Journal of Nursing Education

Educational Innovations 

Promoting and Supporting a Doctor of Nursing Practice Program of Scholarship

Yovan Gonzalez, DNP, FNP-BC; Deborah S. Finnell, DNS, CARN-AP, FAAN

Abstract

Background:

Mentoring in the context of the faculty–student relationship can be one in which each benefits. Creative approaches are warranted to help discriminate the boundaries between the student and the teacher as a mentor, which are often ill-defined and blurred given the high-stakes summative assessments of performance.

Method:

Six specific, measurable, achievable, relevant and time-based (SMART) goals were established for a mentor and mentee relationship spanning a 2-year period based on a vision for building a program of scholarship. Weekly mentoring sessions were used to monitor progress toward goal attainment.

Results:

While completing the Doctor of Nursing Practice program, the mentee expanded professional networks, obtained funded fellowships, expanded knowledge and skills related to the substantive area of scholarship, and disseminated that work through professional presentations and publications coauthored with the mentor.

Conclusion:

Cognizant of the boundaries between course-related products and professional presentations and publications, the goal-driven mentor–mentee relationship is transformational to both. [J Nurs Educ. 2020;59(9):526–530.]

Abstract

Background:

Mentoring in the context of the faculty–student relationship can be one in which each benefits. Creative approaches are warranted to help discriminate the boundaries between the student and the teacher as a mentor, which are often ill-defined and blurred given the high-stakes summative assessments of performance.

Method:

Six specific, measurable, achievable, relevant and time-based (SMART) goals were established for a mentor and mentee relationship spanning a 2-year period based on a vision for building a program of scholarship. Weekly mentoring sessions were used to monitor progress toward goal attainment.

Results:

While completing the Doctor of Nursing Practice program, the mentee expanded professional networks, obtained funded fellowships, expanded knowledge and skills related to the substantive area of scholarship, and disseminated that work through professional presentations and publications coauthored with the mentor.

Conclusion:

Cognizant of the boundaries between course-related products and professional presentations and publications, the goal-driven mentor–mentee relationship is transformational to both. [J Nurs Educ. 2020;59(9):526–530.]

A body of literature exists relative to the rigor and quality of the Doctor of Nursing Practice (DNP) scholarly project (Becker et al., 2018; Durham et al., 2019; Roush & Tersoso, 2018; Terhaar et al., 2016) that serves as a foundation for future scholarly practice (American Association of Colleges of Nursing [AACN], 2006). The DNP graduate is expected to have the competencies and expertise to improve health care outcomes through translating evidence into practice. Nurse educators can promote and support DNP students in establishing a program of scholarship within the context of a mentoring relationship. Eller et al. (2014) identified key components of an effective mentoring relationship to include

  • open communication and accessibility
  • goals and challenges,
  • passion and inspiration,
  • caring personal relationship,
  • mutual respect and trust,
  • exchange of knowledge,
  • independence and collaboration, and
  • role modeling.

Literature on mentoring focuses on helping the future nurse educators (Block & Florczak, 2017; Nowell et al., 2017), nurse researchers (Hafsteindóttir et al., 2017), graduating nurses (Lavoie-Tremblay et al., 2020), nurses in clinical settings (Hale & Phillips, 2018), nurse authors (DeMeyer & DeMeyer, 2018), and future nurse leaders (Galuska, 2012). Mentoring in the context of the faculty–student relationship has received less attention, perhaps because the faculty member as mentor provides high-stakes summative assessments of performance. As Volkert et al. (2018) suggested, it should be the responsibility of the faculty member to acknowledge this differential power structure and build both communication and relational skills that provide for successful negotiation. In turn, the mentor–mentee relationship can be one in which each benefits, particularly when focused on the optimal growth of each individual. Described herein are the goals for a mentor and mentee relationship over the 2-year period when the mentee was engaged in a DNP program, discussed within the context of current literature related to mentoring. These goals were formulated with a vision for building a program of scholarship within and beyond the DNP program.

Goal 1: Begin a Program of Scholarship Aligned With the DNP

The DNP program in which the mentee was enrolled was delivered via a distance-learning format beginning with a week-long immersion at the school of nursing. Welch (2017) examined the lived experiences of doctoral nursing students who participated in a virtual mentoring program. A first step for those students was the confirmation of mentoring in which not only academic but also personal support was provided (Welch, 2017). A scholarly project is a key outcome of the DNP program, and thus having a subject matter expert to help inform and shape that work is important. A national survey of research-focused doctoral nursing students highlighted the important mentoring practices. When respondents were asked about mentoring practices of advisors, the highest ranked was discussions of concerns about research, followed by monitoring of progress and provision of feedback, and discussing career plans (Neresian et al., 2019).

