Faculty Practice Promotion and Tenure

Introduction and Background

Advanced practice nursing has become a dominant focus of graduate nursing education over the past two decades. Faculty must be prepared both academically and clinically to teach effectively in these programs. Academic institutions expect and reward ongoing development and excellence of teaching ability. Clinical excellence requires the same nurture and practice. Clinical practice, however, has not been traditionally recognized as a tenurable activity (Burns, 1997).

In most academic institutions, research, teaching, and service are the primary components of scholarship, and the basis of university merit reviews, promotion, and tenure decisions. Within this traditional model, nursing faculty, particularly nurse practitioner faculty, have faced a dilemma of how to meet their professional practice expectations while simultaneously fulfilling the traditional academic components of scholarship.  In research intensive institutions, the challenges are often heightened as the level of scholarship necessary to promote tenure and advancement must be of the quality that receives a favorable peer review from the highest level in the country. Taylor (1997) writes that "Practice contributes to scholarship and could or should promote the goals of academia and advancement within the academic system...challenges to the future of faculty practice will include integrating practice into traditional academic missions of teaching and research" (p3).   In an effort to meet these challenges, NONPF has prepared this position statement on Faculty Practice and Promotion and Tenure. Findings from the recent NONPF Faculty Practice Survey (Pohl, 1999) are included to help describe the current state of faculty practice activity in the country. Additionally, the scholarship of practice is defined and the recognition and integration of scholarly practice as a viable, essential component in promotion and tenure guidelines in contemporary academia is proposed.

NONPF Faculty Practice Survey Findings

The American Association of Colleges of Nursing (AACN, 1999) has acknowledged the scholarship of practice as a critical component in the maintenance of clinically competent faculty in the current academic setting. Recently NONPF (1999) conducted a survey of its membership to further define the role of faculty practice in promotion and tenure decisions. Out of 892 surveys mailed, 453 were completed and returned. Of the 453 respondents, 76% (n = 332) were in clinical practice and a majority were doctorally prepared (69%, n = 306).  Almost half (43%, n =192) were tenured as either the associate professors (29%) or full professors (14%). Of those respondents who practiced, 45% (n = 155) documented that practice was included in their faculty FTE. Despite these figures, 50% (n = 210) of the respondents indicated that practice was not considered in either promotion or tenure and practice was weighted less than teaching and research in promotion and tenure decisions.

A majority of the respondents (53%, n= 218) reported that practice was encouraged but not required and 21% (n = 76) indicated that practice was required either for some faculty or all. Yet, 60% (n = 122) reported that practice was weighted less than teaching and research in promotion and tenure decisions at their institutions. When asked how practice was viewed within the academic structure for promotion and tenure (teaching, research, and/or service), 87% (n = 201) of the respondents reported that practice was considered a component of service, 43 %(n = 98) reported it was considered a part of teaching and 29% (n = 66) acknowledged that practice was considered a component of research.

Survey results indicate there is a need to better clarify the role of scholarly faculty practice in the current academic system. Boyer's work (1990) has given a refreshing new insight into scholarship and support for the scholarship of practice. Others further defining and clarifying Boyer's work suggest that scholarly faculty practice can meet the criteria for discovery, integration, application, and/or teaching and needs to carry unique weight in terms of promotion and tenure criteria (Glassick, 1999). When considered solely as a component of service, however, it is less likely to take on scholarly form.

Definition of Scholarly Practice

Boyer (1990) challenged all those involved in the academic setting to broaden their view of scholarship, with an emphasis on embracing a diversity of scholarship.  He explained his expanded view of scholarship as including four separate but overlapping functions:

1. The Scholarship of Discovery - similar to the current concept of research, it entails the generation of new knowledge.
2. The Scholarship of Integration - refers to giving meaning to isolated facts, putting them in perspective, and making connections across disciplines.
3. The Scholarship of Application - seeks engagement with society, asks for an agenda that benefits individuals, institutions, and society.
4. The Scholarship of Teaching - through the process of teaching, knowledge is transformed and extended, new scholars are born (p. 16).

