THE PAST DECADE has been one of rapidly growing

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1 ORIGINAL ARTICLES REFOCUSING RESEARCH PRIORITIES IN SCHOOLS OF NURSING KRISTINE M. KULAGE, MA, LAURA ARDIZZONE, DNP, CRNA, DCC, WILLIAM ENLOW, DNP, ACNP, CRNA, KATHLEEN HICKEY, EDD, C-ANP, C-FNP, FAAN, CHRISTIE JEON, SCD, JOAN KEARNEY, PHD, PMHCNS, APRN, REBECCA SCHNALL, PHD, RN, AND ELAINE L. LARSON, PHD, RN, FAAN, CIC # It is critical for schools of nursing to periodically reassess their scholarly programs to ensure that their conceptual framework and approaches address current challenges and enhance productivity. This article describes the process undertaken at Columbia University School of Nursing to evaluate scholarly enterprise so that it remains relevant and responsive to changing trends and to revise our research conceptual model to be reflective of the foci of our clinicians and researchers. As part of a larger strategic initiative, a two-phase Research Excellence Planning and Implementation Workgroup was convened, consisting of a broad representation of faculty and administrative staff, with an overall goal of expanding scholarly capacity. During Phase I, members developed measurable outcomes and tactics and revised the school's conceptual research model. In Phase II, the workgroup implemented and monitored tactics and presented final recommendations to the dean. To measure progress, faculty members completed a survey to establish baseline scholarship and collaboration with results indicating room for growth in interdisciplinary and inter-institutional collaboration. Ongoing assessment of outcomes includes Web-based tracking of scholarly activities and follow-up surveys to monitor expansion of faculty collaboration. We recommend this process to other schools committed to sustainable, increasingly relevant scholarship. (Index words: Research priorities; Nursing; Strategic initiative; Conceptual model) J Prof Nurs 29: , Elsevier Inc. All rights reserved. Director, Office of Scholarship and Research, Columbia University School of Nursing, New York, NY. Assistant Professor of Clinical Nursing, Columbia University School of Nursing, New York, NY. Assistant Professor of Nursing, Columbia University School of Nursing, New York, NY. Postdoctoral Research Fellow, Columbia University School of Nursing, New York, NY. Assistant Professor of Nursing, Columbia University School of Nursing, New York, NY. Professor of Therapeutic and Pharmaceutical Research and Associate Dean for Research, Columbia University School of Nursing, New York, NY. #Professor of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Address correspondence to Kristine M. Kulage, Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY kk729@columbia.edu /12/$ - see front matter THE PAST DECADE has been one of rapidly growing complexity in the health care landscape. For nursing as a core health care discipline, this demands reassessment of our educational and research programs to assure that their conceptual underpinnings and approach continue to address current challenges. The Columbia University School of Nursing (CUSON), like many other schools across the nation, has grown and evolved to include both practice and research doctorates. Following the first formal iteration of our research mission as articulated 8 years ago and published in this journal (Peirce, Cook, & Larson, 2004), we convened a working group to examine and update the research program at the school as part of a larger strategic planning initiative which was inclusive of all faculty, staff, and administrators. The aim of this article is to describe the formal process undertaken at the school to evaluate and revise our research enterprise so that it remains relevant Journal of Professional Nursing, Vol 29, No. 4 (July/August), 2013: pp Elsevier Inc. All rights reserved.

