Transcript 

Hello, this is Sally Cohen, and I'm pleased to welcome you all to the first episode of Conversations with Sally. We hope to do a couple of these and get it going, and the first one we have today is titled PhD DNP Collaboration, Why It Matters.

We have two guests Kathleen Zawadzki, who is the Systems Senior Director of Nursing Research and Program Evaluation at NYU Langone. And with her is Kurt Pinto, who is the Systems Director of Nursing Evidence-Based Practice also at  NYU Langone. They both bring a wealth of experience.

Kathy is a PhD prepared clinical nurse specialist with over 20 years of leadership, research, and education experience. She's a board-certified APRN in adult gerontology, and she's a fellow in the American Academy of Emergency Nursing, and in the fellow in the Clinical Nurse Specialist Institute. Kurt is a DNP-prepared nurse leader and board-certified psychiatric nurse practitioner with over 10 years of nursing experience.

He's a triple header, three degrees from NYU Myers, most recently a DNP. So, I'm Kathleen Ivanovich Zavadsky. I am very proud to be a clinical nurse specialist and have been one since 1993.  I think a lot of the conversation that we're going to talk about today has been influenced by that.

And all of the early mentors that I've had way back in the 80s to be able to teach me the value of nursing science and how you get advanced education and how that's going to impact the practice. , so I'm Kurt Pinto I work primarily with DMP students in the NYU Langone Health Network to help them launch their projects, as well as the existing DMP students that are within the network, which we have over 200 active graduate DMP students at NYU Throughout the system in which we have a robust PMP council and really try to promote evidence-based practice throughout the whole health network.

Thank you. So  Kathy she has a PhD and a strong clinical nurse specialist background, and A PRN preparation. And Kurt is a recent DNP. So we've got PhD, DNP, and his expertise is as A-A-P-R-N in psych mental health nursing.

 Because we're focusing on PhD DNP collaboration, can you tell us a little bit about your work in this area?  So there's over 200 active DMPs, so individuals that have their doctorate in nursing and they are practicing within the network.

They serve a various amount of roles from being just advanced practice providers. Those DMPs, of the MP specialty and many of them are leaders within the health network Okay do you know how many phds you have? We have around 50 and there's more.

So we have honestly about three or four Ph. D. students and some that are early in the application process.  One of the things that we realized very early on that we needed to get the PhDs together.  So some of them are APRNs taking direct care of patients, and some of them are nurse leaders, nurse executives, and there are people who are also nursing professional development specialists. They focus on education and we also have the EDD role as well.

We just really feel how important it is to be able to bring the two groups together and that we collaborate on what each has to bring to the table to advance the science of nursing at, at NYU Langone.

So, can you give me some examples of how, of that kind of collaboration?  I could say, some of the best research I've ever done has been with DNP-prepared nurses.

 The practice is so important, especially for somebody who works in acute care that we still have a lot of work to do. It's forever changing whether or not it's clinically based or whether or not it's. Programatically based that each of us has something to bring to that.

 we have active studies, active nursing research studies that are being conducted that do involve both DNP and PhD-prepared nurses. So I'll give you an example on our Brooklyn campus, which is the family health clinic. We've got a DNP-prepared nurse who is very interested and committed to breastfeeding, especially with a very vulnerable population.

And she came to me and wanted to do a research study. We reviewed the research, we reviewed the evidence. There was very little about breastfeeding exclusivity in this particular population. So she and I talked about it,  we went through the whole evidence-based practice process, and her questions were not.

, something that could be translatable. It wasn't translational science. It was creating new knowledge. So we're in the process of conducting that research and she is the P. I. and I am her co-I. So what does that mean? I mean,  I'm. teaching her. There are certain things that I need to teach her about methodology and about statistical analysis, et cetera, et cetera.

But she's taught me so much about breastfeeding and about that population that if I was going to conduct that study in and of myself, I wouldn't have been able to do it without her. That's a great example. When you bring DMPs and PhDs together, you can achieve things that you normally wouldn't be able to do.

