- Email: [email protected]
Nursing research education practices in Australia
Professional Issues
Nursing research education practices in Australia Rita L Axford and Barbara E Carter ABSTRACT: - An Australia-wide survey of nursing research education practices found zvide variability in subject requirements for the same award. Respondents disagreed about when students should first implement research projects using 'real' data from the clinical practice environment. Half believed research projects at the undergraduate level were more appropriate, ivhile the other half thought research implementation should be reserved for honours and higher degree aivards. Respondents were clear that research policy formulation across university, state and national levels is needed. One policy objective identified was that undergraduate education should prepare clinicians to use research. Resources for research education must be carefully utilised. This includes using simulated data for instruction and conserving clinical data for quality research studies.
BACKGROUND TO THE STUDY
•
What resources are required for research education? Do students
need
computer
tools
(eg word
As a professional nursing activity, research is clearly
processing, database management systems and
gaining acceptance in Australia (Bartu, McGovvan,
quantitative and qualitative data analysis packages)?
Nelson, Ng & Robertson 1993; Sellick, McKinlcy, Botti, Kingsland & Behan 1993). nursing is less clear.
•
How to teach research in
A review of tertiary education
•
institutions in Victoria a decade ago revealed that
•
research
was taught
by requiring
Do students need access to 'real' subjects (patients and nurses)?
undergraduate
Arc we teaching nurses to use research in their practice? What are the unintended outcomes of our current practices?
students to implement a research project (Phillip Institute of Technology handbook 1981; Lincoln Institute of Health Sciences handbook 1980).
Is this current Australian
nursing research education practice or has it changed?
Many educators shared their conviction that the only way to teach research at any level is to have the student undertake a research project in its entirety.
Some
colleagues asserted that unless 'real' nursing problems
Rita L Axford RN BSMSPhDFRCNA is Professor of Clinical Nursing, Centre for Graduate Studies in Clinical Nursing, Sub-faculty of Nursing, Faculty of Medicine at Monash University in Victoria. Barbara E Carter RNDNEMNSFCN (NSW) FRCNA is Manager Quality Improvement (Nursing) for the Alfred Healthcare Group, Victoria.
The Nursing Research Targets into the Twenty-first Century
(using patients and nurses) were addressed, nursing
(1992) by the Royal College of Nursing, Australia,
research was trivialised.
Australian Nursing Federation, Florence Nightingale
practice of beginners conducting projects lo learn about
Committee and New South Wales College of Nursing
research cited three negative outcomes:
Colleagues who opposed the
focused attention on the development of strategies to promote a research-based practice in nursing. While this
•
national statement affirms the profession's commitment to research, it does not go far enough in guiding educators in curriculum development and resource utilisation.
students' interpretations of good marks often led to the erroneous conclusion that a limited initial research effort equated with good nursing research;
•
prized
research resources (nursing data)
contaminated
current research education practices highlighted some
precluding
access by more experienced researchers, and
Discussions with academic nursing colleagues about
specific questions.
and / o r over-utilised,
were
•
nurses did not learn about using research to ground their practice.
What outcomes should be expected for the various
As a result of these developments and discussions, a
award levels?
study was undertaken, asking: what are contemporary
How much time and energy should be devoted to
nursing
teaching research?
institutions in Australia?
| R$Y*Lr-COVLJBqe-frF NURSIN&. AUSTRALIA
23
research
education
practices The study
in
tertiary
specifically
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
examined each award level for structure and content of
pre-registration
research education. It questioned whether students were
(Nursing) with Honours; Graduate Diploma in Nursing,
BN; post-registration
BN; Bachelor
required to write a proposal and undertake a research
and Master of Nursing by coursework.
project and, if so, what resources were provided. Finally,
assumed to be generic course titles and respondents had no
These were
nurse educators were asked their views on nursing
difficulty with the convention. Master of Nursing by
research policy for Australia.
research and PhD courses were not included in the study.
METHOD
The survey items arose from the experiences of the research team and a review of the literature.
The first
A descriptive exploratory study was conducted using a
part of the questionnaire asked about current educational
structured questionnaire distributed by mail to all
practices, including the number of research subjects and
tertiary education
hours taught within each course.
institutions conducting
programs in Australia.
nursing
It also asked about
requirements for writing proposals and implementing
Dillman's (1978) Total Design
Method (TDM) was employed in full to ensure a high
research projects and for computer support. Part 2 dealt
response rate. TDM is based on social exchange theory
with other types of research taught:
epidemiology,
and utilises prescriptive methods for questionnaire
research utilisation, quality assurance and program
design, distribution and follow-up.
evaluation (Hamilton 1993; Polit & Hungler 1991; Stctlcr
SAMPLE AND TIME FRAME
believed students should first implement a research
Surveys were addressed to each head of school as listed
invited respondents' views on nursing research policy
1985). The survey also asked at what level respondents
project in the practice environment. Part 3 of the tool
in the Directory of Higher Education Nursing Courses
formulation. One question dealt with the level at which
for 1991 (Royal College of Nursing, Australia 1990).
policy should be established (institution, state a n d / o r
Heads of schools were asked to respond to the survey or
national). An open-ended question asked what direction
to delegate the task to the appropriate faculty member.
this policy should take.
