For RNs wanting to pursue a doctorate, it is important to pick a degree that best matches your anticipated career path. The shortest simplest explanation of the difference in these degrees is probably:
- PhD – If you want to be a nurse scientist & teach in a university & conduct nursing research.
- DNP – If you want to be an advanced practice nurse, who primarily uses research in leadership, QI, patient care, etc. along with measuring project outcomes.
An excellent, free full-text, critique can be found at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547057/
Of course, some DNPs teach in universities, particularly in DNP programs. PhDs may otherwise be better prepared for faculty roles. I encourage you to look carefully at the curriculum at the school where you hope to study and expectations of a university where you hope to teach. Speak with faculty, & choose wisely.
Yes. Change can be painful.
Yes. It is easier to do things the way we’ve always done them (and been seemingly successful).
Yet, most of us want to work more efficiently or improve our own or patients’ health.
So, there you have the problem: a tension between status quo and change. Perhaps taking the easy status quo is why ‘everyday nurses’ don’t read research.
Ralph (2017) writes encountering 3 common mindsets that keep nurses stuck in the rut of refusing to examine new research:
- I’m not a researcher.
- I don’t value research.
- I don’t have time to read research.
But, he argues, you have a choice: you can go with the status quo or challenge it (Ralph). And (admit it), haven’t we all found that the status quo sometimes doesn’t work well so that we end up
- choosing a “work around,” or
- ignoring/avoiding the problem or
- leaving the problem for someone else or
- ….[well….,you pick an action.]
How to begin solving the problem of not reading research? Think of a super-interesting topic to you and make a quick trip to PubMed.com. Check out a few relevant abstracts and ask your librarian to get the articles for you. Read them in the nurses’ lounge so others can, too.
Let me know how your challenge to the status quo works out.
Bibliography: Fulltext available for download through https://www.researchgate.net/ of Ralph, N. (2017 April). Editorial: Engaging with research & evidence is a nursing priority so why are ‘everyday’ nurses not reading the literature, ACORN 30(3):3-5. doi: 10.26550/303/3.5
Practice based in evidence (EBP) means that you must critique/synthesize evidence and then apply it to particular setting and populations using your best judgement. This means that you must discriminate about when (and when NOT) to apply the research. Be sure to use best professional judgment to particularize your actions to the situation!
Add to your repertoire of EBP tools, the Number Needed to Treat (NNT). This is not mumbo -jumbo. NNT explained here–short & sweet: http://www.thennt.com/thennt-explained/
CRITICAL THINKING: Check out this or other analyses at the site. How does the info on antihypertensives for mild hypertension answer the question of whether more is better? Are there patients in whom you SHOULD treat mild HTN? (“We report, you decide.”) http://www.thennt.com/nnt/anti-hypertensives-for-cardiovascular-prevention-in-mild-hypertension/
MORE INFO: Check out what the data say about other risk/benefit treatments at http://www.thennt.com/
Want to know the standardized format for writing up your research study, QI report, case study, systematic review, or clinical practice guideline? Check out these standardized reporting guidelines: http://www.equator-network.org/reporting-guidelines/
Of course you should always give priority to the author instructions for the particular journal in which you want to publish, but most adhere generally or fully to these standardized guides.
Last post I commented on the potentially misleading terms of Filtered & Unfiltered research. My key point? Much so-called “unfiltered research” has been screened (filtered) carefully through peer-review before publication; while some “filtered research” may have been ‘filtered’ only by a single expert & be out of date. If we use the terms filtered and unfiltered we should not be naive about their meanings. (Pyramid source: Wikimedia Commons )
This week, I address what I see as a 2nd problem with this evidence based medicine pyramid. That is, missing in action from it are descriptive, correlation, & in-depth qualitative research are not mentioned. Where are they? This undercuts the EBM pyramid as a teaching tool and also (intentionally or not) denigrates the necessary basic type of research on which stronger levels of evidence are built. That foundation of the pyramid, called loosely “background information,” includes such basic, essential research.
You may have heard of Benner’s Novice to Expert theory. Benner used in-depth, qualitative interview descriptions as data to generate her theory. Yet that type of research evidence is missing from medicine’s pyramid! Without a clear foundation the pyramid will just topple over. Better be clear!
I recommend substituting (or at least adding to your repertoire) an Evidence Based NURSING (EBN) pyramid. Several versions exist & one is below that includes some of the previously missing research! This one includes EBP & QI projects, too! Notice the explicit addition of detail to the below pyramid as described at https://www.youtube.com/watch?v=MfRbuzzKjcM.
Critical thinking: #1List some EBM & EBN pyramid differences. #2 Figure out where on the hierarchy this project would go: Crowell, J., OʼNeil, K., & Drager, L. (2017). Project HANDS: A bundled approach to increase short peripheral catheter dwell time. Journal of Infusion Nursing, 40(5), 274-280. doi: 10.1097/NAN.0000000000000237. 1st use medicine’s EBM pyramid; & then 2nd use nursing’s EBN pyramid. #3 Label Crowell et al.’s study as filtered or unfiltered and explain what you mean by that.
For more info: Watch the YouTube video at the link above.