In recent years, efforts to increase educational offerings in geriatric/gerontologic health care have targeted nursing, medical, and allied health professions faculty. Despite these efforts, there remains a lack of sufficient numbers of health professionals with adequate knowledge in geriatrics. This is highly problematic because health care providers may find themselves in the prime of their careers spending as much as 75% of their practice time with older people as a result of the unprecedented rise in both the number and proportion of elderly individuals in the United States (Butler, 1980).
According to the National Institute on Aging publication, Personnel for Health Needs of the Elderly Through the Year 2020 (1987),
Nurses provide services to elderly persons in many settings, including older persons' homes, as well as in doctors' offices, community health clinics, nursing homes, and hospitals. In most of these situations, nursing personnel are the largest segment of formal caregivers.
Of the approximately 2 million registered nurses (RNs) in the U.S., 68% are employed in hospitals and 8% in nursing homes; 44% of their efforts focus on the care of older adults. Based on this information, it is crucial that nurse educators' knowledge of geriatrics be increased so that they can educate the RNs who ultimately will provide care to older persons.
Although most gerontologie attention has focused on developing baccalaureate nursing program (BSN) faculty, slightly over 60% of all RNs in the U.S. are taught each year in 815 community college 2-year associate degree nursing programs (ADN). Two of the National Institute on Aging's (1987) recommendations regarding faculty development were to expand efforts to update knowledge and skills of current school of nursing faculty members, and to increase the quantity and quality of continuing education offerings focused on health care of both well and ill older persons for all levels and types of nursing personnel.
The results of two recent surveys (211 associate and baccalaureate degree nursing programs in 15 southern states and 64 such programs in California) underscore the need for faculty development that can lead to increased scholarly productivity in teaching and research.
Brewer's (1991) findings of the nursing programs in southern states were the following: (1) only 13% of all undergraduate nursing faculty surveyed had any formal preparation in gerontological nursing; (2) gerontological nursing's status is not as high as that accorded to other specialized areas of nursing practice; (3) there are few faculty members with an interest in gerontological nursing who can foster interest in undergraduate students.
The California study by Fullerton, Lantz, and Quayhagen (1992) concluded that, the respective 3:1 ADN to BSN program ratio notwithstanding, faculty preparation for the gerontologie teaching role highly favors BSN faculty over their ADN counterparts who, paradoxically, teach the majority of registered nurses.
Purpose of the Study
Given the large numbers of DN and BSN programs, we were interested in determining if differences or similarities exist between samples of these two groups of nursing faculty on selected measures of biographical, experiential, and scholarly productivity data, since these professional characteristics relate to gerontologie education.
This study focused on the outcomes of 15 nursing educators involved in a faculty development program conducted by the Texas Consortium of Geriatric Education Centers (TCGEC) headquartered at Baylor College of Medicine (BCM): 11 were from two local community colleges and 4 from a historically Black college/university.
In January 1991, the 15 faculty members began meeting each month to participate in a graduate-level course in gerontological nursing. Designed in conjunction with nursing educators, the course was led by TCGEC experts in gerontology/geriatrics. The scope and content of the year-long course was viewed as an intervening variable.
The 12 sessions covered the following topics:
* Demography and Epidemiology of Aging Concepts and Aging Myths, Beliefs, and Attitudes;
* Biology of Aging: Sensory Changes, CNS Changes, Cellular Changes, and Body System Changes;
* Psychological Aspects of Aging, Social Aspects of Aging, and Assessment of the Older Individual;
* Management of Selected Disorders: Dementia/Depression, Falls and Immobility, and Polypharmacy;
* Management of Selected Disorders Continued: Cardiovascular Disease, Urinary Incontinence, and Dental Health;
* Aging in the Physical Environment and Personal Action Plan Development;
* Service Delivery Issues: Long-Term Care, Home-Based Services, Community Services, and Financing Health Services;
* Legal and Ethical Issues;
* Compliance with OBRA/HCFA Guidelines;
* Ethnographic Issues in Aging: Intergenerational Issues, Gender Issues, and Cultural Changes;
* Practitioner Beliefe and Service Provision Implications for Training and Research in Ethnicity; and
* Personal Action Plan Presentations and Curriculum Infusion and Dissemination Methods.
The 11 ADN faculty in the present study, along with the 10 other community college nursing educators who had completed another year-long TCGEC Professional Development Program (PDP), were compared with a convenience sample of 25 BSN nursing educators who had also completed the PDP. All 46 nurses were given the TCGEC Enrollee Survey Instrument used since 1985 to gather biographical, experiential, and scholarly productivity data on the then 350 PDP enrollees from eight health-related disciplines (Fässer, Roush, & Wright, 1988). As one endpoint (dependent variable), scholarly prodi uctivity was used as a proxy for academic activity following faculty development; it was defined as the number of publications, papers presented, and grants written in a 3-year period. Personal background and professional training were combined to form a quasi-independent variable.