Confidentiality of responses was assured. collected following ratification
Data were
RESULTS A N D ANALYSIS
of the Bachelor of
Nursing (BN) as the entry to practice award (June through October, 1992).
In all, 40 schools, faculties,
Research education practices
departments or divisions were identified, of which 37 (92.5 per cent) responded. For simplicity, all academic
Thirty-four schools (92 per cent of the totai sample)
units are referred to as schools throughout the paper.
reported having a pre-registration BN course.
Most
schools (n-26; 76 per cent) reported teaching one or two
INSTRUMENT
research subjects, although the number of research subjects ranged from zero to six (Table 1). The school
A three-part questionnaire asked about research education
reporting the unusually high number of subjects offered
practices concerning each of the following courses:
also reported an average of only 12 hours per subject.
Number of research subjects Number of schools Percentage
0
2
1
3
4
6
5
2
12
14
4
0
1
1
6%
35%
41%
12%
0%
3%
3%
Table 1. Number of research subjects taught in pre-registration BN courses (n=34).
Number of hours Number of schools Percentage
8-15
28-60
2
5
21
5
1
6%
14%
62%
14%
3%
0
70-90
300
Table 2. Total number of hours of research content in pre-registration BN courses (n-34).
tbL^Gl'fift VdtiUHE 2 (4fOt^diei? 1993
24
ROTOU COLLEGEOTNURSING, AUSTRALIA
When the study inquired specifically about total hours
the profession. The following types were reported for the
taught, responses ranged from 0 to 300 hours, with a
pre-registration level: epidemiology 30 (81 per cent);
mean response of 51 hours (Table 2).
research utilisation 34 (92 per cent); quality assurance
At the pre-registration level, students in 19 (51 per cent)
(Table 3).
30 (81 per cent) and program evaluation 13 (35 per cent)
of the courses were required to write a research proposal. The survey asked if these were about 'real' nursing
In all, 30 schools conducted post-registration BN courses
problems. Interpretation of the word 'real' was left open
(81 per cent) and the overwhelming majority (n=26;
to the respondents, as discussions with colleagues had
83 per cent) taught one or two subjects (Table 4). Total
determined that 'real' would be interpreted as meaning
hours taught ranged from 0 to 194 hours and averaged
clinical information involving patients and/or clinicians
74 (Table 5). Overall, these courses required 145 per cent
in practice. All responded affirmatively to this question.
more hours of research instruction than pre-registration
Four (11 per cent) of the courses required students to
degree curricula.
implement their proposal in full and all of these projects were conducted in the practice environment.
For 23 (70 per cent) of the courses, the focus for research
Instruction in the use of computer tools for data analysis
proposal. Of these proposals, 21 (95 per cent) were about
at post-registration level involved writing a research
Two
'real' nursing problems and nine (27 per cent) required
schools did not indicate whether or not they provided
students to carry them out. Students at all nine schools
was provided in 23 (66 per cent) of the courses.
instruction in computers, it is interesting to note that, of
were investigating 'real' nursing problems using 'real'
the four schools requiring students to implement
data.
research fully only half provided instruction in the use of the computer as a research tool.
Instruction in the use of computer tools for data analysis was provided in 22 (73 per cent) of the courses, although
Respondents were questioned specifically about whether
one school did not indicate whether or not computer
their curriculum included other research types used by
instruction was provided.
Another school, while
Preregistration BN (n=34)
Postregistration BN (n=30)
BN with Honours
Graduate Diploma (n=22)
Masters of Nursing by Coursework (n=21)
Epidemiology
81%
55%
56%
55%
71%
Research utilisation
92%
91%
78%
91%
81%
Quality assurance
81%
70%
22%
70%
62%
Program evaluation
35%
36%
22%
36%
52%
1
2
3
7
Table 3. Other research types in nursing courses.
Number of research subjects Number of schools Percentage
0 I
16
10
4
1
3%
53%
30%
13%
3%
Table 4. Number of research subjects taught in post-registration BN courses (n-30).
Number of hours
0
15-60
80-150
194
Number of schools
1
16
11
1
3%
53%
33%
3%
Percentage
Table 5. Total number of hours of research content in post-registration BN courses (n=30).
K6YAL C O U £ < ^ OF NUJfeiNO, AUSTfiALIA
COULfiOlAN V0LUHE 2 (*) OCTOBER 1995
requiring students to carry out their project, did not
length of research subjects ranged from 25 to 60 hours,
provide computer instruction.
with the exception of the two schools reporting only 4 to 5 contact hours total (Table 7).
Other research types reported at the post-registration level were epidemiology 18 (55 per cent), research utilisation 30
For 16 of the 22 courses conducted (73 per cent), the focus
(91 per cent),
of research in Graduate Diplomas was proposal writing.
quality assurance 23 (70 per cent) and
All these proposals concerned 'real' nursing problems.
program evaluation 12 (36 per cent) (see Tabic 3).
Of these courses, 14 (64 per cent) required students to At the Bachelor (Nursing) with Honours level the focus
carry out their research. Again, all these projects were
of research for all nine universities (100 per cent) with
conducted in the nursing practice environment.
these programs was research implementation.
