Vol.8, No.1 April 2002
Contents
Is this scholarship?
A Refereed Article
Author
Linda S. Smith, MS, DSN, RN
Assistant Professor, Oregon Health Sciences University School of Nursing
3201 Campus Drive SN-OIT
Klamath Falls OR 97601 USA
E-mail: smithli@oit.edu; Fax: 541-885-1855
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Abstract
The concept of nursing scholarship is analyzed in this paper using five divisions or attributes. The five characteristics of a scholar are long academic study resulting in mastery of knowledge within a discipline, investigative skills, analytic skills and original/creative/integrative thinking, knowledge dissemination, and knowledge application. These perspectives are interrelated, one cannot occur without the rest. Concern is expressed, however, over the loss of essential scholarly nursing content from baccalaureate, master’s, and doctoral nursing programs.
Key words: scholarship, nursing profession, discipline of nursing, nurse scholar
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Introduction
"What is scholarship?" I asked a university reference librarian. Her carefully chosen response was, "It depends." "Depends on what?" I queried. "On who, what, and when you’re applying the term. It can mean anything." "Do I have it yet?" I asked. Or maybe it is something one always strives for but never achieves. Is it a process like self actualization that never quite materializes? How would you know," I continued, "if I did or didn’t have scholarship?" Her response, "You would publish in juried journals." The phone rang and our discourse ended.
So I tried several on-line and print dictionaries (Collins Cobuild 2000; Grove 1961, Looksmart 2000; WordNet 1999; Wordsmyth 1999; wwwebster 1996) and concluded that scholarship referred to profound knowledge acquired through long and rigorous academic research and study within a field; it means enlightenment (education resulting from analysis, understanding, and shared knowledge), eruditeness, and learnedness. Thus, scholarship is the character, qualities, achievements, and activities of scholars and is synonymous with learning, knowledge, and study. Scholars endeavor to be creative, original thinkers within a field of learning. In summary, the attributes of scholars include long academic study resulting in mastery of knowledge within a field or discipline, investigative skills, analytic skills, and creative, reflective original thought.
According to the consulted dictionaries, scholars possess five attributes. According to the librarian, scholars publish. How does all of this apply to nursing scholarship? I believe I will delve deeper.
In her classic 1964 article for the American Journal of Nursing, Henderson described her passion, her plans, and her definitions of nursing. She wrote of nursing’s unique contributions to client health and described such terms as world-wide social activity, individualized care, interrelations between psychosocial and physical elements, client independence and rehabilitation, client coping, and the nurse-patient relationship. Henderson wanted nurses to be educated broadly, at the university level, with a strong curricular emphasis on human needs, not medical diagnoses.
I met Virginia Henderson several times and cherished each experience as leaving a lasting impression. During long and heated meetings, she never failed to add refreshingly insightful comments to almost every discussion. Truly, Henderson was a nursing scholar. But does scholarship exist only with nursing’s elite? Can we, should we expect scholarship at the baccalaureate, master’s, and doctoral preparation levels?
Scholarship is a lifelong commitment toward the dissemination of gifts given to nurses by clients, colleagues, educators, peers, and society. A nurse scholar, (a) endures long academic study resulting in the mastery of nursing knowledge, (b) possesses investigative skills (the scholarship of discovery) resulting in original research, (c) has the ability to creatively think through and analyze connections (scholarship of integration and originality), (d) is dedicated toward the dissemination of nursing knowledge through teaching and publishing activities inside and outside the discipline of nursing, and (e) demonstrates commitment toward the application of nursing knowledge within an international context of human needs. These categories are not unlike others proposed in nursing literature (Sellers, Brady & Hansen, 1996, Brown et al. 1995, Diers 1995, Meleis, Hall & Stevens 1994, Parse 1994, Shoffner, Davis & Bowen 1994, Tanner, 1991). Though categories seem consistent among authors, members of the nursing profession hold divergent views within each stated area.
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KNOWLEDGE MASTERY
The first description of a scholar centered around a lengthy period of academic study that results in knowledge mastery within the discipline of nursing. The content (measure) of this study across disciplines is agreed to be the earned doctoral degree. These programs must be of the highest quality because of their critical importance to the development of the discipline (Germain et al. 1994), and because they educate scholars able to make major contributions to nursing (Meleis, Hall & Stevens 1994) and healthcare. Programs must have environments that nurture, support, and facilitate scholarship (Meleis 1992) through scholarly caring (Salmon 1999).
