Researchers at the UAB School of Nursing generate knowledge that changes the landscape of nursing and health care and revolutionizes education and practice to improve lives. The School is internationally recognized for its seminal research and scholarship in nursing science, education and practice generated over the past 70 years. From teaching evidence-based practice discoveries in the classroom to supporting early career nurse scientists in practice, community and even bench side, the School works to revolutionize nursing and health care education and practice to improve the lives of all persons.
Since the hiring of Dr. Kathryn “Kitty” Barchard by Dean Marie O’Koren, the School’s second dean, to head the school’s first research program — the Center for Research and Development (today the Office of Research and Scholarship) — the UAB School of Nursing has developed and established its role as a premier center for nursing research, attracting nurse scientists from around the country and reaching a wide swath of health care topics, ranking #8 in the nation among public schools of nursing in National Institutes of Health research funding in 2019.
“We can trace the foundations of nursing research back to Florence Nightingale’s actions in the 19th century, but nursing research has not always held the influence it holds today. While the nursing profession and health care field now recognize the importance of nurse scientists and the important perspective nurses bring to the table, that was not always the case,” said Dean and Fay B. Ireland Endowed Chair in Nursing Doreen C. Harper, PhD, RN, FAAN. “Thanks to projects started by former deans and a sustained focus on increasing research funding, the UAB School of Nursing is well-positioned to create the next generation of nurse scientists to discover new knowledge that continually improves care.”
Firm Foundation
While research was not the strongest part of the UAB School of Nursing’s portfolio during the 1970s and 1980s, the School’s second dean, Marie O’Koren, EdD, RN, planted seeds that continue to support research on campus.
“Dr. O’Koren recognized the value of an improved research program, and those first steps helped build the foundation of what we see today,” said Interim Associate Dean of Research and Scholarship Marie Bakitas, DNSc, CRNP, NP-C, AOCN, ACHPN, FAAN, FPCN, who is also a Professor and Marie L. O’Koren Endowed Chair in Nursing. “Through research and scholarship, we have been able to affect change in practice and improve care. Dr. O’Koren recognized that, and we continue to build on that vision.”
The role of Associate Dean of Research was created in the 1990s by Dean Rachel Booth and was dedicated to continuous growth in research. From that point forward, faculty became more engaged in research, more research faculty were recruited, and by the mid to late 2000s, the School’s research portfolio expanded further to cover a range of topics from Alzheimer’s and dementia care to family caregivers to cancer survivorship.
This surge came from a dedicated effort by Dean Doreen Harper to focus significant efforts and resources on research. In addition to recognizing research and scholarship are foundational elements in knowledge creation to advance nursing practice, she also saw an opportunity to align with UAB's Research Centers and further address disparities in care through research.
As of 2020, nearly all research programs out of the UAB School of Nursing work to address health disparities and/or to develop tailored interventions and solutions that can meet the needs of medically underserved populations.
“In research, it is important to recognize the community component to care, and that is something we greatly emphasize in our research programs,” Bakitas said. “A research program without an eye on equity and inclusion is an incomplete research program, and its scope and application is severely limited. In order to truly impact care, we must not only acknowledge health disparities and social determinants of health, but actively work toward health equality.”
Building Blocks
When Harper arrived at the School of Nursing in 2005, she knew the foundation of research was primed for an upward climb. It just required the next step of building blocks to sustain growth. Shortly after her arrival, Harper spoke with Edward E. Partridge, director of the UAB Comprehensive Cancer Center, and he provided valuable advice regarding recruiting strong researching faculty.
“He advised me to recruit individuals whose interests already aligned with our school and university,” she noted. “By taking this approach, we align ourselves with the overall strengths of UAB, and new faculty can leverage the benefit of all of the organization’s resources.”
Harper recruited the late Dr. Karen Meneses, a highly successful researcher in cancer survivorship. She also expanded the School’s research portfolio to interdisciplinary faculty such as Professor and former Associate Dean of Research and Scholarship David Vance, PhD, MGS, MS, Professor Mirjam-Colette Kempf, PhD, MPH, Professor and Director of Statistics and Biostatistician Andres Azuero, PhD, MBA, to bring a variety of backgrounds and perspectives to the School, opening opportunities for interdisciplinary collaboration and expanded research topics.