All
required proposals concerning 'real' nursing problems
Instruction in computer tools for data analysis was
and students had to conduct their research in the nursing
provided in 17 (77 percent) of the courses. All but one of
practice environment. Instruction in the use of computer
the
tools for data analysis was provided in all of the courses.
implementation of a research project also reported
Other research types reported at the Honours level were
providing computer instruction.
schools
(n=l6;
94 per
cent)
requiring
full
epidemiology 5 (56 per cent), research utilisation 7 (78 per cent), quality assurance 2 (22 per cent) and
Other research types reported at the Graduate Diploma
program evaluation 2 (22 per cent) (see Table 3).
level were epidemiology 18 (55 per cent), research
Twenty-two schools (59 per cent) conduct Graduate
cent) and program evaluation 12 (36 percent) (seeTable3).
utilisation 30 (91 per cent), quality assurance 23 (70 per
Diploma courses. While two (9 per cent) did not report the number of research subjects taught the remainder
Twenty-one schools (57 per cent) reported having a
reported between one and four subjects (Table 6). The
Masters by coursework degree program.
Number of research subjects
1
Number of schools Percentage
Like the
2
3
4
no response
10
6
3
2
2
46%
27%
9%
9%
9%
Table 6. Number of research subjects taught in graduate diploma courses (n=22).
Number of hours Number of schools Percentage
4-5
26-60
84-180
no response
2
11
7
2
9%
50%
32%
9%
Table 7. Total number of hours in research content in Graduate Diploma courses (n=22).
Percentage
1
2
3
4
5
LP,
Number of research subjects Number of schools
12
2
0
2
24%
57%
10%
0%
10%
no response
Table 8. Number of research subjects taught in Master of Nursing courses (n-21).
Number of hours
8
28-60
75-90
128-322
Number of schools
1
9
4
5
2
5%
47%
21%
26%
10%
Percentage
Table 9. Total number of hours of research content in Master of Nursing courses.
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
26
ROYAL COLLEGEOF WutelNOV AUSTRALIA
Graduate Diploma courses, variation in the number of
RESEARCH EDUCATION POLICY
research subjects taught was small (one to five) while the range in number of hours of instruction was large, from
The third part of the questionnaire targeted research
8 to 322 hours (Tables 8 and 9).
education policy.
Nineteen of the 21 Masters by coursework programs (90 per
level for policy development. None requested state-level
Thirty-five schools (95 per cent)
responded to the question regarding the most appropriate cent) required research proposals. Of these 18 (95 per cent)
policy only. Seventeen (49 per cent) indicated the need for
concerned 'real' nursing problems and 17 (81 per cent)
a university policv, while 22 (63 per cent) indicated the need
required full research implementation.
Of the latter,
15 (88 per cent) were conducted in the nursing practice
for a national policy either alone or in conjunction with university and state-level policy.
environment. Fighteen programs (86 per cent) provided instruction in the use of computer tools for data analysis.
Contributions to the open-ended question concerning
The three that did not were among the schools requiring
content for research education policy were grouped, and
full implementation of a research study. Other research
recurring responses are presented in descending order of
types reported at the Masters level were epidemiology
frequency.
15 (71 per cent}, research utilisation 17 (81 per cent), quality assurance 13 (62 per cent) and
program
•
evaluation 11 (52 per cent) (see Table 3).
Undergraduate education should focus on research utilisation, while postgraduate
(and
Honours)
education is the appropriate level to begin research In order to better understand the wide variability in responses to the structured questions about subjects and
implementation (n=6). •
hours taught, outliers were examined in detail. It was found that three schools (8 per cent) accounted for all
Research should underpin and advance nursing practice (n=4).
•
outlying data.
Resources for research education must be carefully utilised. This includes conserving clinical data for research while using simulated problems and data
Beliefs concerning the course level at which it was most appropriate for students to conduct their first research project in the nursing practice environment
for instruction (n=4). •
were
compared with actual practice, and some interesting discrepancies emerged.
Ten schools indicated a belief
critique research to their practice (n=4). •
that the prc-rcgi strati on BN course was the appropriate level for research implementation but only two actually
appropriate level at which to do this.
Cooperation between academic and clinical institutions for research activities is needed (n=3).
•
specify this. In two other schools students implement at this level, but the schools do not believe it is the most
Pre-registration education should include research content which ensures that all levels of nurses can
Policy must address research ethics and access to client groups (n=3).
•
National priorities and large-scale, collaborative studies should be identified, encouraged and funded (n=3).
A mismatch between beliefs and practices occurs in 10
CONCLUSIONS
schools at the pre-registration BN course level. At the postregistration BN course level, this mismatch characterised
While the methodology was undoubtedly helpful in
10 schools and, at Graduate Diploma level, a single school
producing the high response rate for this study, the fact
reported practices which differed from its beliefs.
that 92.5 per cent of these mailed questionnaires were returned may also reflect the high level of interest in this
At the Honours level, beliefs about and involved
in
project
implementation
practices
were
more
consistent. Sixteen (43 per cent) schools indicated that
contemporary topic. This parallels similar interest and concern noted by nurse educators overseas (McQuaid, Dvorak et al 1993).
research in nursing practice should first be conducted by Honours students. Of these, seven are among the nine
The study was limited by the methodology chosen and the
schools which actually have Honours programs and do
relative validity of researcher-constructed instrumentation.
