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University of New Mexico College of Nursing Honors Program

Cultivating the Next Generation of Nurse Scientists: Partnering Academia and the IRB to Teach Undergraduate Nursing Students How to Move From Process Improvement to Research 

Baccalaureate Honors nursing student nurses are taught to use evidenced-based practice (EBP) in clinical care settings. This foundation often leads to students participating in quality improvement projects as their aim is to design interventions based on assessments of patient care processes and delivery care systems. While these are critical elements to learn, students were missing the knowledge and skills necessary to make a distinction between what constitutes application of knowledge in quality improvement and the generation of new knowledge founded in the nursing research process There is often confusion for the students working within a health care entity about whether a proposed quality improvement project is subject to human research regulations and needs to undergo review by institutional review boards (IRBs) and many practicing nurses are fearful of research and IRBs and steer students away from research.  As the majority of these Honors students plan to go on for masters or doctoral education, it is imperative they understand the difference between quality improvement and research so they begin building their research trajectory at the undergraduate level. In addition, clinicians and students often find they obtained results from a quality improvement project they now want to publish, but as the original intent of the project was not to “generalize” knowledge, they may have not engaged the IRB at the outset of the activity.

Program Overview

Honors 1A series of learning experiences that develop the necessary skills, knowledge and attitudes involved in identifying how quality improvement activities can be placed within the research context of IRB oversight were designed through collaboration between the College of Nursing and the Human Research Protections Office. This joint program established a series of learning activities for students that included: 1) taking the fear our of research and understanding human subject protection (didactic content related to steps in the research process and taking the IRB human protections training module as a course assignment); 2) clarifying the contributions of quality improvement activities and identifying challenges from the ethical viewpoint (using a decision tree to identify when quality improvement crosses over into research and collecting QA data in a way that protects human participants);  3) understanding the intent to generalize or not to generalize the data (through training/discussion with knowledgeable IRB staff in order to determine the threshold of when a QA activity becomes research); 4) bridging a quality improvement project into a research study (through creation of a simplified consent form or information sheet for quality improvement projects designed to teach students the required elements of informed consent); 5) disseminate information to enhance the learning process for future students (developed a quality improvement to research handbook with examples of consent forms for quantitative and qualitative quality improvement and research consent forms/information sheets, abstracts of projects and studies, examples of IRB template forms and completed submissions, protocols for development of quality improvement and research studies).

Program Evaluation

Honors 2To evaluate the success of the program, we collect qualitative feedback from both students and clinicians in our partner health care entities related to the understanding of the differences between the quality improvement process and the research process.  Consent forms, information sheets, abstracts and outlines are routinely reviewed by the IRB for content and clarity and feedback is provided to the students as to whether they are meeting the criteria for quality improvement, research, or both.  Since the program began in 2005, we have had 57 groups present at the UNM Undergraduate and Research Symposium with 23 scholastic and monetary award winners with scores of 98/100; 14 of these earned perfect scores of 100 and we have admitted numerous students to our MSN programs and our Honors students are thrilled that the UNM CoN has admitted its first three students (one of them a former honors student) to our exciting new BSN-PhD program!