As a family nurse practitioner working in a primary care clinic, the mentee identified being ill-equipped to manage patients with substance use. The faculty member who subsequently became the mentor was one who had long-term experiences in the field of substance use and addictions and was currently focused on advancing substance use screening, brief intervention, and referral to treatment (SBIRT). Thus, from the onset of confirming the mentoring, the mentor and mentee engaged in discussions about how to advance substance-related knowledge and skills and implement system-wide practice changes to improve health outcomes for individuals who may be at risk because of substance use. According to White et al. (2018), “Intentional, well-aligned knowledge, skills, and attitudes [between the mentor and mentee] promote quality, meaningful scholarly project outcomes, and produce knowledgeable, confident DNP graduates who will positively influence nursing practice” (p. 110).

Shortly after beginning the DNP program, the mentee attended a day-long SBIRT workshop conducted by the mentor. This immersive experience provided foundational knowledge and experiential activities related to evidence-based screening, brief intervention using motivational interviewing skills, and resources for and approaches to referral to specialty treatment. The expected outcome of the workshop was that participants apply what they learned from the workshop to their practice. This workshop provided the opportunity to interact with the mentor outside the virtual mentoring experience and understand the importance of relationships—two themes identified by Welch (2017) from students describing building communities with their mentors. Specifically, in attending the workshop with the mentor, the mentee was able to interact face to face with other workshop faculty members. One of the faculty members who subsequently collaborated with the mentee on presentations and publications. He later relayed feedback to the mentor regarding the mentee's presentation at an international conference saying, “I'm also proud of him. His delivery and presentation are very smooth.” Armed with the new knowledge and skills from that initial workshop, the mentee focused on how to translate this into practice as well as how what was learned could be applied to further shaping the DNP scholarly project.

Some may view the time for mentoring as burdensome when considering the workload of faculty and competing demands for maintaining their own scholarship. However, Smeltzer et al. (2014) reported that the practices that most strongly supported faculty maintaining their level of scholarship productivity were the belief that engaging in scholarship made them better teachers and the personal gratification in experiencing doctoral students' successes. Recognizing the critical importance of the DNP scholarly project, Dole et al. (2017) surveyed DNP faculty about the environment of the DNP program and the final scholarly project. The amount of time to complete the DNP project was often more than anticipated; in turn, the outcome measures were limited and thus jeopardized the success of publishing the work (Dols et al., 2017). To this end and within the context of formal coursework, the mentor and mentee were able to have directed teaching–learning time. Specifically, in these courses, the mentee could enhance substance-related knowledge, gain experience in quality improvement activities that would strengthen the rigor of the DNP project, and have opportunities for dissemination.

The first course focused on a pilot project to evaluate an online program related to SBIRT. This project was the mentee's first experience in developing pretest–posttest surveys, a proposal for institutional review board approval, and a poster presented at the 2019 AACN Doctoral Education Conference. The second independent study course focused on increasing the mentee's knowledge related to the spectrum of substance use. This study was guided by content in the textbook The ASAM Principles of Addiction Medicine (Ries et al., 2014). Other learning experiences included attendance at professional conferences where cutting-edge substance-related research was disseminated. Weekly meetings with the mentor focused on how the mentee was applying the new knowledge to practice and in shaping career goals. With guidance from the mentor, the DNP scholarly project took shape, along with building a knowledge base upon which to build further work. Collectively, these two credit-bearing courses provided substantial time, beyond that of the virtual mentoring to invest in learning and scholarship.

Goal 2: Broaden Professional Networks

Over 64% of the doctoral students surveyed by Nersesian et al. (2019) agreed that help with professional networking was a mentoring practice exhibited by their advisor. Effective mentoring helps develop a sense of affiliation or belonging (Eby et al., 2013). Professional networks were expanded by attending nine professional conferences, initially together and later by the mentee alone. These conferences and meetings provided opportunities to expand knowledge and networks related to substance use (i.e., American Society of Addiction Medicine; Association for Multidisciplinary Education and Research in Substance Use and Addiction; International Network on Brief Interventions for Alcohol and Other Drug Use; National Drug Abuse Treatment Clinical Trials Network), nursing academia (AACN Doctoral Education Conference), and psychiatric mental health nursing (American Psychiatric Nurses Association), all of which allowed the mentee to interact with prominent national and international leaders, educators, and scholars. With a particular focus on the health disparities of the Hispanic community, the mentee forged connections with Latin American members of the Pan American Health Organization at the International Network on Brief Interventions for Alcohol and Other Drug Use conferences. For his work focusing on substance use and Hispanic families, the mentee was selected as a 2019 finalist by the American Society of Hispanic Psychiatry for the Don Quixote Award competition.

