With co-authors Mollie Hobensack, PhD, RN; Kylie Dougherty, MPhil, BSN, RN; Jung A. "Chloe" Kang, MSN, AGACNP-BC, AGCNS-BC; Sarah I. Leonard, MPhil, MSN, RN; and Yashika Sharma, MPhil, MSN, RN.
Nurse scientists play an indispensable role in generating and advancing knowledge to improve the health and well-being of patients, families, clinicians, and communities. Compared to Doctor of Nursing Practice (DNP) programs that prepare clinicians to be experts in advanced nursing practice, many PhD programs focus on training nurses to be independent researchers with an emphasis on investigating research questions and solutions driven by the nursing perspective. Despite this important role, enrollment in nursing PhD programs has declined by about 11% since 2013. Research-intensive universities report that finding nursing faculty able to conduct research is a critical issue related to faculty recruitment. The Future of Nursing 2020-2030 report notes that the slow growth of PhD-prepared nurses is a concern for the profession because nursing practice relies on a pipeline of research to advance equity, evidence-based care, inform policy, and improve the health of people and communities.
We are nurses with diverse and interdisciplinary experience (ICU, ED, telemetry, medical-surgical, global and community nurses, chemists, social workers, nurse practitioners, and clinical nurse specialists) who are pursuing a PhD in nursing at a research-intensive university. We believe that sharing why we chose this path, along with our perspectives on barriers and facilitators to nursing PhD recruitment, may provide unique insight for institutions to consider to increase enrollment, ultimately mitigating the nursing research faculty shortage.
Collectively, we were driven to pursue a PhD in nursing because we desired to extend our clinical reach to support the nursing profession at the policy level. We sought to gain the scientific knowledge and skills to improve patient outcomes and mitigate the health disparities that we witnessed at the bedside and in the community. Instead of pursuing a PhD in another discipline (e.g., public health, chemistry, etc.), we chose nursing because we wanted our work to be grounded and shaped by the holistic nursing perspective, which comprehensively considers the physical, social, and emotional determinants of health.
Fueling our early interests in research, many of us were mentored by scholarly nursing researchers during our clinical nursing programs who encouraged us to consider a PhD in nursing as a career option. Our hands-on, individualized experiences with these mentors working on systematic reviews, data management, grantsmanship, dissertations, and presentations gave us first-hand experience in exploring our curiosities through research science. We were able to do this work through honors programs, specialized mentor partnership programs, internships, work-study, or other independent extracurricular work. Networking opportunities at conferences (NSNA, ENRS, and Sigma) granted us further exposure to nursing science as a potential career.
The funding opportunities of PhD programs led us to consider certain programs over others. We believe that the availability of funding and scholarships for domestic and international students is a barrier to recruiting diverse nursing scientists, whose perspectives help foster dynamic conversations in the classroom and inspire innovative programs of research. The full-time, demanding nature of nursing PhD programs means that financial incentives are warranted if schools wish to recruit students from underrepresented backgrounds who may be hesitant to leave the financial stability of their clinical nursing jobs. We encourage institutions to include students from all backgrounds in all conversations about funding to ensure that their needs are met.
We perceive a broad, comprehensive lack of knowledge of nursing research as a career path in the larger nursing community. Many of our classmates in our clinical nursing programs and coworkers at the bedside were unaware that pursuing a PhD in nursing was an option available to them. Even if they did know about PhD programs, they often thought the nursing PhD path was focused on teaching. The disconnect between the clinical and research communities inhibits the integration of science and practice, thereby hindering the advancement of both fields. Many of us have been told that by pursuing research, we are leaving clinical nursing behind. We believe that fostering integration between these two communities is key to both recruiting nursing PhD students and improving the quality of nursing science and practice. Exposure to nursing science through committees or career fairs in hospitals, clinics, and undergraduate programs may help mitigate the disconnect. Involving frontline nurses as active participants in the development, implementation, and dissemination of research may help foster connections between the two communities.
We believe that the strongest healthcare innovations will be developed by nurses and by fostering an environment that champions the intersection of clinical and research science. Exposing nurses to research early in their education and careers can foster a love for pursuing better health outcomes and answering the clinical questions that impact us, and thus increase the number of PhD-prepared nurses in the field. A review of the literature may be warranted to synthesize and summarize successes and failures of nursing PhD recruitment techniques and further inform best practices. To summarize, we perceive a disconnect between clinical nursing and nursing research and believe that early exposure to research, equitable funding, and improved awareness of nursing science as a potential career could help increase recruitment in nursing PhD programs.
Overall, our perspectives on recruitment of PhD in nursing students are limited to our collective personal experiences. But we also have unique individual journeys. Here are our stories:
Eleanor Turi, PhD, RN, CCRN: As a BSN student at the University of Pittsburgh, I was exposed to nursing research early on through a program that paired nursing students with faculty to assist with research activities. This experience was instrumental in my decision to pursue research because I understood that it was a viable career option for me and, perhaps more importantly, learned to love the curiosity inherent in science. During this time, I also worked as a student nurse at a local food pantry conducting health screenings where I gained hands-on experience in addressing the social determinants of health. Moreover, after school when I worked as a bedside nurse in the pediatric ICU, I witnessed how gaps in preventive healthcare caused many admissions to our unit. Finally, I also noticed how the work environment influenced the quality of care I was able to deliver. Pursuing a PhD in nursing was an avenue for me to address many of these issues, including social risks, work environment factors, and gaps in preventive healthcare. I believe that, given proper support and mentorship, all nurses have the knowledge and power to improve our healthcare system through research. Better communication about the viability of nursing research as a career to the broader clinical nursing community, paired with recruitment and retention of nurses from diverse backgrounds into nursing science, can transform the field and improve population health.