implement research in the practice environment first at
While structured questions are open to misinterpretation
this level.
by respondents, unstructured questions arc equally
ROYAL COLLEGE OF NURSING. AUSTRALIA
27
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
The
than for the d e e m e d equivalent pre-service a w a r d . What are
questionnaire was not piloted with an equivalent sample, as
the consequences of this practice for these t w o cohorts of
comprehensive
n u r s e s - experienced clinicians and beginning practitioners?
vulnerable to misinterpretation by the investigators.
sampling
enhances
validity
in
small
populations. Only face validity w a s ascertained by having a small g r o u p of selected nurse researchers review the
T h e r e is i n c o n s i s t e n c y in m a n y r e s p o n d e n t s '
questionnaire. Despite these limitations, the findings raise
about w h e n students should
important questions for d e b a t e and further inquiry.
project a n d w h e n this actually occurs. A l s o of c o n c e r n is
implement
a
beliefs research
the frequent practice of e x p e c t i n g s t u d e n t s to e n g a g e in Whilst variation across different curricula is expected, of
research w i t h o n l y l i m i t e d access to the c o m p u t e r , a vital
particular concern is the large difference in time-on-lask
research tool. H o w c a n e d u c a t i o n a l practices be c h a n g e d
required for research preparation for the two BN a w a r d s .
in o r d e r to better u s e research r e s o u r c e s a n d
Overall, schools are requiring approximately one and a half
g r a d u a t e s ' interest in research?
sustain
times more subject h o u r s for post-registration BN degrees There is a shared view that a policy is needed, and at several levels. U n d e r g r a d u a t e education should focus on research as the basis for professional n u r s i n g practice, whereas it as
Department of Health and Community Care AUSTRALIAN CAPITAL TERRITORY ^ WODEN VALLEY HOSPITAL ACT MENTAL HEALTH SERVICES and T H E CENTRE FOR PROFESSIONAL DEVELOPMENT GRADUATE CERTIFICATE M E N T A L H E A L T H NURSING
at the p o s t g r a d u a t e level that research should begin.
implementation
Clinical data m u s t be valued and used
ethically, cooperatively and appropriately by clinical and academic research colleagues.
H o w is the
profession
furthering these aims? This s t u d y establishes a b e n c h m a r k for Australian research education practices in the 1990s. The questions raised flag the need to continue
monitoring
nursing research curricula and to develop n u r s i n g research education policy further.
Applications are invited for the Mental Health Nursing Course coordinated from Woden Valley Hospital in the Australian Capital Territory, commencing in April 1996. This course is for experienced Registered Nurses interested in pursuing a career in Mental Health. This is a progressive graduate certificate course which provides a comprehensive foundation for nursing practice in mental health.
REFERENCES Barttt A, McCowan S, Nelson M, Ng C, Robertson J 1993 A Western Australian delphi survey of staff development research
DUTIES Successfully complete a prescribed course of theoretical studies and supervised clinical practice in mental health nursing (expected duration - 15 months). Provide nursing care to clients, function as a team member and develop professional standards of practice under the supervision of a Registered Mental Health Nurse
priorities. Journal of Nursing Staff Development 9:141-47 Dillman DA 1978 Mail and telephone surveys: the total design method. John Wiley & Sons, New York Hamilton GA 1993 An overview of evaluation research methods with implications for nursing staff development.
QUALIFICATIONS Registered Nurse with the ACT Nurses' Board and 12 months relevant clinical nursing experience.
Journal of
Nursing Staff Development 9:148-54 Lincoln Institute of Health Sciences 1980 handbook. Melbourne McQuaid Dvorak fc, Brophy KB, Binder DM, Carlson F 1993 A
C O N D I T I O N S AND SALARY In accordance with the ACT Nurses' Award Registered Nurse Level 1, incremental year of service.
survey of BSN curricula: research content. Journal of Nursing tducation 32:265-69 Phillip Institute of Technology 1981 handbook. Melbourne
A P P L Y BY Written application addressing the selection criteria, slating reasons for doing the course and curriculum vitae, submitted in triplicate.
Polit DP and I lungler BP 1991 Nursing research: principles and methods. JB Lippincott and Co, Philadelphia Royal College of Nursing, Australia, Australian
TO:
Course Recruitment Officer (MH) Centre for Professional Development Woden Valley Hospital PO Box 11 WODEN ACT 2606 Selection criteria and duty statement available from Ms M Tolley - 06 244 3429/2258 Enquiries - Jon Chesterson - 06 244 2258
Nursing
federation, Florence Nightingale Committee, Australia, and New South Wales College of Nursing 1992 Nursing research targets into the twenty-first century Melbourne Royal College of Nursing, Australia 1990 Directory of higher education nursing courses for 1991. Melbourne Sellick K, McKinley S, Botti M, Kingsland S and Behan J 1993 How
Applications close 10 N o v e m b e r 1995 ACT DEPARTMENT OF HEALTH AND COMMUNITY CARE IS AN EQUAL OPPORTUNITY EMPLOYER
many hospitals have a nursing research policy? A Victorian survey. Australian Journal of Advanced Nursing 10:20-25 Stetler CB 1985 Research utilization: defining the concept. Image: The Journal of Nursing Scholarship 7:40-44
•£OULE
2&
^4^S^^W^^^^^0^^^^^-\
Nursing research education practices in Australia Rita L Axford and Barbara E Carter ABSTRACT: - An Australia-wide survey of nursing research education practices found zvide variability in subject requirements for the same award. Respondents disagreed about when students should first implement research projects using 'real' data from the clinical practice environment. Half believed research projects at the undergraduate level were more appropriate, ivhile the other half thought research implementation should be reserved for honours and higher degree aivards. Respondents were clear that research policy formulation across university, state and national levels is needed. One policy objective identified was that undergraduate education should prepare clinicians to use research. Resources for research education must be carefully utilised. This includes using simulated data for instruction and conserving clinical data for quality research studies.