2 192 KULAGE ET AL and responsive to the changing health care landscape and reflective of our current scholarly and research focus. Our intent is that the process described here may be relevant and useful to other schools as they seek to sustain, evolve, and improve their research programs. Background The mission of CUSON since its founding in 1892 has been to prepare nurses with clinical and research expertise. After initially identifying our research priorities (Peirce et al., 2004), CUSON experienced steady increases in both the number of peer-reviewed scholarly publications and active sponsored projects. Concurrently, the academic programs within the school expanded to include the doctor of nursing practice (DNP), which was established in 2005 and is designed to produce experts for comprehensive clinical care. Subsequently, in 2008, the school's doctor of nursing science was transitioned into a doctor of philosophy (PhD) program with the goal of preparing nurse scholars to contribute to the body of nursing knowledge through the conduct and dissemination of research. These changes in the school's terminal degrees prompted a reevaluation of our research and scholarship priorities to encompass the broadened scope of expertise and interests of both doctorally prepared clinicians and researchers. In addition, the school's ability to secure new funding plateaued after 2007 when annual federal research funding budgets flattened and the composition of the faculty changed (Figure 1). In light of the continued current downward economic trends, combined with greater competition for a diminishing number of funding opportunities, we recognized the need to develop methods to sustain a high level of productivity and improve our ability to secure research funding. Acknowledging the existing silos and the untapped potential therein, we recognized that facilitating collaboration between the PhD and DNP faculty would provide new opportunities for scholarly and research productivity. Melding together the scholarly and research endeavors of these two groups would allow for expansion and enrichment in the areas of clinically focused scholarship as well as grantsmanship and funding procurement. We envisioned this initiative as having the potential to create new, innovative ways of conducting nursing research while enhancing scholarship capacity. A formal mechanism currently underway to bridge this gap is the school's TRANSIT grant, TRAining in Nurse Scientists in Interdisciplinary & Translational in the Underserved, funded by the Health Resources and Services Administration (D09HP14667, PI: Dr. Nancy Reame). In addition, we recognized the need to improve the current infrastructure and research endeavors and to implement changes at a systems level to create and sustain novel collaborations. When a new dean joined CUSON in September 2010 and proposed several broad strategic initiatives, including the research excellence initiative, an opportunity to reexamine and refocus our scholarly and research priorities was afforded. Process CUSON's strategic initiatives began with an all-school retreat held in the fall of The dean suggested several broad strategic goals and charged the faculty and staff to become actively engaged and develop and prioritize initiatives. Interested faculty, staff, and administrators joined one of several strategic initiative groups, one of which focused on research excellence. There was representation from the research, educational, and clinical faculty as well as administrative staff. This group was formalized, and Figure 1. CUSON scholarly publications and funded research projects,

3 REFOCUSING RESEARCH PRIORITIES IN SCHOOLS OF NURSING 193 Figure 2. Phases of the Research Excellence Strategic Workgroup. duringthecourseofapproximately18months,atwo-phase process began, led first by a planning workgroup and then an implementation workgroup (Figure 2). Phase I: Research Excellence Planning Workgroup The Research Excellence Planning Workgroup of 10 individuals met every other week for approximately 3 months. The workgroup quickly identified their overall strategic goal of expanding the research and scholarly capacity of CUSON and identified several critical action items including increasing grant submissions and external funding, taking inventory of existing collaborations within and outside the university, and expanding the role and resources offered by our internal Office of Research Resources. The workgroup then developed a list of measures, tactics, and outcomes for achieving these objectives and, ultimately, the overall strategic goal. In Phase I, group members developed tangible measures and outcomes of success that would demonstrate the strategic goal of expanding our research and scholarly capacity. Initially, the group produced a long list of measures that was subsequently consolidated into three main aims: (a) enhance faculty development, (b) increase institutional support for faculty, and (c) expand faculty collaboration. The next task was to identify specific tactics for accomplishing these aims. As part of this process, the workgroup identified tactics that were already in place but needed refinement. For example, the school had already awarded annual internally funded pilot grants, but the frequency of the calls for proposals was doubled and the proposed projects needed to align with the focus areas of one of the School's Centers of Excellence (Health Policy, Clinical Practice, Children and Families, WHO Collaborating Center). In their article on Best and worst practices in research administration, Miner, Miner, and Griffith (2003) identified administrative financial commitment, such as that demonstrated by providing internal mechanisms for seed funding, as one of three specific institutional behaviors that operationally define the research culture