Kylie Dougherty, MPhil, BSN, RN: I was first exposed to nurse-led research during my sophomore year at the University of Kentucky when I served as a research intern for Dr. Kristin Ashford. During the rest of my undergraduate career, I continued to learn more about the role of nurses in research and had the incredible experience of leading my own pilot project and serving as the primary investigator during my senior year. From this experience, I knew I wanted research to be a part of my career. However, I also wanted the experience of working at the bedside. I took a volunteer position in a non-profit neonatal intensive care unit in Fort Jacques, Haiti. After experiencing the complex drivers of mother-newborn death in Haiti, I resolved to advance my skills in creating realistic, powerful, and contextual solutions. I decided to pursue a PhD and focus on my research on creating solutions to improve health outcomes in low- and middle-income countries. Exposing nurses to research early in education and careers can foster a love for pursuing better health outcomes and answering the clinical questions that impact us, thus increasing the number of PhD-prepared nurses in the field.
Mollie Hobensack, PhD, RN: During my BSN education, I worked as a research assistant for Dr. Andrew Reimer in a work-study position at Case Western Reserve University. This work cultivated my interest in the intersection of nursing and informatics. In addition to my clinical studies, I was exposed to thinking about how structure and policy impacted the individual-level decisions we as nurses make at the bedside. The university offered campus-wide research events that allowed me to engage with other interdisciplinary students excited about research. These two experiences were pivotal to fostering my interest to pursue a career in research. Upon graduation, I desired to work clinically first to ground my research questions in bedside practice. During my time working as a geriatric medical-surgical nurse, I was exposed to pre-existing healthcare disparities that were exacerbated by the pandemic within the older adult population. Following these experiences, I was excited to begin my PhD journey focused on leveraging informatics to promote equity in care for older adults. Regardless of your path, I encourage you to consider your value as a nurse and how you can use your experiences and voice to shape the science and research that informs emerging technologies, practice, and policy.
Yashika Sharma, MPhil, MSN, RN: I was introduced to research early in my undergraduate program; I worked as a research assistant in a biochemistry lab at the University of Rochester. Although my training as a biochemistry research assistant focused on technical skills, I also gained experience conducting literature reviews, developing research questions, collecting data, and disseminating research findings. These experiences solidified my desire to build a research career. My experience in nursing school and clinical experience in hospitals solidified my interest in sexual minority health as I witnessed how little was taught about social determinants of sexual minority health and the unique stressors experienced by sexual minority people. However, I did not fully understand what it meant to build a research career as a nurse until I met my mentors. They encouraged me to apply to the PhD program and introduced me to population health research, including how it can be used to address sexual minority health disparities. I chose to pursue a PhD to conduct policy-oriented research to reduce health disparities among minority populations. I would encourage others to pursue a PhD as it can equip them with the skills required to produce the evidence necessary to reduce systematic barriers, inform policy and practice, achieve health equity, and advocate for institutional change.
Jung A. "Chloe" Kang, MSN, AGACNP-BC, AGCNS-BC: My previous clinical experiences as a registered nurse, nurse practitioner, and clinical nurse specialist in different care settings have led me to numerous opportunities. I have led a quality improvement project, educated nurses, given poster presentations, and met with nursing leadership in numerous seminars. These opportunities have honed my leadership skills and given me a broader perspective to think about nursing practice at a system level. In general, I have learned that while science and technologies in healthcare have advanced significantly in a brisk manner, many patients that I have encountered have not always received care that was based on the best scientific knowledge. Along with experience as a critical care nurse and research assistant, this chasm inspired me to pursue a research doctorate and close this gap by transforming the care delivery system for elderly patients at the end of life.
As we already know, nurses should be ready to partner with other interdisciplinary team members who often already have their master’s or doctoral-level degrees. To not only fluently utilize but also generate the best scientific evidence for practice, nurses also should be familiar with research, and one of the ways is by entering into a PhD program. Many of us have been exposed to research activities during our undergraduate programs. Student nurses and registered nurses should be encouraged to participate in research projects so that those experiences allow them to recognize their potential as changemakers, policymakers, advocators, and leaders of the health professionals.
Sarah I. Leonard, MPhil, MSN, RN: I have always been interested in adolescent mental health research. Initially, I studied social work at The Ohio State University where I had the opportunity to complete an undergraduate research thesis. I was then drawn to nursing in order to better understand mental health and its treatment holistically, incorporating physical as well as social and emotional well-being. As a nursing student, I initially had no idea that nursing research was its own field, let alone a field full of opportunity. I decided to pursue a nursing PhD because of contact I had with nursing research faculty as a nursing student. This included inspiring presentations given by PhD-prepared nurse researchers during my classes and conversations with faculty members who encouraged me to apply for a PhD. In my PhD program, it has been incredibly gratifying to apply my perspective as a nurse to my research on LGBTQ+ adolescent mental health equity. I encourage other nurses who wish to improve something about health and/or healthcare to consider pursuing a PhD in nursing, particularly at schools that offer tuition and stipend funding. I also recommend that nursing schools and funding agencies devote more resources to educating nursing students about the PhD path and providing nursing PhD program funding, including tuition coverage and stipends that match the local cost of living. Increased awareness and adequate funding are essential to ensuring that nursing students from all backgrounds can pursue PhD education.
Eleanor Turi, Kylie Dougherty, Mollie Hobensack, Yashika Sharma, Chloe Kang, and Sarah Leonard are nursing PhD students at a research-intensive university. Kylie, Chloe, and Sarah are members of Sigma’s Alpha Zeta Chapter, and Mollie is a member of Sigma’s Alpha Mu Chapter.