BACKGROUND TO THE STUDY
•
What resources are required for research education? Do students
need
computer
tools
(eg word
As a professional nursing activity, research is clearly
processing, database management systems and
gaining acceptance in Australia (Bartu, McGovvan,
quantitative and qualitative data analysis packages)?
Nelson, Ng & Robertson 1993; Sellick, McKinlcy, Botti, Kingsland & Behan 1993). nursing is less clear.
•
How to teach research in
A review of tertiary education
•
institutions in Victoria a decade ago revealed that
•
research
was taught
by requiring
Do students need access to 'real' subjects (patients and nurses)?
undergraduate
Arc we teaching nurses to use research in their practice? What are the unintended outcomes of our current practices?
students to implement a research project (Phillip Institute of Technology handbook 1981; Lincoln Institute of Health Sciences handbook 1980).
Is this current Australian
nursing research education practice or has it changed?
Many educators shared their conviction that the only way to teach research at any level is to have the student undertake a research project in its entirety.
Some
colleagues asserted that unless 'real' nursing problems
Rita L Axford RN BSMSPhDFRCNA is Professor of Clinical Nursing, Centre for Graduate Studies in Clinical Nursing, Sub-faculty of Nursing, Faculty of Medicine at Monash University in Victoria. Barbara E Carter RNDNEMNSFCN (NSW) FRCNA is Manager Quality Improvement (Nursing) for the Alfred Healthcare Group, Victoria.
The Nursing Research Targets into the Twenty-first Century
(using patients and nurses) were addressed, nursing
(1992) by the Royal College of Nursing, Australia,
research was trivialised.
Australian Nursing Federation, Florence Nightingale
practice of beginners conducting projects lo learn about
Committee and New South Wales College of Nursing
research cited three negative outcomes:
Colleagues who opposed the
focused attention on the development of strategies to promote a research-based practice in nursing. While this
•
national statement affirms the profession's commitment to research, it does not go far enough in guiding educators in curriculum development and resource utilisation.
students' interpretations of good marks often led to the erroneous conclusion that a limited initial research effort equated with good nursing research;
•
prized
research resources (nursing data)
contaminated
current research education practices highlighted some
precluding
access by more experienced researchers, and
Discussions with academic nursing colleagues about
specific questions.
and / o r over-utilised,
were
•
nurses did not learn about using research to ground their practice.
What outcomes should be expected for the various
As a result of these developments and discussions, a
award levels?
study was undertaken, asking: what are contemporary
How much time and energy should be devoted to
nursing
teaching research?
institutions in Australia?
| R$Y*Lr-COVLJBqe-frF NURSIN&. AUSTRALIA
23
research
education
practices The study
in
tertiary
specifically
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
examined each award level for structure and content of
pre-registration
research education. It questioned whether students were
(Nursing) with Honours; Graduate Diploma in Nursing,
BN; post-registration
BN; Bachelor
required to write a proposal and undertake a research
and Master of Nursing by coursework.
project and, if so, what resources were provided. Finally,
assumed to be generic course titles and respondents had no
These were
nurse educators were asked their views on nursing
difficulty with the convention. Master of Nursing by
research policy for Australia.
research and PhD courses were not included in the study.
METHOD
The survey items arose from the experiences of the research team and a review of the literature.
The first
A descriptive exploratory study was conducted using a
part of the questionnaire asked about current educational
structured questionnaire distributed by mail to all
practices, including the number of research subjects and
tertiary education
hours taught within each course.
institutions conducting
programs in Australia.
nursing
It also asked about
requirements for writing proposals and implementing
Dillman's (1978) Total Design
Method (TDM) was employed in full to ensure a high
research projects and for computer support. Part 2 dealt
response rate. TDM is based on social exchange theory
with other types of research taught:
epidemiology,
and utilises prescriptive methods for questionnaire
research utilisation, quality assurance and program
design, distribution and follow-up.
evaluation (Hamilton 1993; Polit & Hungler 1991; Stctlcr
SAMPLE AND TIME FRAME
believed students should first implement a research
Surveys were addressed to each head of school as listed
invited respondents' views on nursing research policy
1985). The survey also asked at what level respondents
project in the practice environment. Part 3 of the tool
in the Directory of Higher Education Nursing Courses
formulation. One question dealt with the level at which
for 1991 (Royal College of Nursing, Australia 1990).
policy should be established (institution, state a n d / o r
Heads of schools were asked to respond to the survey or
national). An open-ended question asked what direction
to delegate the task to the appropriate faculty member.
this policy should take.
