make it difficult for faculty to provide hands-on research experiences for students. However, by challenging the status quo and developing innovative programming, it is possible to engage students in gerontological nursing research.
Different programs designed to foster the development of student nurse researchers have been described in the literature. For example, Vessey and DeMarco (2008) reported on an undergraduate research fellows program developed to promote honors student participation in research, while the subject of Klemm’s (2012) work used a collaborative, participatory approach with the goal of meeting both research course requirements for students and faculty needs in their breast cancer research program. Perhaps the most successful program in the development of gerontological nurse researchers is the Building Academic Geriatric Nursing Capacity (BAGNC) program, coordinated by the American Academy of Nursing with funding from the John A. Hartford Foundation. Franklin et al. (2011) described results from an external evaluation of BAGNC, demonstrating impressive results in the area of research productivity among their scholars and fellows over a 10-year period. One advantage of BAGNC is the availability of funding to support the fellowship experiences. The BAGNC program is a successful example of creating gerontological nurse researchers and is facilitated by availability of funding. Unfortunately, this is not the case in most schools of nursing. The challenge for nursing is fostering the development of gerontological nurse researchers using available resources. STudents Advancing Reminiscence Research (STARR) is an example of an innovative program that fosters hands-on student participation in gerontological research using available faculty resources.
Students Advancing Reminiscence Research
The STARR program at the University of Massachusetts Lowell evolved as a result of the Department of Nursing’s master’s-level research project requirement. After completing a didactic research course, master’s students are required to complete 100 hours of research-related work with a faculty member. The hands-on experience gives students opportunities to apply research concepts learned in class. At the end of the academic year, students develop posters and participate in a poster presentation where they learn how to disseminate their work.
The impetus for developing STARR was aided by the faculty advisor’s (J.S.) reminiscence research program. Students became familiar with the faculty member and her reminiscence research program, which is based on the use of integrative reminiscence to decrease depressive symptoms in Black older adults. As the number of graduate students’ requests to work on research projects increased, creating a research group to mentor—instead of working with students on an individual basis—became the next logical step. Once the group began to form, other opportunities arose for student participation in STARR. For example, a doctoral student needed an independent study for an advanced qualitative methods course, and an undergraduate student requested placement for a university work-study research cooperative learning program. Eventually, STARR was composed of nine diverse students across three levels (undergraduate, master’s, and doctoral) with varying degrees of research experiences.
The primary aim of STARR is to provide hands-on research experiences for undergraduate and graduate students. Guidelines, objectives, and requirements for STARR were developed by the faculty mentor. Students were required to provide evidence of completion of National Institutes of Health Institutional Review Board (IRB)-training, keep journals throughout the process, and commit to monthly team meetings. A wiki page specific to STARR was created to serve as a medium for communication and learning. Students and the faculty mentor posted research materials, journal entries, and worked collaboratively on posters and abstracts through the site. Interested students had the choice of working on the faculty member’s active reminiscence study or developing a project related to reminiscence. For instance, three students expressed an interest in nurses’ use of reminiscence in end-of-life care. These three students reviewed the literature related to nursing and reminiscence at end of life. A proposal for a pilot study was developed, IRB approval was obtained, and students collected and analyzed data.
Since the inception of STARR 1 year ago, one graduate student had the opportunity to present a paper at the Gerontological Society of America’s annual conference. The team had two abstracts accepted at the University of Massachusetts Lowell Undergraduate Research Day, and one group developed a poster for the Department of Nursing’s Clinical Preceptor/Research Day, when graduate students present their research projects to faculty, students, and preceptors. Currently, the team, under the supervision of the faculty mentor, is developing an article describing findings from a study in which students collected data using the Modified Reminiscence Functions Scale developed by Washington (2009) (N = 335) in a sample of Black adults.
Structured research meetings facilitated by the faculty advisor were held on a monthly basis. Attendance was required, minutes were taken, and the different subgroups reported on progress. The meetings cultivated a nonthreatening atmosphere for problem solving, group solidarity, and pride in team accomplishments. The meetings also included refreshments and an opportunity for socialization. Aside from meeting the 100-hour research requirement, a sense of the students’ enthusiasm for their research projects was evident in their journals and personal communications. For example, one team member stated, “I look forward to future research rather than feel afraid of it.” Additionally, students felt validated by receiving feedback from faculty and other students when presenting their work at the conferences.
While STARR had benefits for student members, the faculty advisor’s scholarship was also enhanced because of student involvement. Students collected data on the patterns and functions of reminiscence in Black adults and entered these into a database. In addition to the previously described study of nurses’ use of reminiscence at end of life, another student examined the use of group reminiscence at an assisted living facility. Student participation enabled the faculty mentor to enhance her reminiscence research program and include important uses of reminiscence in gerontological nursing practice that otherwise would not have been explored.