and how it is planning for the future. In addition, the school's research support office was renamed the Office of Scholarship and Research (OSR), and its services were refined and expanded to better support both clinical and research scholarship. Specific Objectives and Aims for Research (SOAR) sessions were created and made mandatory for center-based pilot grant applicants. In addition, mock review sessions for externally funded grants, which had been previously only occasionally conducted, were reemphasized and expanded. Formal written policies and procedures for mock reviews and SOARs were developed and posted on the school's intranet site. The Reach for Research Excellence (REX) Group was formed, and our biannual Research Seminar Series was incorporated into the REX group, along with mock review sessions. Another tactic recognized early and quickly implemented was a need to increase the number of tenure track, research-focused faculty members. Miner et al. (2003) described hiring practices as another key behavior that defines an institution's research culture. Since faculty members hired today will affect the level of extramural funding an institution will secure several years later, CUSON hired three new faculty members (one senior and two junior) at the end of Phase I, two

4 194 KULAGE ET AL Figure 3. Left: original conceptual model (2004); right: revised conceptual model (2011). of whom brought to the school immediate external funding sources. Revising the Research Conceptual Model As part of the planning process, The REX group updated the conceptual model, which informs the school's research focus and was originally developed 8 years previously (Peirce et al., 2004). The process included a thorough review of the literature on definitions of research and scholarship, as well as several discussions about the current interests and expertise of faculty members. Using information gathered from the literature review, members of the REX group provided feedback on the necessary changes to the 2004 model. The group determined that the school had expanded both its areas of focus and its research methods, dictating changes which would better reflect the interests and expertise of a larger group of diverse faculty as well as the increased scope of and enrollment in both of our doctoral programs. The new model guided the group's continued work and now outlines the school's research approaches and areas of focus for improving health outcomes, health systems, and health policy. Figure 3 shows the original research conceptual model and the revised version. By the end of the 3-month Phase I period, the group arrived at a consensus goal statement: The Table 1. Research Excellence Strategic Workgroup: Selected Process Examples Strategic goal: Expand our research and scholarly capacity Enhance faculty development Tactics Outcomes Outcomes achieved Final recommendations Develop a formal support system for faculty development Provide a formal orientation program for faculty members Associate dean for finance and administration and staff are working on a formal new faculty orientation program Orientation program should have dedicated time for nuts and bolts of being a faculty member with introduction of mentoring program Increase institutional support for faculty Tactics Outcomes Outcomes achieved to date Final recommendations Further develop/refine CUSON internal centers of excellence Develop a support mechanism for pilot funding awardees for completion and dissemination of project results A full-time database manager for the school of nursing was hired and is available to assist pilot grant principal investigators in conducting their projects OSR services expanded to assist pilot principal investigators Require center-based pilot grant awardees to present study findings at a REX group at the conclusion of their project and submit a final progress report to the center director and the OSR within 90 days of completion Expand faculty collaboration Tactics Outcomes Outcomes achieved to date Final recommendations Reexamine CUSON research conceptual model Revise model to reflect school's new research approaches and areas of focus Model reviewed by REX Group and Research Excellence Working Group, and consensus revisions were made Incorporate model into OSR Web site and review as needed

5 REFOCUSING RESEARCH PRIORITIES IN SCHOOLS OF NURSING 195 Figure 4. Summary of research and scholarship activities of CUSON faculty. School is internationally renowned for its high quality scholarship, particularly in collaborative research between clinicians and researchers within nursing and across disciplines. A final report was presented to the dean, and workgroups were then charged with the task of designing implementation strategies. Phase II: Research Excellence Implementation Workgroup In Phase II, the Research Excellence Implementation Workgroup expanded to include 13 faculty and administrative staff members who met every other week for an additional 3 months. This group began identification of outcomes that had already been previously achieved, implementation of the remaining tactics, and compilation of final recommendations. Table 1 presents selected process examples from the workgroup's plans. Other key tactics implemented included adopting a formal mentoring program, revising and expanding the OSR Web site to increase functionality and visibility, and determining the standard computer software programs available to support faculty productivity with a recommendation for a procedure for requesting others as needed. To assess faculty collaborations, we had existing metrics for measuring sponsored projects funding and scholarly publications and presentations. However, we had no formal mechanism for measuring the amount or assessing other types of collaborative research and scholarship