Confidentiality of responses was assured. collected following ratification
Data were
RESULTS A N D ANALYSIS
of the Bachelor of
Nursing (BN) as the entry to practice award (June through October, 1992).
In all, 40 schools, faculties,
Research education practices
departments or divisions were identified, of which 37 (92.5 per cent) responded. For simplicity, all academic
Thirty-four schools (92 per cent of the totai sample)
units are referred to as schools throughout the paper.
reported having a pre-registration BN course.
Most
schools (n-26; 76 per cent) reported teaching one or two
INSTRUMENT
research subjects, although the number of research subjects ranged from zero to six (Table 1). The school
A three-part questionnaire asked about research education
reporting the unusually high number of subjects offered
practices concerning each of the following courses:
also reported an average of only 12 hours per subject.
Number of research subjects Number of schools Percentage
0
2
1
3
4
6
5
2
12
14
4
0
1
1
6%
35%
41%
12%
0%
3%
3%
Table 1. Number of research subjects taught in pre-registration BN courses (n=34).
Number of hours Number of schools Percentage
8-15
28-60
2
5
21
5
1
6%
14%
62%
14%
3%
0
70-90
300
Table 2. Total number of hours of research content in pre-registration BN courses (n-34).
tbL^Gl'fift VdtiUHE 2 (4fOt^diei? 1993
24
ROTOU COLLEGEOTNURSING, AUSTRALIA
When the study inquired specifically about total hours
the profession. The following types were reported for the
taught, responses ranged from 0 to 300 hours, with a
pre-registration level: epidemiology 30 (81 per cent);
mean response of 51 hours (Table 2).
research utilisation 34 (92 per cent); quality assurance
At the pre-registration level, students in 19 (51 per cent)
(Table 3).
30 (81 per cent) and program evaluation 13 (35 per cent)
of the courses were required to write a research proposal. The survey asked if these were about 'real' nursing
In all, 30 schools conducted post-registration BN courses
problems. Interpretation of the word 'real' was left open
(81 per cent) and the overwhelming majority (n=26;
to the respondents, as discussions with colleagues had
83 per cent) taught one or two subjects (Table 4). Total
determined that 'real' would be interpreted as meaning
hours taught ranged from 0 to 194 hours and averaged
clinical information involving patients and/or clinicians
74 (Table 5). Overall, these courses required 145 per cent
in practice. All responded affirmatively to this question.
more hours of research instruction than pre-registration
Four (11 per cent) of the courses required students to
degree curricula.
implement their proposal in full and all of these projects were conducted in the practice environment.
For 23 (70 per cent) of the courses, the focus for research
Instruction in the use of computer tools for data analysis
proposal. Of these proposals, 21 (95 per cent) were about
at post-registration level involved writing a research
Two
'real' nursing problems and nine (27 per cent) required
schools did not indicate whether or not they provided
students to carry them out. Students at all nine schools
was provided in 23 (66 per cent) of the courses.
instruction in computers, it is interesting to note that, of
were investigating 'real' nursing problems using 'real'
the four schools requiring students to implement
data.
research fully only half provided instruction in the use of the computer as a research tool.
Instruction in the use of computer tools for data analysis was provided in 22 (73 per cent) of the courses, although
Respondents were questioned specifically about whether
one school did not indicate whether or not computer
their curriculum included other research types used by
instruction was provided.
Another school, while
Preregistration BN (n=34)
Postregistration BN (n=30)
BN with Honours
Graduate Diploma (n=22)
Masters of Nursing by Coursework (n=21)
Epidemiology
81%
55%
56%
55%
71%
Research utilisation
92%
91%
78%
91%
81%
Quality assurance
81%
70%
22%
70%
62%
Program evaluation
35%
36%
22%
36%
52%
1
2
3
7
Table 3. Other research types in nursing courses.
Number of research subjects Number of schools Percentage
0 I
16
10
4
1
3%
53%
30%
13%
3%
Table 4. Number of research subjects taught in post-registration BN courses (n-30).
Number of hours
0
15-60
80-150
194
Number of schools
1
16
11
1
3%
53%
33%
3%
Percentage
Table 5. Total number of hours of research content in post-registration BN courses (n=30).
K6YAL C O U £ < ^ OF NUJfeiNO, AUSTfiALIA
COULfiOlAN V0LUHE 2 (*) OCTOBER 1995
requiring students to carry out their project, did not
length of research subjects ranged from 25 to 60 hours,
provide computer instruction.
with the exception of the two schools reporting only 4 to 5 contact hours total (Table 7).
Other research types reported at the post-registration level were epidemiology 18 (55 per cent), research utilisation 30
For 16 of the 22 courses conducted (73 per cent), the focus
(91 per cent),
of research in Graduate Diplomas was proposal writing.
quality assurance 23 (70 per cent) and
All these proposals concerned 'real' nursing problems.
program evaluation 12 (36 per cent) (see Tabic 3).
Of these courses, 14 (64 per cent) required students to At the Bachelor (Nursing) with Honours level the focus
carry out their research. Again, all these projects were
of research for all nine universities (100 per cent) with
conducted in the nursing practice environment.
these programs was research implementation.