The mentee's professional networks exponentially increased with each conference attended and in joining several professional organizations (i.e., American Association of Nurse Practitioners, American Nurses Association, Association for Multidisciplinary Education in Substance use and Addiction, International Network on Brief Interventions for Alcohol and other Drugs, International Nurses Society on Addictions, National Association of Hispanic Nurses). These relationships were strengthened over time because the same individuals are members of several professional organizations and attend those conference. Thus, the mentee was becoming a member of a small community of scientists, clinicians, and educators who likewise focused on substance use.

Goal 3: Secure Funding for Scholarship

Initially, the mentee's travel support for professional conferences was sponsored by the mentor's grant and discretionary funds. During the second year of study, the mentee, with guidance from the mentor, wrote and submitted two successful grant applications. Through a partnership between the AACN and the National Institute on Drug Abuse, the mentee received $10,000 as a training award in the field of substance use to support travel and attendance at professional conferences. Another award was the appointment as fellow for the Substance Abuse and Mental Health Services Administration (SAMHSA) Minority Fellowship Program through the American Nurses Association. A third award was from a specialty nursing organization to support travel and registration for their annual conference. As a student scholar awardee, the mentee was engaged in small-group interactions and meetings with that organization's leadership furthering the networks among this specialized nursing community. The receipt of these awards provided support for the mentee's scholarship, increased visibility, and expanded networks at a national level. In recognition of the mentee's leadership as a SAMHSA minority fellow in reducing mental health and substance use disparities among ethnic/racial minority populations, the mentee received the Faye A. Gary Leadership Scholarship, which provided additional funds for ongoing scholarship.

Pursing other funding support, the mentee developed a collaboration with a company that produces online health simulations including one focusing on SBIRT. The outcome of this collaboration, including the mentor, has been a postdoctoral project in which the simulation was provided without cost and data provided to address the specific aims of the project. Nurse researchers are important contributors to the translation of evidence into clinical practice. The extension of the mentoring relationship to this postdoctoral collaboration provides ongoing support to improve and strengthen the mentee's scientific career development. A scoping review of competencies for a postdoctoral nursing researcher career by Numminen et al. (2019) found that career management was the least addressed competency domain, highlighting the need to take seriously the need to support and encourage new DNP graduates to continue to advance their scholarship and nursing science.

Goal 4: Present Scholarly Work at Professional Meetings

In discussing the role for doctoral students in advancing knowledge translation, Younas and Porr (2019) encouraged mentors to urge their students to use creative approaches, including early dissemination. Joshua (2017) described the value of such an experience, including helping to develop confidence in presenting the scholarly work in the context of recognizing that presenting at professional conference can be challenging and emotionally laboring. Over a 2-year period, the mentor–mentee generated three abstracts that led to poster presentations at national and international conferences, two of which resulted in published abstracts in high-impact journals (i.e., Alcoholism: Clinical and Experimental Research, Substance Abuse). With colleagues from three other schools of nursing, the mentor and mentee provided a podium presentation at the AACN 2017 Doctoral Conference. In 2018, the mentoring team was invited to present a webinar on the role of nurses in health homes and integrated care settings for the SAMHSA-HRSA Center for Integrated Health Solutions. These five presentations furthered the mentee's experiences relative to dissemination of scholarly work. Based on the experience of presenting at a professional conference, Joshua (2017) stated, “I now understand what I had heard about the power and value of networking” (p. 28). Similarly, for the mentee, the experiences of poster and paper presentations synergistically advanced the goal to broaden professional networks. The presentations expanded the mentee's visibility among large audiences of educators, practitioners, and health care administrators.

Goal 5: Build a Record of Publications

Mentoring has been identified as a critical strategy for the successful development of scholarly skills in novice and junior faculty. Van Schyndel et al. (2019) highlighted several implications for nursing scholarship that were relevant for the mentoring relationship described herein. Specifically, there is a need to recognize that such novices require more and continued assistance in developing their scholarship (Van Schyndel et al., 2019). DNP students take courses in which a publishable manuscript can be an expected outcome.

While taking a course on nursing inquiry for evidence-based practice, the mentee conducted an integrative review of studies in which nurses delivered SBIRT. The course instructor, who was not the mentor, provided feedback on various phases of the paper throughout the semester. The mentor remained at arm's length, yet discussed variables that may be of interest and helped to identify relevant publications that may or may not have been identified from the database search. After the course grades were finalized, the mentee sought direction on moving the paper to publication. This discussion provided the opportunity to discuss potential coauthors, publishing ethics, target journals, and provide guidance on how to proceed with publication.