Boyer (1990) suggests that scholarly practice activities relate to one's area of expertise and knowledge, and this effort is serious and demanding requiring the same rigor and accountability (peer review) associated with research activities. Thus, scholarly, academic faculty practice requires more than mere allocation of time to provide patient care.

Based on the work of Boyer (1990) and other critical authors, the American Association of Colleges of Nursing (AACN) published a position statement, "Defining Scholarship for the Discipline of Nursing" (1999), which supports a comprehensive view of scholarship.   "Scholarship in nursing can be defined as those activities that systematically advance the teaching, research, and practice of nursing through rigorous inquiry that 1) is significant to the profession, 2) is creative, 3) can be documented, can be replicated or elaborated, and 5) can be peer-reviewed through various methods". (p. 373)

In a study by Tolve (1999) that explored nursing scholarship and its relationship to faculty practice, the author found that "scholarship was viewed as the generation, application, dissemination, and advancement of nursing knowledge in a variety of roles and settings" (p.31).  The findings from this study also suggested that "faculty practice roles could be considered a component of scholarship, as long as scholarly outcomes are demonstrated" (p. 32).

Glassick (1999), expanding on Boyer's original work, offers measures of how any form of scholarship might be evaluated. Faculty practice, which aspires to be scholarly, should reflect these standards:

• Clear goals.  The practitioner will state the overall goal of improving the health status of an individual/community, and then add additional goal as needed for the appropriate practice setting.
• Adequate preparation.  The individual practitioner will demonstrate that s/he has attained the necessary education and experience to provide expert care in the practice setting. Clinical excellence requires both maintaining national certification and continuing growth and experience through practice and continuing education.
• Appropriate methods.  The practitioner will incorporate evidence-based methods and innovative delivery system components into practice as evidenced by current standards, protocols and research.
• Significant results.  The practitioner will monitor the effectiveness of one's advanced practice nursing interventions through a variety of quantitative and qualitative methods.
• Effective communication.  The practitioner will share methods of care delivery, interventions, and unique experiences through broad methods of dissemination including presentations, publications in professional and consumer literature, and enhanced teaching.
• Reflective critique.  The practitioner will continuously attempt to improve practice expertise by ongoing self and peer evaluation, and by identifying areas for further research.

Recommendations for Recognition and Integration of Faculty Practice

The central mission of practice is to improve the health of the community/nation (Starck, 1999) and "is the provision and/or management of high-quality, cost-effective health care. The mission includes teaching, research and service." (Marion, 1997, p. 9).  NONPF believes that faculty practice is an essential role activity for all nurse practitioner faculty, especially if they are teaching clinical courses. Practice is required to maintain certification in the specialty area because of recognition that practice is necessary to maintain and improve skills.

NONPF acknowledges the necessity of administrative support for scholarly faculty practice. Integration of faculty practice into the faculty member's role requires such support.  Norbeck and Taylor (1999) identified four strategies for successful faculty practice.

1. Integration of faculty roles (clinician, educator, researcher);
2. Collaboration that is interdisciplinary for support networks, creativity, and increased funding opportunities;
3. Organizational support for professional and policy oversight;
4. A faculty practice plan to guide financial and workload considerations. 

Traditionally, research, teaching, and service have been the primary components of scholarship and the basis of university merit reviews, and promotion and tenure decisions.  This philosophy is reflected in the findings of the NONPF survey (Pohl, 1999) which reported that, while the majority of NP faculty are involved in faculty practice, many nursing programs do not consider faculty practice in their promotion and tenure decisions. The challenge and opportunity now is to define what is scholarly and acknowledge faculty practice as a scholarly activity.  AACN (1999) has provided excellent examples of the definition of the scholarship of practice.  They include:

• Peer reviewed publications of research, case studies, outcome/evaluation projects
• Funded research (level of funding would be determined by the research level of the institution)
• Presentations/posters based on research and/or practice at national and international meetings
• Presentations/posters informing policy from practice and research
• Requests for consultation
• Peer review of practice consistent with evidence based guidelines
• Develops and informs standards of practice based on research
• State, regional, national, international recognition as master practitioner
• Non research grant awards in support of practice

NONPF recommends that all academic institutions expand the definition of scholarship using Boyer's model (1990) which has been described in the AACN Position Statement in terms of its relevance to nursing (1999):  Scholarship of Discovery, Scholarship of Integration, Scholarship of Application and Scholarship of Teaching. Faculty practice should be viewed as an essential component of scholarship that is encouraged and rewarded through merit review, tenure and promotion as long as scholarly outcomes are demonstrated. The standards of scholarship described by Glassick can be used as a guide for evaluation: clear goals, adequate preparation, appropriate evidence based practice methods and innovative processes of care, significant outcome results including added value to the school's mission, effective communication, and reflective critique. NONPF recommends these strategies should serve as a guide for both administrators and faculty members when establishing and maintaining faculty practice and in evaluating faculty practice activities for promotion and tenure.

References

American Association of Colleges of Nursing (AACN), (1999).  Position Statement: Defining Scholarship for the Discipline of Nursing.

Boyer, E. (1990). Scholarship reconsidered: Priorities for the professoriate. Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching.

Burns, C. E. (1997). Faculty clinical practice as a tenurable activity. In Faculty Practice: Applying the Models, L. N. Marion (Ed.)

Glassick, C. (1999). Scholarship assessed: A special report on faculty evaluation (pp. 1-8).  Hallmarks of scholarly nursing practice. Proceedings of the American Association of Colleges of Nursing's 1999 Faculty Practice Conference.

Marion, L. (1997). National Organization of Nurse Practitioner Faculties Guidelines for Evaluation of Faculty Practice (pp. 9-10).  In Faculty Practice: Applying the Models.

Norbeck, J. S., & Taylor, D. L. (1999). Faculty practice. In E. Sullivan (Ed.), Creating nursing's future: Issues, opportunities and challenges. St. Louis, MO: Mosby Publishing Co.

Pohl, J. M. (1999). NONPF Faculty Practice Survey Results. Presented at the National Organization of Nurse Practitioner Faculties Annual meeting, April, 1999, San Francisco.

Starck, P. L. (1999).  Hallmarks of scholarly practice: Distinguishing features and guiding principles. Hallmarks of Scholarly Nursing Practice, Proceedings of the American Association of Colleges of Nursing'' 1999 Faculty Practice Conference.

Taylor, D. (1997). Faculty practice: The next steps. In Faculty Practice: Applying the Models, L. Marion (Ed.), National Organization of Nurse Practitioner Faculties.

Tolve, C.J. (1999).  Nursing scholarship: Role of Faculty Practice. Clinical Excellence for Nurse Practitioners, 3(1), 28-33.

This report was prepared by a sub-committee of the Faculty Practice Committee for NONPF, August 21, 2000.
Approved by the NONPF Board of Directors, October 21, 2000.

Joanne Pohl, PhD, RN, CS, FAAN (Chair)
Associate Professor, School of Nursing
The University of Michigan, Ann Arbor

Karen Duderstadt, RN, MS, CPNP
Associate Clinical Professor, School of Nursing
University of California, San Francisco

Patricia Murray Given, RN, PhD, CCRN, CS, FNP
Professor, Nursing
Monmouth University, West Long Branch, New Jersey

Margaret (Peg) Thorman Hartig, PhD, RN, CS
Associate Professor, College of Nursing
University of Tennessee Center for Health Science
Memphis, TN

Candice Tolve Schoeneberger, PhD, RNC, WHCNP
Associate Professor, Department of Nursing
Regis University, Denver

Constance Uphold, PhD, ARNP
Nurse Practitioner/Research Scientist
Veterans Affairs Medical Center, Gainesville, FL