All
required proposals concerning 'real' nursing problems
Instruction in computer tools for data analysis was
and students had to conduct their research in the nursing
provided in 17 (77 percent) of the courses. All but one of
practice environment. Instruction in the use of computer
the
tools for data analysis was provided in all of the courses.
implementation of a research project also reported
Other research types reported at the Honours level were
providing computer instruction.
schools
(n=l6;
94 per
cent)
requiring
full
epidemiology 5 (56 per cent), research utilisation 7 (78 per cent), quality assurance 2 (22 per cent) and
Other research types reported at the Graduate Diploma
program evaluation 2 (22 per cent) (see Table 3).
level were epidemiology 18 (55 per cent), research
Twenty-two schools (59 per cent) conduct Graduate
cent) and program evaluation 12 (36 percent) (seeTable3).
utilisation 30 (91 per cent), quality assurance 23 (70 per
Diploma courses. While two (9 per cent) did not report the number of research subjects taught the remainder
Twenty-one schools (57 per cent) reported having a
reported between one and four subjects (Table 6). The
Masters by coursework degree program.
Number of research subjects
1
Number of schools Percentage
Like the
2
3
4
no response
10
6
3
2
2
46%
27%
9%
9%
9%
Table 6. Number of research subjects taught in graduate diploma courses (n=22).
Number of hours Number of schools Percentage
4-5
26-60
84-180
no response
2
11
7
2
9%
50%
32%
9%
Table 7. Total number of hours in research content in Graduate Diploma courses (n=22).
Percentage
1
2
3
4
5
LP,
Number of research subjects Number of schools
12
2
0
2
24%
57%
10%
0%
10%
no response
Table 8. Number of research subjects taught in Master of Nursing courses (n-21).
Number of hours
8
28-60
75-90
128-322
Number of schools
1
9
4
5
2
5%
47%
21%
26%
10%
Percentage
Table 9. Total number of hours of research content in Master of Nursing courses.
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
26
ROYAL COLLEGEOF WutelNOV AUSTRALIA
Graduate Diploma courses, variation in the number of
RESEARCH EDUCATION POLICY
research subjects taught was small (one to five) while the range in number of hours of instruction was large, from
The third part of the questionnaire targeted research
8 to 322 hours (Tables 8 and 9).
education policy.
Nineteen of the 21 Masters by coursework programs (90 per
level for policy development. None requested state-level
Thirty-five schools (95 per cent)
responded to the question regarding the most appropriate cent) required research proposals. Of these 18 (95 per cent)
policy only. Seventeen (49 per cent) indicated the need for
concerned 'real' nursing problems and 17 (81 per cent)
a university policv, while 22 (63 per cent) indicated the need
required full research implementation.
Of the latter,
15 (88 per cent) were conducted in the nursing practice
for a national policy either alone or in conjunction with university and state-level policy.
environment. Fighteen programs (86 per cent) provided instruction in the use of computer tools for data analysis.
Contributions to the open-ended question concerning
The three that did not were among the schools requiring
content for research education policy were grouped, and
full implementation of a research study. Other research
recurring responses are presented in descending order of
types reported at the Masters level were epidemiology
frequency.
15 (71 per cent}, research utilisation 17 (81 per cent), quality assurance 13 (62 per cent) and
program
•
evaluation 11 (52 per cent) (see Table 3).
Undergraduate education should focus on research utilisation, while postgraduate
(and
Honours)
education is the appropriate level to begin research In order to better understand the wide variability in responses to the structured questions about subjects and
implementation (n=6). •
hours taught, outliers were examined in detail. It was found that three schools (8 per cent) accounted for all
Research should underpin and advance nursing practice (n=4).
•
outlying data.
Resources for research education must be carefully utilised. This includes conserving clinical data for research while using simulated problems and data
Beliefs concerning the course level at which it was most appropriate for students to conduct their first research project in the nursing practice environment
for instruction (n=4). •
were
compared with actual practice, and some interesting discrepancies emerged.
Ten schools indicated a belief
critique research to their practice (n=4). •
that the prc-rcgi strati on BN course was the appropriate level for research implementation but only two actually
appropriate level at which to do this.
Cooperation between academic and clinical institutions for research activities is needed (n=3).
•
specify this. In two other schools students implement at this level, but the schools do not believe it is the most
Pre-registration education should include research content which ensures that all levels of nurses can
Policy must address research ethics and access to client groups (n=3).
•
National priorities and large-scale, collaborative studies should be identified, encouraged and funded (n=3).
A mismatch between beliefs and practices occurs in 10
CONCLUSIONS
schools at the pre-registration BN course level. At the postregistration BN course level, this mismatch characterised
While the methodology was undoubtedly helpful in
10 schools and, at Graduate Diploma level, a single school
producing the high response rate for this study, the fact
reported practices which differed from its beliefs.
that 92.5 per cent of these mailed questionnaires were returned may also reflect the high level of interest in this
At the Honours level, beliefs about and involved
in
project
implementation
practices
were
more
consistent. Sixteen (43 per cent) schools indicated that
contemporary topic. This parallels similar interest and concern noted by nurse educators overseas (McQuaid, Dvorak et al 1993).
research in nursing practice should first be conducted by Honours students. Of these, seven are among the nine
The study was limited by the methodology chosen and the
schools which actually have Honours programs and do
relative validity of researcher-constructed instrumentation.
implement research in the practice environment first at
While structured questions are open to misinterpretation
this level.