Several challenges existed in this initial collaborative writing experience, which were navigated effectively as the mentoring relationship had matured. First, the mentor and mentee discussed expanding the authorship to others, including the faculty member who taught the course and two faculty members with SBIRT expertise. Next, the paper was fully developed for the course, but there was a higher bar for publication. As such, the database search was replicated to identify any studies published since the paper was completed and to ensure consensus of all authors on studies and subsequent data for the integrative review. The mentee led all phases of this process, with guidance from the mentor, including the submission process. A final challenge was when the mentee was informed that the paper was rejected. It was important for the mentor to put this into perspective by conveying data on the small number of manuscripts of that type published by DNP students across eight cohorts (Becker et al., 2018). Van Schyndal et al. (2019) pointed out that occasional setback should be expected, so building resiliency and providing support are key for the development of complex skills required of successful scholarly endeavors. To that end, the mentor pointed out the merits of the reviewer comments, reframing them as providing support for improving the work.

Based on the mentor's experience in disseminating work at conferences, the mentee learned about organizations that publish abstracts in their respective professional journals. Another important learning experience was the development of manuscripts based on those abstracts, receipt of feedback at poster sessions, and from paper presentations. As the abstract was developed the supporting literature was archived so writing the manuscript would be a natural extension of the poster or paper presentation. Although published abstracts disseminated the work beyond the presentation, a fully developed manuscript allows for further expansion of the work and access to a larger audience. This lesson was important for continuing to build a record of scholarship.

At the onset of the mentoring relationship, the mentee had no publications and only limited experience in presenting scholarly work. At the end of the 2-year period, the mentee had two publications in peer-reviewed journals, a revised manuscript re-submitted, and the manuscript for the DNP scholarly project in final stages for submission. With those manuscripts published (Gonzalez, Kozachik, Hansen et al., 2020; Gonzalez, Kozachik, & Finnell, 2020), the mentee is equipped to move forward with continued contributions to the body of knowledge, building on a solid record of generating manuscripts and the experiences of identifying target journals and leading the submission process.

Goal 6: Advance Nursing Practice Related to Substance Use Prevention, Intervention, Treatment, and Recovery

Results of a study by Bowie et al. (2019) validate that DNP education prepares advanced practice nurses for leadership across complex health care systems. Such was the case for the mentee, who while in the DNP program was leading efforts to integrate primary and behavioral health/substance use prevention, intervention, treatment, and recovery into routine care within the health care system. Consistent with the DNP graduates who were interviewed for the study by Bowie et al. (2019), the mentee felt empowered to lead change and be impactful with regard to both the organization and patient outcomes. As an active member of the organization's Integrated Mental Health Services in Primary Care Committee, the mentee serves as a role model for other practitioners. At the beginning of the 2-year mentoring period, the mentee was the first nurse practitioner with the health care organization to obtain a waiver to prescribe buprenorphine. Over the 2-year period, the mentee has successfully integrated provision of buprenorphine and SBIRT into routine clinical practice and has presented on his experiences to other buprenorphine providers, a dominantly physician group.

The mentee was invited to contribute to the development of global nursing competencies related to prevention, health promotion, harm reduction, and treatment of at-risk substance use and substance use disorders, joining his mentor and colleagues from Canada, the United States, the United Kingdom, and Australia. The mentee contributed to the development of entry-level nursing competencies related to the area of “Policy Development and Planning.” Working with this team on competencies that were introduced at the 2019 International Council of Nurses Congress in Singapore help further expand the mentee's networks globally.

Conclusion

The mentor–mentee relationship has been synergistic, evidenced by the coauthored presentations and publications. The greatest joy may be to realize that the mentee is continuing to engage in and champion many of the mentor's causes and forge new ground in leading and advocating for an expanded nursing workforce prepared to address the health of the nation and beyond.

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Authors

Dr. Gonzalez is Family Nurse Practitioner, New York City Health & Hospitals, Gotham Health, Roberto Clemente Center, New York, New York; and Dr. Finnell is Professor Emerita, Johns Hopkins University, School of Nursing, Baltimore, Maryland.

Funding for Dr. Gonzalez's DNP scholarly project manuscript was made possible (in part) by grant no. 1H79SM080386-01. The views expressed in written training materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Yovan Gonzalez, DNP, FNP-BC, Family Nurse Practitioner, New York City Health & Hospitals, Gotham Health, Roberto Clemente Center, 540 East 13th Street, New York, NY 10009; email: yovan.gonzalez@nychhc.org.

Received: June 08, 2019
Accepted: April 03, 2020

10.3928/01484834-20200817-10

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