 Ideally, the foundation of the DMP was the concept of translating. The evidence, so taking research and then translating that into the practice setting.

 It took very long for evidence to really come to the bedside. So there was huge delays, and there was a recognition that we needed clinical experts to be able to do this quicker and to critically appraise literature. Well,

and then the PhD is to bring that new knowledge to the entire practice.  Together new research can be found and implemented concurrently. So, would you say that you have some other ideas percolating in the works?

Oh, yes. No, it's, it's ongoing. Yeah. We have a council, it's a DNP council and a PhD EdD prepared council. Now, it's one together or they're two separate ones. . Well, there are two separate ones, but now I will say for the audience, so they may say, well, gosh, that seems a little kind of strange.

, it's not exclusive.  Were,  bringing the groups together. We're getting them to work together.

It's really what I tell people. It's the question that drives the methodology.  , to have a Ph. D. Sally, as you know, you have to conduct research. We are obligated , when we commit to that degree,  but when you're a DMP,, it's the question that drives the methodology, so they are invited to every single committee, so I had a DMP student right now, Who's conducting a research study with leadership and he was insistent same situation wanted to conduct a research study There was not anything out there in the literature.

So . He's a DNP student He comes to the DNP Council always welcome But he came and he presented his work to the PhD Edd Council because they're the experts in developing The new knowledge that we wanted to make sure that methodology was good, making sure that he had the support he needed, making sure that all of his credentials were up to snap,, city training,  and he embraced it.

The study is complete. We're analyzing the data now. Which is something that I can help with. And I have staff here to help us with that. But from a DMP perspective, his,  strength was really his leadership and his ability to translate that evidence into practice. Yeah, I think what's really important to spotlight in this conversation is Kathy's leadership is bringing this together.

But oftentimes. This doesn't necessarily always occur. And I think that's why we're here today to really encourage that thought process of collaboration, because nurses need to work together always in order to achieve the best outcomes.   I want to ask you for people who are not.

In a DNP or PhD program, or not, a graduate of one of them, why does this topic matter to them? What is the greater meaning of this topic to all practicing nurses as they travel their own career paths? The foundation of nursing is based, on evidence. And so we need new evidence and we need active translation.

 If you take a look at the current stats of academia, the number of DNP students outnumber PhD students. Some quotes say five times the amount. Yes. Which can be a conundrum and can be an issue for organizations to manage but also to ensure that new evidence is coming forth.

, you know, I have people all the time who come to me and say, what degree do I get?  Yes. And that's something that, our Center for Innovation and Advancement of Care at SEAC, Is that we meet with them and I talk to them and I try to simplify it, but I tell them that this is a huge commitment on your part, not only financially, emotionally, your family, time, you have to decide.

I always tell where do you see yourself in five years? I have had students who adamantly vehemently said to me I want to be a nurse practitioner for the rest of my career. I don't want to conduct research  So when we talk that's the terminal clinical degree if that's what they're interested in if they're somebody who's  Thinking about things they'd like to analyze things and They're able to take a problem and really be strategic about it, developing it, and they like to look at the literature and they like to create things.

Then, we talk and we say, perhaps maybe the Ph. D. might be the route for you. And again, time is important for people because sometimes some of the programs make it a little easier in terms of time. You know, my Ph. D. took me seven years. I'm not sure about you, Sally. Yeah, same. But.  Same thing, right?

And then, Kurt, how long did your DMP take? I believe it's two. . So, it's definitely a big difference.  So, a couple things I just want to point out in the practice setting is the idea that, first off, the DMP degree is newer.

The PhD was existing for, many decades before the DMP so I think it's becoming well acquainted with now, just because the number of applicants continue to kind of really rise, tremendously. So people are really learning about this degree now at a high level.

And then also the idea that there is a time difference. And so there can be some academic intimidation the terminal degree that they earned took them longer. And sometimes I think that can cause some friction when someone's able to obtain a terminal degree at a shorter pace.

 I think it's important to keep challenging these,   norms that were developed over time. I just wanted to tag on to what Kurt said, because he and I've worked so closely together in his new role.