“One of the School’s greatest strengths is the diversity of its research portfolio, and the fact that our faculty include individuals with nursing, psychology, epidemiology, statistics, medicine and other backgrounds adds to that strength,” Bakitas said. “We are all able to exit our silos and learn from each other’s experience and perspective, which only strengthens our research and health care as a whole.”
This expansive portfolio has remained well-matched with UAB’s interdisciplinary university-wide research centers (UWIRCs), which are recognized for their high-quality research, multitude of resources and collaborative partnerships.
“Dr. Harper has led the way for a research-intensive culture at the UAB School of Nursing that is very much in keeping with the overall research culture of UAB,” Partridge said.
As the School’s research program has grown, faculty involvement in UWIRCs continues to expand.
“University-wide interdisciplinary research centers open doors to research, funding and greater collaboration,” said Bakitas, who is also the first nurse to serve as co-director of a UAB UWIRC, the Center for Palliative and Supportive Care. “These research centers, along with UAB’s patient population and support from the School of Nursing and Office of Research and Scholarship, are one reason why researchers are so attracted to the University and SON. They know that by coming here, they’ll have enhanced opportunities for collaboration and the overall resources necessary to succeed.”
As part of UAB’s first UWIRC to be co-directed by two departments, Bakitas works alongside UAB School of Medicine Professor Rodney Tucker, MD, MMM, FAAHPM.
This UWIRC not only advances research in palliative and supportive care across disciplines but opens additional opportunities for funding and collaboration.
“We’ve been able to recruit scientists who have generated research, funding and collaborations across nursing, medicine and other health professions with well-developed programs of research in cancer, heart failure, palliative care, HIV, aging, dementia and health services research in patient safety and quality,” Harper said. “We are fortunate to be aligned with UAB Medicine and the academic health science center and that also has helped to grow our research, especially around population health.”
Mentorship Mentality
The UAB School of Nursing also prides itself on providing another important tool for success—mentorship. The importance of research and scholarship is integrated within the School’s graduate and undergraduate programs in order to provide students with an introduction to the impact of nursing research.
“Dr. O’Koren did a lot of team building, and I so strongly believe in the power of team-building,” said Bakitas. “When you are building teams, you are mentoring people who can carry on good work into the future. Through her ability in team building, Dr. O’Koren did work at this school that did not go away when she was no longer dean. She left a legacy that existed far beyond that.”
Students also benefit from the wide range of research at the School, Bakitas said, as they are able to find mentors meeting their research interests and can learn about different schools of thought from interprofessional faculty. Mentors are also dedicated to their mentees, working to connect early in their careers and to continue to offer support as they develop as researchers.
“I can think of around 20 individuals right now for whom I am either the primary mentor or a co-mentor who are interested in helping to develop the science of palliative care,” said Bakitas. “And this is interprofessional — I’m talking about health professionals such as nurses, physicians, sociologists, and psychologists. I see mentorship as a chance to expand influence in research and to make sure the next generation of nurse scientists is prepared to step up to the plate.”
In addition to mentorship, the School is solidifying a strong pipeline of scientists and nurse leaders through the development of a dual PhD/DNP program. This program will combine the two terminal degrees, enabling graduates to seamlessly progress between the programs, and to combine clinical knowledge and expertise within research.
“As we look toward the future of nursing research, it’s important to recognize the importance of integrating advanced practice nursing expertise with a research perspective,” Harper said. “By completing both degrees, nurse scientists can utilize their strengths as a clinical expert and develop their experience into new programs of research fueled by on-the-ground, up-to-the-minute experience.”
Scholarship is also far from limited to research faculty. All DNP faculty and students receive support to produce scholarly articles on topics ranging from clinical topics to pedagogical practices to innovations and simulations.
“Often, faculty and students who are practitioners are not experienced in writing papers for publication. It can be fairly daunting when you’re doing this for the first time,” said Vance, who has a strong history of being published and guiding others in being published. “Through research and scholarly development, we’re trying to take the bull by the horns and support these faculty and students to identify with the concept of ‘Yes, you are a practitioner. But remember that you’re also a scholar.’”
Continued research and scholarship are also supported through resources in the Office of Research and Scholarship, grant writing support and regular writing workshops. These tools provide space for continued growth and expanded research within a structure of support and guidance, Moneyham said.
