Careers in Clinical Research Obstacles and Opportunities (1994) / Chapter Skim
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Appendix B: Report of the Task Force on Clinical Research in Nursing and Clinical Psychology
Appendix B: Report of the Task Force on Clinical Research in Nursing and Clinical Psychology
Pages 251-278
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From page 251... ...
Nevertheless, the limited number of nurses with the doctoral training needed to conduct clinical research and oversee research Paining, the erosion of federal funding for research and research training, and the frequent lack of administrative and financial incentives to pursue research rather than more financially rewarding administrative or other positions in the clinical and private sector mitigate against He pursuit of careers in clinical research. Although the focus of nursing research has shifted over more than a century, its roots were formed in clinical practice and remain in clinical practice.
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From page 252... ...
Nurses currently holding doctorates may have been prepared for clinical research through a nursing doctoral program or a doctoral program in a related discipline such as one in the biological, social, or behavioral sciences. The pool of doctorate-prepared nurses capable of pursuing careers in clinical research is on the increase.
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From page 253... ...
A strong interdisciplinary focus is evident and encouraged for nursing research and research Paining. Given the complexity of clinical nursing research concerns and questions, synthesis of knowledge from across many disciplines is required in the quest to generate new information for nursing practice.
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From page 254... ...
Both institutional and professional barriers are evident in clinical nursing research. Access for independent nurse-investigators is critical to the quality of the research conducted and the science developed for nursing practices.
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From page 255... ...
In addition to the group of doctorate-prepared nurses conducting clinical research, there are tens of thousands of nurses trained at He master's level who are involved in clinical research. This involvement includes serving as research nurses in clinical centers, working as research project managers, serving as data collectors, or conducting small-scale, limited clinical practice studies.
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From page 256... ...
Second, there is an equal need to maintain the productivity of those already engaged in research and research training. Because of the limited pool of nurses with doctorates prepared for and engaged in research, this small group bears the heavy burden of conducting clinical research studies to develop the underpinnings of clinical practice to improve care and of conducting research training at all levels.
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From page 257... ...
There is a need to enhance the research intensity at some research training sites to ensure the rigor of clinical research training. The current need for this enhancement has arisen, in part, from the rapid growth of doctoral programs in nursing, which draw from the limited pool of doctorate-prepared individuals in the discipline.
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From page 258... ...
Commission on Nursing Research's (1981) guidelines for the investigative functions for the master's prepared nurse are as follows: · analyze and reformulate nursing practice problems so that scientific knowledge methods can be used to find solutions, enhance the quality and clinical relevance of nursing research by providing expertise in clinical problems and by providing knowledge about the way in which these clinical services are delivered, facilitate investigations of problems in clinical settings through such activities as contributing to a climate supportive of investigative activities, collaborating with others in investigations, and enhancing nursing's access to clients and data, conduct investigations for the purpose of monitoring the quality of the practice of nursing in a clinical setting, and · assist others in applying scientific knowledge in nursing practice.
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From page 259... ...
The environments and actual mentorship experiences in research in doctoral programs in nursing, however, are uneven. The ANA Commission on Nursing Research (1981)
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From page 260... ...
Most positions for clinical nurse-researchers are in academic settings, which have lower entry-level salaries and fewer rewards than positions in clinical institutions. Academic positions are not enticing to nurses who have made major financial investments-in their doctoral education, while at the same time foregoing income they could have made if they had remained in their clinical positions.
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From page 261... ...
In most cases, nurses reenter the practice arena between their educational degrees, which results in interruptions in research training. Although clinical experience is beneficial to the nurse-researcher because it helps to clarify research problems in need of investigation, such interruptions thwart progress in the research career and often keep nurse-investigators from proceeding with much-needed postdoctoral education.
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From page 262... ...
As noted previously, it is not unusual for heavy workloads, isolation, lack of resources, and low-intensity research environments to mitigate against Be produc~vi~ of new clinical n~se-researchers. Recommendations The task force recommends promotion of an institutional leadership that supports and values clinical nursing research and clinical nurse investigators, increased availability and levels of funding for research training and career development in clinical nursing research, and promotion of the education of the public and people in other health care disciplines regarding the research training of nurses.