by respondents, unstructured questions arc equally
ROYAL COLLEGE OF NURSING. AUSTRALIA
27
COLLEGIAN VOLUME 2 (4) OCTOBER 1995
The
than for the d e e m e d equivalent pre-service a w a r d . What are
questionnaire was not piloted with an equivalent sample, as
the consequences of this practice for these t w o cohorts of
comprehensive
n u r s e s - experienced clinicians and beginning practitioners?
vulnerable to misinterpretation by the investigators.
sampling
enhances
validity
in
small
populations. Only face validity w a s ascertained by having a small g r o u p of selected nurse researchers review the
T h e r e is i n c o n s i s t e n c y in m a n y r e s p o n d e n t s '
questionnaire. Despite these limitations, the findings raise
about w h e n students should
important questions for d e b a t e and further inquiry.
project a n d w h e n this actually occurs. A l s o of c o n c e r n is
implement
a
beliefs research
the frequent practice of e x p e c t i n g s t u d e n t s to e n g a g e in Whilst variation across different curricula is expected, of
research w i t h o n l y l i m i t e d access to the c o m p u t e r , a vital
particular concern is the large difference in time-on-lask
research tool. H o w c a n e d u c a t i o n a l practices be c h a n g e d
required for research preparation for the two BN a w a r d s .
in o r d e r to better u s e research r e s o u r c e s a n d
Overall, schools are requiring approximately one and a half
g r a d u a t e s ' interest in research?
sustain
times more subject h o u r s for post-registration BN degrees There is a shared view that a policy is needed, and at several levels. U n d e r g r a d u a t e education should focus on research as the basis for professional n u r s i n g practice, whereas it as
Department of Health and Community Care AUSTRALIAN CAPITAL TERRITORY ^ WODEN VALLEY HOSPITAL ACT MENTAL HEALTH SERVICES and T H E CENTRE FOR PROFESSIONAL DEVELOPMENT GRADUATE CERTIFICATE M E N T A L H E A L T H NURSING
at the p o s t g r a d u a t e level that research should begin.
implementation
Clinical data m u s t be valued and used
ethically, cooperatively and appropriately by clinical and academic research colleagues.
H o w is the
profession
furthering these aims? This s t u d y establishes a b e n c h m a r k for Australian research education practices in the 1990s. The questions raised flag the need to continue
monitoring
nursing research curricula and to develop n u r s i n g research education policy further.
Applications are invited for the Mental Health Nursing Course coordinated from Woden Valley Hospital in the Australian Capital Territory, commencing in April 1996. This course is for experienced Registered Nurses interested in pursuing a career in Mental Health. This is a progressive graduate certificate course which provides a comprehensive foundation for nursing practice in mental health.
REFERENCES Barttt A, McCowan S, Nelson M, Ng C, Robertson J 1993 A Western Australian delphi survey of staff development research
DUTIES Successfully complete a prescribed course of theoretical studies and supervised clinical practice in mental health nursing (expected duration - 15 months). Provide nursing care to clients, function as a team member and develop professional standards of practice under the supervision of a Registered Mental Health Nurse
priorities. Journal of Nursing Staff Development 9:141-47 Dillman DA 1978 Mail and telephone surveys: the total design method. John Wiley & Sons, New York Hamilton GA 1993 An overview of evaluation research methods with implications for nursing staff development.
QUALIFICATIONS Registered Nurse with the ACT Nurses' Board and 12 months relevant clinical nursing experience.
Journal of
Nursing Staff Development 9:148-54 Lincoln Institute of Health Sciences 1980 handbook. Melbourne McQuaid Dvorak fc, Brophy KB, Binder DM, Carlson F 1993 A
C O N D I T I O N S AND SALARY In accordance with the ACT Nurses' Award Registered Nurse Level 1, incremental year of service.
survey of BSN curricula: research content. Journal of Nursing tducation 32:265-69 Phillip Institute of Technology 1981 handbook. Melbourne
A P P L Y BY Written application addressing the selection criteria, slating reasons for doing the course and curriculum vitae, submitted in triplicate.
Polit DP and I lungler BP 1991 Nursing research: principles and methods. JB Lippincott and Co, Philadelphia Royal College of Nursing, Australia, Australian
TO:
Course Recruitment Officer (MH) Centre for Professional Development Woden Valley Hospital PO Box 11 WODEN ACT 2606 Selection criteria and duty statement available from Ms M Tolley - 06 244 3429/2258 Enquiries - Jon Chesterson - 06 244 2258
Nursing
federation, Florence Nightingale Committee, Australia, and New South Wales College of Nursing 1992 Nursing research targets into the twenty-first century Melbourne Royal College of Nursing, Australia 1990 Directory of higher education nursing courses for 1991. Melbourne Sellick K, McKinley S, Botti M, Kingsland S and Behan J 1993 How
Applications close 10 N o v e m b e r 1995 ACT DEPARTMENT OF HEALTH AND COMMUNITY CARE IS AN EQUAL OPPORTUNITY EMPLOYER
many hospitals have a nursing research policy? A Victorian survey. Australian Journal of Advanced Nursing 10:20-25 Stetler CB 1985 Research utilization: defining the concept. Image: The Journal of Nursing Scholarship 7:40-44
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