“It’s critical that we support our faculty in their development, including with mentoring; otherwise we are not going to be effective,” Moneyham said. “We have to build a culture — a supportive environment and structure and guidance system — that will move our faculty to achieve what they might not even know that they can achieve. We have these new faculty members who come in with excitement and new ideas and we say, ‘Go for it!’”
Ever-growing Portfolio
Mentorship, collaboration and support all come together to position the UAB School of Nursing for a strong future in nursing research.
When Harper joined the School in 2005, research and training funds only just passed $1 million. Only five years later, however, those numbers more than quadrupled to $4.4 million. In 2015, the School entered the top 20 ranked Schools for funding from the National Institutes of Health, with $2.2 million in NIH grant funding alone. That NIH number continues to grow. In 2019, NIH funding reached $4.9 million and in 2020, NIH annual funding grew to almost $6 million.
“Sustained growth in our research funding, as well as workforce improvement and training grants, are proof that Dean Harper’s vision for research is producing results,” Bakitas said. “She has positioned the School of Nursing for sustained growth moving forward, through a steady pipeline of nurse scientists and attractive offerings to new faculty. Even in 2020, we have hit several milestones for funding.”
Overall grant funding in 2020 surpassed a record $12.7 million. PhD student and BSN graduate Macy Stockdill received the School’s first F31 grant, which provides funding for her PhD studies. Assistant Professor J. Nicholas Dionne-Odom, PhD, RN, ACHPN, FPCN, also received the School’s first R37 grant, a $3.2 million, five-year grant to create a lay navigator-led, community-based palliative care intervention for rural and African American family caregivers in the Southeast. Professor Mirjam-Colette Kempf continued leading an important seven-year, $16.8 million federal grant to improve HIV/AIDS care and research. Assistant Professor Edwin Aroke, PhD, CRNA, has received two grants to continue his research into racial disparities in pain and pain management in an effort to end the disparities. The School also welcomed Associate Professor Carolyn Pickering, PhD, RN, to the faculty in 2019. As an early career scientist, Pickering has received millions in grant funding, including two NIH grants funding research in healthy aging and dementia she brought to the UAB School of Nursing.
UAB School of Nursing’s reputation as a research-intensive school, as well as UAB’s reputation for supporting researchers through collaborative centers, attracted Pickering and her husband, School of Medicine faculty member Assistant Professor Andrew Pickering, PhD, to Birmingham and to UAB.
Their joint decision to join the School, Harper said, is one example of the many stories in which researchers recognized the reputation of UAB and chose to bring their important research to campus.
“Nursing research is a vital step toward improved care and overall success for working nurses. Our research and scholarship can positively impact nursing education, address challenges in the workforce and develop interventions to improve the lives of our patients and their families,” Harper said. “We’re opening doors for even more scholarship at the School of Nursing, and we are seeing the impact in our communities and the UAB Health System.”
Future Vision
As the School looks to the future for its research mission there will be growth in the number of interdisciplinary and nurse scientists in the school because continued growth in the diversity of disciplines brings a diversity of thought, which is a benefit to those whose lives are improved by the research.
Harper said the emphasis on eliminating health care disparities and health inequities will continue to grow and be a part of all of the School’s research endeavors. And in addition to the School’s continued focus on its current programs of research, the current state of health and the environment are informing the forward trajectory.
“We will continue to focus on the populations we serve in Alabama the South, especially our medically underserved population,” she said. “COVID-19 has brought so many disparities to the forefront and have shown us where they are and what we have to do in achieving health equity. Then there are the genetics associated with COVID infections that we know little to nothing about right now that will make those avenues of research critical. And the acuity of people being discharged home from the hospital is growing.
“Telehealth for transitional care and also how we are going to use it to work on public health issues is another part of the future. We also are looking at the impact of disaster preparedness and related health care issues around climate change. The possibilities are endless when you sit back and reflect on where our world is going.”
Research creates new knowledge and discovery science, finds new patterns or connections of data, but to see its true impact, it is necessary to translate that knowledge into real-world application. Bakitas said there is no place better to make an impact with your research than UAB.
“Nurse scientists who come to work in the Southeast see the vast health care needs of our underserved communities and the wealth of opportunities they have to improve so many lives,” Bakitas said. “At UAB, we have the expertise and the resources to reach these vulnerable, minority and rural populations through our research. The translational piece that we bring through nursing and the community-based work we do here really makes a difference in peoples’ lives.”