The 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, calls for schools of nursing to double the number of nurses with a doctorate by 2020 to increase the pool of nurse faculty and researchers. Recommendations to achieve this goal include implementing accelerated degree programs and encouraging students enrolled in baccalaureate programs to complete advanced education sooner rather than later. Examples of action that can be taken are curricular changes that include innovative programming, mandates for research project requirements at all levels of education, assisting faculty to develop and strengthen programs of research, and creating links between schools of nursing and practice.
The traditional approach to teaching nursing research includes the use of didactic lectures, testing of material covered in class, and having students critique research articles. These courses support knowledge development but typically involve little or no student engagement. Consequently, students complete coursework without seeing the value of a research course or understanding the research-practice connection. Today’s students require different teaching strategies to engage them in research. For example, McCurry and Martins (2010) described an innovative approach to teaching research to junior nursing students using presentations by clinical nurse researchers, interactive group work, and experiential assignments. At the end of the course, students reported they preferred the active learning assignments and were able to articulate the research-practice connection.
One of the most important factors in the success of the STARR program was the 100-hour research project required of master’s students by the nursing program. This mandate was key in recruiting students for the team. At first, students viewed the experience as a task necessary to complete to graduate. However, at the end of the semester, one STARR team member stated, “Overall, this experience was great and it has made me love research.” According to the American Association of Colleges of Nursing (2005), programs need to be put in place to increase the number of nurse researchers and the number of years they have to contribute to nursing research. As demonstrated by STARR program evaluations, nursing students can be socialized into research early through curriculum mandates.
Critical to fostering student interest in research are nursing faculty with programs of research. However, many schools of nursing lack research infrastructures and resources necessary to recruit and develop a critical mass of faculty with active programs of research. Academic administrators must be open to ways to foster faculty scholarship through partnerships, incentives for faculty mentoring in gerontological research, and building infrastructure so faculty have the resources to further their scholarship. One successful example, described by Maas, Conn, Buckwalter, Herr, and Tripp-Reimer (2009), is a strategy in which 17 schools of nursing formed a regional consortium to spread research capacity to area schools of nursing with fewer resources. Outcomes suggest this kind of collaboration increases gerontological nursing research productivity in individual schools with fewer resources.
Despite nurses’ knowledge of the importance of research, few nurses incorporate research findings into practice. Research utilization by practicing nurses at 1 and 3 years postgraduation has been reported as low (Forsman, Gustavsson, Ehrenberg, Rudman, & Wallin, 2009). Balancing the responsibility of patient care with time needed for research remains a challenge. An integrative review of the literature examining barriers to research utilization by nurses found lack of time, difficulty understanding research findings, and an inability to change practice as common barriers experienced in practice settings (Solomons & Spross, 2011). However, Fink, Thompson, and Bonnes (2005) suggested that nurses’ attitudes and beliefs about research can improve through organizational commitment to research use in practice. This commitment includes provision of resources and support through continuing education programs, financial incentives for staff to advance their education, and creating academic-practice partnerships.
If organizations lack resources, administrators must look for creative programming to implement models that have been shown to increase use of evidence-based practice and narrow the research-practice gap. For example, Hendrix, Matters, West, Stewart, and McConnell (2011) described Duke University’s Nurses Improving Care for Healthsystem Elders academic-practice collaboration, developed to improve care to older adults and generate scientific knowledge at point of care. They demonstrated that two separate institutions with different missions can successfully collaborate by focusing on common ground, which in their study is the shared belief that nursing care of older adults needed to be improved.
With the expected increase in the nation’s older adult population, it is critical that schools of nursing focus on preparing gerontological nurse researchers. Older adults are at higher risk for adverse care outcomes because of comorbidities and fragmented care (Cherry, Lucas, & Decker, 2010). The most critical missing link in providing optimal care for older adults is bedside assessment and care and research utilization. For example, when a long-term care nurse identifies symptoms of depression in an older adult, the usual intervention is to ask for medication. However, there are other nonpharmacological approaches that could be used instead if a literature search could be conducted or a gerontological specialist (gerontological nurse practitioner or doctor of nursing practice) was easily available to consult for best practice. The gerontological nurse, having helped that particular patient, would consequently use the best practice for depression with other patients on the unit. Additionally, it would be worthwhile to initiate studies evaluating the efficacy of nonpharmacological interventions on depression in older adults. STARR is an example of one strategy to increase student interest in gerontological nursing research in an academic setting.
However, it is important to note that fostering utilization of gerontological nursing research requires a multi-level approach that includes education and practice. While STARR has been shown to be a successful academic program, the students’ abilities to conduct and use gerontological nursing research will depend on not only what they learned as STARR members, but whether their site of employment promotes evidence-based practice and the improvement of care for older adults. Translation of research into practice and policy can be complex. Programs like STARR should also include content and experiences on how research can impact policy.
- American Association of Colleges of Nursing. (2005). Faculty shortages in baccalaureate and graduate nursing programs: Scope of the problem and strategies for expanding the supply. Washington, DC: Author.
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