The difficulty arises, however, in the disparity of how one earns a doctorate. Currently, there are five ways to do this within nursing. These five include a controversial hierarchy of perceived value topped by the Ph.D. in nursing (Flaherty 1989, Forni 1989).The professional degree (practice-focused) and the academic degree (research-focused) controversy is alive and well. Forni (1989) wrote that the multiplicity of doctoral nursing programs would continue and the two trajectories (Ph.D./DNSc) would be important for the advancement of the discipline, even though the Ph.D. was gaining in popularity among all nursing doctoral programs. To many, the Ph.D. traditions of theory, research, and scholarship are appropriate and congruent with the goals of the discipline of nursing. Ph.D.
An additional and growing controversy is the proliferation of masters nursing programs preparing nurse practitioners (NP) (see http://www.healthcentre. org.uk/np/courses.htm for web sites and links to UK nurse practitioner programs). I strongly caution the profession of nursing against an exclusive investment in these programs as a method to improve society’s perception of nursing’s value. MSN programs are being reformatted and faculty in these programs are being retooled so that greater and greater numbers of nurse practitioners can be produced (Hall & Stevens 1995).
Educational programs for NPs include a great deal that is borrowed from the discipline of medicine. The important question, of course, is what do nurse practitioners do that is nursing and how will they enhance and advance our profession (Hall & Stevens, 1995). Yet, consistently, the most valued credential in the nursing want ad sections is the nurse practitioner - even for faculty positions in colleges and universities. As NP numbers increase, medicine gains in two ways. They will enjoy the increasing rift between academic and clinical preparation for nurses and their less-than-desirable tasks will be absorbed by NPs for far less remuneration (Hall & Stevens 1995). But as NP numbers increase and NP programs continue to promote the idea of mid-level medicine, how will nursing scholarship move forward and develop?
In 1992 Meleis wrote a seven-item list of required content for MSN programs (p. 329). NP preparation did not appear on this list. What appeared, rather, were delineation’s regarding theory, research, and critical knowledge of nursing science development. Presently, however, the goals of NP programs are service driven (Hall & Stevens 1995) and program curricula seem more and more to have eliminated scholarly content related to the theory generating and theory building endeavors of scientific inquiry.
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DISCOVERY
The second scholarly descriptor is the scholarship of discovery. Here, investigative skills and original research are expectations. Nursing research must be based on nursing theory (Blegen & Tripp-Reimer 1994), mediated by knowledge of research designs and instruments, and complemented by knowledge within a substantive area (Hall & Stevens, 1995, Meleis 1992).
The scholarship of discovery is at the heart of all academic disciplines because discovery produces the basis for all other scholarship descriptors (Brown et al. 1995). Although primary investigators need doctoral preparation, all nurses need to participate in knowledge discovery activities (Kitson 1999, Schutzenhofer 1991) because researchers and scholars engaged in discovery ask important questions such as, "What do we need to learn; what is yet to be discovered," These questions are at the heart of an academic and scholarly profession.
Nursing research began with Nightingale who systematically and statistically communicated devastating healthcare conditions to political leaders. The organization of Sigma Theta Tau places the highest possible regard for nursing’s scientific progress by sponsoring a research-based journal and funding and sponsoring research activities. Thus, it is clear that the profession of nursing is committed to the scholarship of discovery. But who, I ask, will carry the Nightingale torch if baccalaureate and master’s in nursing programs eliminate the theory-based, research-based foundations of our profession?
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INTEGRATION AND ORIGINALITY
The third description of a scholar includes analytical skills and creative, original thought. Connections that bridge integration between theory, practice, and education are expected. Parse (1994) identified this area as the willingness to risk challenge and the courage of convictions when new ideas threaten the status quo. It is a perpetual curiosity and focused committed attitude characterized by persistent wonder. It is a time to mull over ideas (Armiger 1974) and develop new partnerships and skills (Schutzenhofer 1991). Nightingale spoke of the trained power of attending, observing, and seeing that which was invisible to others (Nightingale 1969/1859). It is a kind of Sherlock Holms investigative mind set that acknowledges ignorance and drafts new theories and awakenings (Diers 1995). This comes with challenge, maturity, experience, as well as rigorous and mentored educational endeavors. New nursing insights are the result of these activities (Tanner 1991) and a continually revised interdisciplinary logic that contributes to world-wide healthcare improvements (Kitson 1999, Henry 1994).
