As career educators and academic leaders, we are writing to commend the authors on their contribution to a better understanding of the teaching-learning process used to prepare clinical nurse faculty. We are sensitive to the impact that the nursing faculty shortage, in particular the clinical nursing faculty shortage, has had on student learning and the profession. Developing a curriculum and pedagogy to better prepare clinical nurse educators is critical to sustaining a nursing workforce for the future. However, we believe that conferring the title of "clinical scholar" on emerging nursing faculty who have completed a 40-hour curriculum is not appropriate because they have yet to demonstrate the role attributes and role processes of scholars. For more than 10 years, we have been studying nursing scholarship with a particular emphasis on what it means to be a scholar in practice. Our early theoretical work proposed a universal model of nursing scholarship with 4 domains: the scholarship of knowing, the scholarship of teaching, the scholarship of practice, and the scholarship of service.1 Findings from a subsequent qualitative descriptive study documented the personal attributes and professional behaviors that characterize scholarly nursing practice.2 More recently, we published the essential elements for an optimal practice environment wherein scholarly nursing practice flourishes3 as well as the description of civic engagement and professional service undertaken by clinical scholars in practice (J. Riley, J. Beal, and D. Lancaster, unpublished observation). We are currently examining the role of the teaching scholar in nursing education. Our funded program of research confirms that not only is scholarship alive and well in all settings where nurses work and teach but more importantly there are specific and unique attributes and role behaviors that are evident in those who are recognized as the "best of the best" in nursing. Scholarly attributes and behaviors develop over a career pathway. We believe that these authors describe a model for developing clinical faculty rather than a clinical scholar model for clinical teaching.

Sincerely yours,

Judy A. Beal, DNSc, RN

Professor, Chair of Nursing, and Associate Dean School of Health Sciences, Simmons College 300 The Fenway, Boston, MA 02115

Joan M. Riley, EdD, RN

Professor of Nursing/Former Chair Department of Nursing, Emmanuel College 400 The Fenway, Boston, MA 02115

REFERENCES

1. Riley JM, Beal JA, Levi P, McCausland MP. Revisioning nursing scholarship. J Nurs Scholarsh. 2002;34(2):383-390. [Context Link]

2. Riley JM, Beal JA, Lancaster DR. Scholarly nursing practice from the perspectives of experienced nurses. J Adv Nurs. 2007;61(4):425-435. [Context Link]

3. Beal J, Riley J, Lancaster D. Essential elements of an optimal clinical practice environment. J Nurs Adm. 2008;38(11):488-493. [Context Link]

Reply:

We appreciate the opportunity to continue the discussion about clinical faculty and clinical scholars. The term clinical scholar has been utilized in several separate contexts. At the University of Minnesota, they have a current program whereby advanced practice nurses partner with academic faculty members to "blend clinical expertise and scholarship"1 to deal with complex nursing issues.2 Sigma Theta Tau has a current continuing education course titled "Clinical Scholars at the Bedside," which targets development and sustaining evidence-based practice. Third, there is a biannual, peer-reviewed journal titled Clinical Scholars Review, which focuses on articles that demonstrate clinical excellence in the application of evidence-based practice in doctoral-level nursing. Thus, the terminology clinical scholar enjoys several separate definitions.

In our context it was first used by the University of Colorado.3 Their belief was that with the rapidly expanding essential knowledge base and the clinical expertise required, the traditional academic faculty and their students were at a strong disadvantage when entering the clinical setting. They created the model that they termed "clinical scholar," which was a "practice-education partnership focused on improving the outcomes of clinical nursing education by bridging the academic and service settings." In their model, clinically expert, agency-employed nurses were tapped to teach groups of nursing students.

There were several very appealing aspects of this model including the ability to readily expand the pool of clinical faculty, a severe shortage in our state, and provide clinical faculty who have current, high-level competency in the clinical setting.

In the development of the model described in a recent article of the Journal of Perinatal and Neonatal Nursing, a 40-hour educational component was added, something that has not traditionally been available for clinical faculty. The prevailing assumption was that because a nurse was a clinical expert and an outstanding bedside nurse, he or she would also be a great teacher. The skill sets vary significantly though, and these nurses often felt overwhelmed and ill-prepared for the challenges of teaching in the clinical nursing education setting. In addition, the model was expanded from a single school and its clinical partners to a much larger community with numerous schools and clinical agencies.

In the purest sense, a clinical scholar in our model is an expert clinical nurse who maintains his or her agency employment and, as a portion of their existing job, takes rotations of nursing students from time to time from local nursing schools. The clinical scholar always has a strong relationship with the course coordinator at the school and has complete responsibility of all phases of the clinical experience for the nursing students. Thus, the clinical scholar is truly the bridge between the practice world and education. According to our anecdotal research, this model has been successful both academically and clinically. Students are overwhelmingly enthusiastic about the clinical experience provided by the clinical scholars; unit staff believe that patients are safer and they are more comfortable when student rotations are led by clinical scholars; and schools, who initially were a bit wary, found the clinical scholars to be clinically competent 100% of the time.

Now, whether at the end of the 40-hour course a nurse has been changed into a "scholarly" professional is a fair question. However, we believe that highly competent bedside nurses must all develop a stronger sense of research curiosity as they continuously strive to provide their patients with the most strongly supported evidence-based care.

Sincerely yours,

Marianne Horner, MSN, CNM, RN

Karren Kowalski, PhD, RN, FAAN, NEA-BC

REFERENCES