Research in Nursing & Health, 2011, 34, 169–170
IOM Report, The Future of Nursing: Leading Change, Advancing Health: Milestones and Challenges in Expanding Nursing Science
The Institute ofMedicine’s (IOM, 2011) report, The Future of Nursing: Leading Change, Advan- cing Health, was released October 5, 2010. The report represents a significant milestone for health care, demonstrating the depth, breadth, and sophistication of nursing science. Nursing’s col- lective body of work withstood the rigors of independent IOM reviewers. The Future of Nur- sing recommendations, like those in all IOM reports, reflect an evidence-based context, and they set forth evidence-based directions for how nursing and nursing research can best serve the public. Research in Nursing &Health (RINAH) is one example of an important scientific dissemina- tion channel. The report creates a sense of urgency about the
future of nursing research. Recommendation 4, which calls for increasing the proportion of nurses with baccalaureate degrees, directly ties to recommendation 5, to double the number of nurses with doctorates by 2020. Simply put, the pool of nurses with the capacity to conduct inquiry and research will be insufficient unless a pipeline of nurses advance to an academic level where they can pursue advanced studies. Not only will research suffer, academe and service also need highly educated nurses to teach and lead. Recom- mendation 8 calls for strengthening the collection and analysis of workforce data. This is a key mandate for PhD-prepared nurses to use their considerable skills beyond the clinical research questions in which they have traditionally engaged. Nurses educated as researchers and scientists
must value, relate to, and interact with nurses who possess other types of doctoral or master’s education, including those with practice doctor- ates. Although master’s and doctorally prepared clinical scholars do not have the benefit of formal education in advanced research methods and statistical techniques, they are nonetheless critical to clinical inquiry at the point-of-care and
evidence-driven decision making within the organizational context. Their clinical expertise and advanced knowledge of nursing practice can be used in partnership with nurse scientists. As knowledge expands and is publically accessible, the public demand for interpretation and immedi- ate application of scientific findings in clinical settings is increasing. Inter- and intra-professional connectivity will optimize nursing’s impact in advancing health via the synergy that bridges scientific knowledge generation with translational expertise at the point of care. This synergy may also serve to link nursing better with other health care professions, giving nurses a stronger voice in decision-making forums and at policy tables.
Chapter 7 of the IOM report, ‘‘Recommenda- tions andResearch Priorities,’’merits the attention of the nursing scientific community. Many nurse scientists and researchers have a dedicated focus on clinical research, which is still much needed in light of concerns for quality, safety, aging, chronicity, and other clinical concerns. In contrast, the priorities identified in chapter 7 reflect a research agenda expanded to less studied areas of transforming nursing practice models, enhancing nursing education, and influencing nursing leader- ship. As a member of the committee developing this report I recognized the importance of these subject areas as essential to the application of clinical research. For example, if nursing practice environments are needlessly complicated, then the implementation of clinical research findings will be stymied. If we have insufficient knowledge about pedagogical strategies that enhance learn- ing, then we waste critical resources in the education of learners who comprise our research pipeline. If we fail to examine the complexities of leadership and their impact on patient care, health systems, and education, then our science is not valued and our input is not felt in settings where nursing should be at the table. If we can accept this broader research portfolio—and I suggest it is
Correspondence to Michael R. Bleich *Dean and Dr. Carol A. Lindeman Distinguished Professor; Vice Provost—
Interprofessional Education. Published online 22 April 2011 in Wiley Online Library
(wileyonlinelibrary.com). DOI: 10.1002/nur.20433
�2011 Wiley Periodicals, Inc.
imperative to do so—then we can attract nurses who have these interests. We do not need to do this alone. With the next generation of nurse scientists we can work in interprofessional teams with organizational, complexity, informatics, and sys- tems scientists. This is a time for action. The Robert Wood
Johnson Foundation (RWJF), whose leadership and funding engaged the IOM in examining the future of nursing, made the commitment to develop a national implementation strategy for the recommendations. It is known as the Cam- paign for Action. At RWJF Dr. Susan Hassmiller, Senior Advisor for Nursing; Dr. Lori Melichar, Senior Economist; and Christine Phares, Grants Administrator have put forth a national research agenda that integrates the prioritized research questions in the report with additional contribu- tions from policy makers and nursing experts. As part of the implementation campaign, an
innovative funding model, the Nurse Funders’ Network, has been announced. This creative model is a clearinghouse that will match research- ers with interested donors. The RWJF hopes to leverage the contributions of smaller foundations or individuals who lack a research review mechanism. With assurance, these funders will now be able to place their contributions through the clearinghouse, concurrently supporting research topics that advance the IOM recommen- dations. Dr. Lori Melichar described the funding goals as iterative and evolving as the results of studies are shared rapidly with policy-makers and other stakeholders. Researchers should note that the inaugural Call
for Proposal is under way. Submissions will be reviewed competitively for relevance and rigor within the Network, and then the best will be announced to funders for their selection and awards. The Call for Proposals will solicit for a range of
research projects from quick studies and scans, policy analyses, secondary data analyses, descrip- tive and case studies, to demonstrations with
program evaluation and theoretical modeling. The research questions will vary too, from ‘‘Is there a value proposition for health plans using APRNS in panels?’’ to ‘‘How effective are various inter- professional education models?’’ to ‘‘What competencies are most important for contempor- ary nursing care?’’ to ‘‘What new technologies support nurse decision-making and care delivery?’’
It is time to ask who will be the next generation of nurse researchers to tackle research to advance quality and safety, nursing education, care deliv- ery, and workforce issues? Let me be direct.When Linda Aiken, Patricia Benner, Peter Buerhaus, Christine Kovner, Mary Naylor, Christine Tanner, and other pioneer organizational, educational, policy, and workforce scientists sunset their careers will the next generation of researchers be ready to step up? Each of these pioneers has been a tenacious leader, scientist, and mentor, but they have had to carry forward their work, often with funding challenges and against many odds.
Does the nursing and nursing science commu- nity have the collective desire to advance the breadth and depth of research, extending the achievements reflected in the IOM report? This is a time for bold leadership from the research community. Like many others, I know that we have the collective talent, skills, and abilities to wisely chart a broader research agenda for nursing and the needs of the public.
Michael R. Bleich* School of Nursing
Oregon Health & Science University 3455 SW US Veterans Hospital Road
Portland, Oregon 97239
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.
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