This proposal is a competing continuation of T32-NR-007104 that began in 1999. The request is for 5 pre- doctoral and 4 post-doctoral trainees. Our proposal is responsive to the Institute of Medicine's recommendation to double the number of nurses with doctoral degrees by 2020. We place high priority on the recruitment of BSN to PhD students, targeting the recruitment of nurses to doctoral study who had not previously decided upon a research career in order to increase the pipeline into PhD education. We have made curriculum changes and organizational adjustments to our mentoring program to enable successful completion of the PhD within 3 years by trainees with and without master's degrees. Our goal is to recruit promising young nurses into research careers and make it feasible for them to complete their training by age 30 thus enabling them to make sustained contributions to nursing science, improved clinical care, and education of the next generation of nurses. Ours is a formal interdisciplinary program comprising the conceptual and empirical foundations and cutting edge methodologic approaches and statistical tools of advanced outcomes research and we specialize in identifying and employing large secondary data sources. Our research priorities, reflected in the funded research of our faculty, are improved outcomes for the chronically ill, reducing health disparities, comparative effectiveness of nursing delivery systems, improved care for critically ill patients and end of life care, and outcomes across settings from hospitals to nursing homes to home care. Our curriculum for BSN to PhD research training includes a year-long course in clinical nursing in recognition that many of our high priority applicants do not have the benefit of extended clinical experience and need increased clinical exposure and mentoring in order to ask clinically-relevant research questions. Our students take coursework with our interdisciplinary affiliated faculty and our program interfaces with related training programs throughout Penn providing a network of educational opportunities for trainees that augment their experience. The program is guided conceptually by the Quality Health Outcomes Model postulating that outcomes of nursing interventions are mediated by the organizational context in which care takes place and the health status and characteristics of patients. Trainees receive state of the science education in the measurement of the organizational context of care, patient risk adjustment methods, nurse sensitive outcome measures, spatial geography and geocoding, comparative effectiveness methods, cost of care measurement, panel studies, and international outcomes research. The program's first 14 years have been highly successful in terms of recruitment and program completion including by minorities, high visibility scientific publications by trainees, success of our alumni in competing for grant funds, and the placement of those who have completed their training in mainstream research positions where their research careers can flourish.

Public Health Relevance

This proposal for a renewal of the longstanding and successful training program 'Advanced Training in Nursing Outcomes Research' is responsive to national needs to produce PhD-prepared nurse researchers in fewer years and at younger ages. By making it feasible for young nurses to complete their training by age 30 we can enable them to make sustained contributions to nursing science, improved clinical care, and education of the next generation of nurses.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Institutional National Research Service Award (T32)
Project #
Application #
Study Section
Special Emphasis Panel (ZNR1)
Program Officer
Banks, David
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Pennsylvania
Other Health Professions
Schools of Nursing
United States
Zip Code
Smith, Jessica G; Morin, Karen H; Lake, Eileen T (2018) Association of the nurse work environment with nurse incivility in hospitals. J Nurs Manag 26:219-226
Lake, Eileen T; Staiger, Douglas; Edwards, Erika Miles et al. (2018) Nursing Care Disparities in Neonatal Intensive Care Units. Health Serv Res 53 Suppl 1:3007-3026
Smith, Jessica G (2018) Does Missed Care in Isolated Rural Hospitals Matter? West J Nurs Res 40:775-778
White, Elizabeth M; Smith, Jessica G; Trotta, Rebecca L et al. (2018) Lower Postsurgical Mortality for Individuals with Dementia with Better-Educated Hospital Workforce. J Am Geriatr Soc 66:1137-1143
Barnes, Hilary; Richards, Michael R; McHugh, Matthew D et al. (2018) Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners. Health Aff (Millwood) 37:908-914
Martsolf, Grant R; Barnes, Hilary; Richards, Michael R et al. (2018) Employment of Advanced Practice Clinicians in Physician Practices. JAMA Intern Med 178:988-990
Smith, Jessica G; Rogowski, Jeannette A; Schoenauer, Kathryn M et al. (2018) Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs. J Perinat Neonatal Nurs 32:72-79
Aiken, Linda H; Sloane, Douglas M; Barnes, Hilary et al. (2018) Nurses' And Patients' Appraisals Show Patient Safety In Hospitals Remains A Concern. Health Aff (Millwood) 37:1744-1751
Smith, Jessica G; Morin, Karen H; Wallace, Leigh E et al. (2018) Association of the Nurse Work Environment, Collective Efficacy, and Missed Care. West J Nurs Res 40:779-798
Jarrín, Olga F; Kang, Youjeong; Aiken, Linda H (2017) Pathway to better patient care and nurse workforce outcomes in home care. Nurs Outlook 65:671-678

Showing the most recent 10 out of 140 publications