ongoing at CUSON. Faculty Collaboration Survey To establish a baseline measurement of faculty collaborations, we invited the CUSON faculty to participate in a 10-item survey to determine the extent and diversity of collaboration for scholarship and research as well as to identify the roles of the faculty. Of the 78 faculty members invited to participate, 45 (57.7%) completed the survey. Fifteen faculty described themselves as primarily Table 2. Essential Elements of Successful Planning for Scholarly Excellence Element Characteristics Administrative Explicit charge from the Dean support Structured process Representative team planning Support systems Building on strengths Ongoing assessment Strategic planning process initiated Working groups formed Timelines, outcomes, and reporting mechanisms outlined Faculty and staff volunteers with interest and commitment to scholarship formed a working group Group co-chaired by PhD and DNP faculty Members included new and senior faculty, tenured and nontenured; clinicians; and researchers Support staff available to set up meetings, take minutes, and contribute their perspective as experienced research administrators Office of Research Resources expanded and revised as Office of Scholarship and Research Mechanisms for mentoring faculty and reviewing grants and other scholarly products formalized with mandated SOARs and mock reviews Database of current grant funding and records of faculty publications reviewed Assessment and updating of school's research conceptual model and mission Survey conducted to assess other ongoing scholarly collaborative activities within and outside the school Internal pilot fund applications linked to school's centers of excellence Mechanisms in place Follow-up retreat Tracking collaborations through faculty surveys and grants and publication database

6 196 KULAGE ET AL educators, 15 primarily clinicians, and another 15 primarily researchers. Figure 4 presents a summary of research and scholarship activities of the faculty respondents. Survey participants most frequently named the school of nursing and the medical school as the most frequently collaborating institutions. Of note, approximately two-thirds (10/15) of the researchers reported collaborating with investigators from the school of public health, compared to only 7% (1/15) of clinicians and 20% (3/15) of educators. Collaboration with the affiliated hospital system was evident with 40% of researchers, 20% of clinicians, and 13% of educators reporting collaborations. Fewer than half of respondents reported collaborations beyond our university (47.7%, 15/45). Based on the survey, there is clearly room for growth in interdisciplinary and inter-institutional collaboration. These results will serve as a baseline for tracking our progress as strategic initiatives are implemented. Future Directions Others have described processes for initiating successful scholarly programs in schools of nursing (Froman, Hall, Shah, Bernstein, & Galloway, 2003; Kohlenberg, 1992). In addition, although other schools of nursing may have undertaken research-focused strategic initiatives (e.g., The University of Maryland School of Medicine, nursing.umaryland.edu/about/mission-and-vision/ initiative/strat-plan), we have been unable to locate anything in the peer-reviewed literature that could assist others in implementing a similar plan. In this article, we summarized the process we have used to assure that our research enterprise continues to thrive and evolve in congruence with new educational programs, a constrained funding environment, and a changing health care landscape. As detailed in Table 2, werecommend this process to others committed to sustainable, increasingly relevant scholarship. Since the Research Excellence Workgroup began efforts to enhance our research enterprise, the school has secured National Institute of Nursing funding for a 5-year renewal of one institutional training grant (T32 NR007969) and establishment of a new one (T32 NR013454). One senior and one junior faculty member, as well as one PhD student, have also received recent federal grant application scores in the exceptional range. A strategic initiative follow-up retreat was conducted, during which implementation workgroups reported outcomes achieved to date and presented their final recommendations. To enable implementation of these recommendations, our dean is working to restructure the school's hierarchy to move responsibility and accountability down to the level of individuals in the workgroups to empower them to make the necessary changes. Plans for ongoing assessment of the Research Excellence Workgroup include the implementation of new Webbased faculty curriculum vitae, which will allow more comprehensive tracking of scholarly publications, travel support request forms which collect information about conference presentations, and continued maintenance and improvements in the functionality of our sponsored projects database. Finally, we plan to conduct follow-up surveys that identify new collaborations between internal CUSON faculty as well as across departments and institutions that emerge as we continue to implement the tactics to achieve the ultimate goal of expanding the school's research and scholarly capacity. References Froman, R. D., Hall, A. W., Shah, A., Bernstein, J. M., & Galloway, R. Y. (2003). A methodology for supporting research and scholarship. Nursing Outlook, 51, Kohlenberg, E. M. (1992). Faculty research productivity and organizational structure in schools of nursing. Journal of Professional Nursing, 8, Miner, L. E., Miner, J. T., & Griffith, J. (2003). Best and worst practices in research administration. Research Management Review, 13, Peirce, A., Cook, S., & Larson, E. (2004). Focusing research priorities in schools of nursing. Journal of Professional Nursing, 20,