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From page 263... ...
Shared barriers include the erosion of federal support for graduate training and continuous financial disincentives to pursue research as opposed to clinical practice. To provide a context for what follows, it may be helpful to describe some of psychology's relatively novel features as a profession and scientific discipline.
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From page 264... ...
Nonclinical psychologists also possess intensive training in one or more of the areas of human learning, perception, cognition, motivation, physiology, emotion, and interpersonal behavior. This training background leaves both clinical and nonclinical psychologists well-equipped to make important discoveries about the mechanisms that give rise to mental and physical health problems.
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From page 265... ...
Psychopathology Accredited clinical psychology programs possess resources in many areas of psychopathology. Expertise in schizophrenia and the affective disorders is well-established.
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From page 266... ...
Promising, high-need areas include the following. Violence and Aggression At both individual and sociocultural levels, clinical psychology has begun to develop a knowledge base aimed at understanding the effects of such violent acts as homicide, rape, and child abuse on victims and survivors.
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From page 267... ...
Clinical psychologists bring to the collaborative enterprise an extremely strong training background in research design and methods and an academic history of openness to interdisciplinary work. Their research expertise can be applied readily to almost any problem in which behavior potentially enhances or allays risk.
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From page 268... ...
Of the remaining 70 percent, 24 percent were in academic positions, 22 percent were employed in hospitals and clinics, and the remainder were employed by government, industry, or the nonprofit sector, where there is at least the opportunity to engage in clinical research. Of nonclinical psychologists in the l9X3 labor force, the vast majority (64 percent)
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From page 269... ...
The excellence of He pool of clinical psychology researchers is validated by their ability to compete successfully for federal research support. Even though the total dollar amount going to support behavioral research is relatively low (approximately 3.5 percent of He federal research support budget)
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From page 270... ...
The shared emphasis on the scientific method during all phases of training and the shared educational content concerning the mechanisms that govern learning, experience, and behavior equips those trained across all psychological specialties to conduct clinically related research. In addition to clinical psychologists, developmental, social, and experimental psychologists have made and continue to make important research contributions that affect the general health as well as the mental health of the nation.
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From page 271... ...
In 1986, by contrast, only six percent of new clinical psychology doctorates versus eight percent of nonclinical doctorates had relied primarily upon federal support for their graduate training. Although many major universities have been able to replace the lost federal training funds by using their own resources, it can O. ~ ~ , _, no longer be assumed that the modal clinical psychology graduate contemplates professional options from a debt-free base.
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From page 272... ...
As a beginning, there needs to be a mechanism whereby postdoctoral research positions in clinical psychology can be funded at more than minimal levels. A subsequent strategy, carrying on into the academic appointment, might be to allow clinical researchers who successfully compete for research awards to supplement their salaries from grants.
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From page 273... ...
Chilly Academic Climate for Women The general difficulties of retaining clinical psychologists as researchers will now be influenced by the increasing proportion of women who are entering the profession. Great suides have been made in recruiting women into the early career stages as clinical psychology researchers.
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From page 274... ...
Efforts to combat isolation, to diversify the areas of study that are encouraged and rewarded for research and scholarship, and to enhance Be flexibility of career timing all need to be encouraged. Erosion of the Science Training Base by Professional Schools of Psychology Until recent years, the bunk of clinical psychologists were trained as scientist-practitioners (the Boulder model)
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From page 275... ...
or state an openness to combining research and clinical practice. Since programs embracing a professional model are now producing about half of the new doctoral-level clinical psychologists, there can be no doubt that proliferation of the professional schools is serving to erode the base of scientific training of the profession as a whole.
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From page 276... ...
Recent changes in He practice portion of the licensure requirements in most states have made it increasingly difficult for new clinical psychologists who engage in research or academic activities to achieve eligibility for licensure. Most states now require two years of postdoctoral experience to be eligible, and they will rarely credit instruction, research, or even the provision of clinical supervision as eligible practice activities.
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From page 277... ...
1949. Training in Clinical Psychology.
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From page 278... ...
II] RNER, Professor of Psychiatry, DeparUnent of Psychiatry and Behavioral Sciences, Medical University of Soup Carolina, Charleston, South Carolina KENNETH A
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