Biographical characteristics of the allfemale ADN and BSN subjects were, respectively: (1) mean ages of 45 and 43 years, and (2) 38% vs. 12% were Black. Regarding academic training and rank, ADN faculty were master's prepared (86%) with no doctorates, whereas 44% of BSN faculty held doctorates and also had almost two times the reported level of formal training in geriatrics; BSN faculty had more tenure track faculty (74% vs. 19%) than did the ADN group. Both groups had essentially the same level of experience - 22 vs. 21 years.
Regarding their scholarly productivity, these were the principal findings: BSN faculty had an annual productivity index (API) of .7 publications per year (53 pubs/ 25 faculty = 2. 12/3 yrs.), which was seven times that of ADN faculty (7 pubs/21 faculty = .33/3 yrs. = .11/yr.), and BSN faculty also presented far more papers (1/yr. vs. .52/yr.) and contributed to more grants (1.3/yr. vs. .06/yr.) than did ADN faculty. As a point of comparison, the BSN faculty of the present study had a slightly higher API (.7 vs. .5 puba/yr.) than did a national group of doctorally prepared BSN faculty in research institutions (Lia-Hoagberg, 1985). Other gerontologie health professions educators in academic health centers average about two publications per year (Roush, Fässer, Wright, & Wilson, 1992).
The two groups of nursing faculty we studied were dissimilar with respect to scholarly productivity; however, their personal backgrounds had less to do with this than did their respective places of employment. While community or senior colleges constituted the milieu in which the subjects' professional socialization occurred, the schools have different expectations of their faculty (Blackburn, 1979). Thus, ADN faculty, who teach the majority of RNs in the U.S. in community colleges, should not be expected to engage in research as much as their BSN counterparts. The scholarly productivity index of ADN faculty should be the quality of their instruction of future caregivers based on current and appropriate knowledge regarding the care of older people. Notwithstanding this distinction, efforts should be made to involve ADN faculty in frequent professional development because they are generally not located in academic health science centers and, thus, don't have as many opportunities to interact with other health professions educators as do their BSN faculty counterparts.
Because all health-related faculty, irrespective of discipline, need to increase their level of scholarship, some of the characteristics of highly productive faculty might prove to be instructive. According to Bland and Schmitz (1986), these persons do the following:
1. acquire an in-depth knowledge in a research area;
2. master methodology skills;
3. adopt mores and expectations of researchers in their fields, e.g., PhD^ dissertations socialize them, whereas MDs become socialized to academic medicine during postresidency fellowships;
4. associate early and collaborate with distinguished faculty mentors;
5. develop scholarly habits early, since publishing in the first 5 to 10 years is highly predictive of future output;
6. maintain professional contacts and network with other productive persons;
7. choose productive departmental peers with whom to share projects and brainstorm ideas;
8. engage in multiple projects so if one doesn't work out, perhaps the other one will;
9. schedule research work for at least 20% of their time;
10. serve on institutional governance and curriculum committees;
11. relate better to such work factors as creativity, problem-solving, and flexibility;
12. choose places of work that support the scholarly interest of the faculty as evidenced by sufficient time, assistance, and an atmosphere of academic freedom.
The need to foster teaching and research productivity in all disciplines is self-evident; the need to do so in geriatrics is imperative, especially in nursing because nurses constitute the largest single source of care necessary to achieve good patient outcomes.
- Blackburn, R.T. (1979). Academic careers: Patterns and possibilities. Current Issues in Higher Education, 2, 25-27.
- Bland, C.J., & Schmitz, CC. (1986). Characteristics of successful researchers and implications for faculty development. Journal of Medical Education, 61, 22-31.
- Brower, H.T. (1991). Gerontological nursing curriculum issues: A regional profile. Atlanta: Southern Regional Education Board.
- Butler, R.N. (1980). Meeting the challenges of health care for the elderly. Journal of Allied Health, 9, 161-164.
- Fasser, CE., Roush, RE., & Wright, T.L. (1988). Education in geriatric medicine: The TCGEC faculty development model. Gerontology & Geriatric Education, 8, 37-47.
- Fullerton, J.T., Lantz, J., & Quayhagen, MR (1992). The level and focus of geriatric nursing content in ADN and BSN programs. Journal of Nursing Education, 31, 390-396.
- Lia-Hoagberg, B. (I98S). Comparisons of professional activities of nurse doctorates and other women academics. Nursing Research, 34, 155-159.
- National Institute on Aging. (1987). Personnel for health needs of the elderly through the year 2020. Washington, DC: US Department of Health and Human Services.
- Roush, R.E. , Fässer, CE., Wright, T.L., & Wilson, N.L. (1992). Scholarly productivity of geriatrics senior faculty members and faculty trainees compared with that of other health professions educators. Academic Medicine, 67(2), 118-120.