Thus, as nurses engage in scholarly endeavors, we are confronted with fresh thought that links tightly with research endeavors and gives meaning and perspective to facts. It is thinking that travels beyond our own profession of nursing and beyond our own science. It is the larger picture (Salmon 1999). Unfortunately, programs that discourage students from introducing and testing new ideas destroy important potential (Boyer 1990) and foster our own elitist exclusionary tendencies (Salmon 1999). Baccalaureate and master’s nursing programs that continue to promote medical model, disease-oriented, task-oriented, memory-oriented endeavors will soon consume the hard-won advances our beloved profession has made.
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DISSEMINATION
The fourth attribute of scholarly activity is the commitment toward knowledge dissemination through teaching and publishing. The process of sharing knowledge is a critically important endeavor for nurse-scholars. It is a process of transforming knowledge through teaching and role modeling excellence (Sellers, Brady & Hansen 1996).
A qualified educator guides students toward personal and professional discovery (Shoffner, Davis & Bowen 1994) by asking questions that provoke thinking rather than merely providing answers, promoting exploration rather than judgment; encouraging free thought rather than rote memory. Faculty role model the passion for the journey of discovery and nursing’s greater obligation to humanity. Concerns for the lack of value placed on the teaching role are not unique to nursing; four physicians wrote of the problems related to teaching activities. Rewards such as top teacher awards are great incentives for quality teaching activities, especially when valued by administrators. As promotional emphasis is placed on teaching endeavors, scholarship and dignity will be appropriately placed on the teaching-learning process (Ernest et al. 1995).
With administrative support, nursing faculty need to create educational experiences that help students respond to community challenges enhance knowledge of the social, political, and healthcare contexts that marginalize our client base (Salmon 1999, Hall & Stevens 1995). This change in curricula further includes a need to educate students with survival skills that help them cope with current and future healthcare challenges (Gorrell & Langenbach 1994).
A problem exists, however. when doctorally prepared faculty need to regroup in order to teach NP courses. Interestingly, in 1964 Hoexter wrote of her growing concerns regarding the function orientation of graduate curricula. Today, as I examine the increased NP programs and their function-oriented course offerings, I continue to express concern
Of course, the process of knowledge dissemination through publishing activities is also important to the advancement of nursing. Most nursing journals have as their mission the publication of scholarly contributions (Akinsanya 1996). Publication requires the scholar to speak and write with clarity, accuracy, creativity, and precision (Diers 1995). This idea also means, read broadly, think more so; write to learn, write to think, think to write. Nursing’s body of knowledge will not increase if nurses selfishly hide their findings (Parse 1994) from peers, colleagues, and public scrutiny. Furthermore, nursing’s body of knowledge will not increase if nursing students in baccalaureate and master’s programs have failed to understand their important role in promoting our future through knowledge dissemination. But how does a nurse choose to engage in such activities if these activities were never presented within their undergraduate and graduate socialization process? Students absorb the values of faculty. As scholars, faculty promote the endeavors of theory-based research and research-based practice. Furthermore, knowledge dissemination should not just be reserved for research-based reports. True contributions that reflect changes such as political, regulatory, and economic pressures of healthcare will help today’s nursing student survive (Sullivan 1996) and the profession to measure its own impact and worth.
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KNOWLEDGE APPLICATION
The fifth and final descriptor of scholarship includes a commitment toward the application of knowledge. It is the backbone of our accountability and commitment to the clients we serve. Nurses need to ask and answer questions and solve problems that concern the most disenfranchised, marginalized clients’ need for health and safety. This is the sacred trust and the reality of nursing practice and it needs to be rewarded with the same vigor as other academic endeavors (Sullivan 1996, Boyer 1990). Armiger (1974) called this humanistic scholarship that increased healthcare quality and ensured caring as a nursing characteristic. Henderson called it nursing’s unique contribution.
In conclusion, as we start the new millennium, I believe the future of the nursing profession is at risk. As baccalaureate, master’s, and doctoral nursing programs remove rigorous nursing theory and nursing research endeavors from their curricula, adding procedure-oriented, function-specific, medically-based content, essential creativity, perpetual curiosity, and role appreciation is lost. Henderson cautioned us to examine human needs, not medical diagnoses, by using a holistic and uniquely nursing theoretical framework. I strongly caution the profession to examine, define, and promote the nursing scholarship our public needs most.
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