And, , he's been here for like 8 months.  But 1 of the things here at NYU Langone Health that even before I came here that I really noticed was the efforts. And the work that has gone around diversity, equity, inclusion, and belonging.

And to me, I embrace it. It is just a wonderful thing for its patients, staff, et cetera. But even for us as, how we're academically.  prepared. I respect Kurt for what he has to bring. And, I'm sure Kurt, , respects what this role has to bring.

And we're always at the table together,  we have a mission,, Dr. Deborah Albert, who is our chief nursing officer for the health system, she challenges us to continue to build on that culture of inquiry and make sure that it stays contemporary,  rooted in the mission, vision and values of the hospital.

And that's kind of my job,, with. The staff that I work with to make sure that that happens. I'm not going to say it's perfect because , there are challenges but we've really,, have done a great job, I can say, in bringing groups of people together.

And I think with all DEIB initiatives, it always starts with the leadership. You need the leaders to believe in that and to invest in that collaboration.

Thank you for that. So, let me follow up on 2 points that you made. Can you tell me about how topics like social determinants of health figure into your work or your DNP PhD collaboration or whatever else might come to mind?

We had developed a a research steering committee when I had first come here, which is we have representatives from the College of Nursing, Dr. Sean Clark is the College of Nursing representative. And what we did was, initially we got together and we took a look at things like the NINR, aa NIR, National Institute for Nursing Research.

 The American Association of Colleges of Nursing. Right. AACN East, right? Mm-Hmm. Mm-Hmm. and all the specialty organizations. We took a look at what their current research agendas were, and we looked, critically at that and it took us several months.

To develop a research agenda, which right at the top of the list, two of the things that come to mind,  the first thing was social determinants of health I've been practicing since the eighties. I'm so glad that we finally have turned it.

It was always important, right? Sally, correct. Yes. Now it's been given a name, which is a good thing. And then nurse wellness, which, we never talked about any of that

so one of the things with DEI and B is that's part of the research agenda. And so that when Kurt has his DMP students or I have my PhD students, we share that research agenda with them.  We embrace it. That's our future. Many are our employees and we want to see them grow and develop. At the same time, we want to make sure that it's helping us to advance our mission and vision and values

 so, D, E, I, and B, we have them fill out a little,  intake form. And then they tell us. Where is their project going to pretty much land and for the most part, they really embrace it.

And I think they welcome us to be able to bucket it. What's interesting is what projects like PhD and DMP projects. They often come from the bottom up. These projects usually are synthesized by the student and we're getting so much of these types of projects brought to us.  nurses naturally are holistic thinking and recognize, inclusion and the importance of diversity and equity and are really pushing boundaries. to make sure that patients receive the best health care that they can.

 I mean, not all research questions that come from nurses or nurse scientists will explicitly address the health equity issues that we're talking about.

Issues, etc. It's great that there's more awareness of it, but how do you encourage or promote or be sure that some of the research looks at the outcomes in terms of promoting health equity, not just implications, but specifically in terms of outcomes.

 That's something that Kurt and I talk about every single day when we brief each other on our students., I hear where you're going, Sally, sometimes we do have to push them a little bit because they have to be able to come out of their own little kind of box of what they're thinking about.

So, for example, I have 1 PhD student right now who's really interested in heart failure. And , the area where this individual is planning to do the, the research is in a area that's really has a social determinants of health are very. It's important for this particular group

so, we're in the process of talking about that, how is that going to be addressed whether or not it's language,  food insecurities, housing insecurities. These are the terms that we have to help them bucket it so that they know conceptually when they're doing their PhD work, but they have to be able to measure.

What is there? We have a nursing science fellowship,  she's a PhD student. She is a fellow, but she's doing a project. And what she's looked at is patients over in our Brooklyn Sunset Park area and looked at their language and how that has impacted their ability to be able to receive care for. stroke.

 We're in the process of looking at the zip codes and we're looking at the different neighborhoods. We're looking to see what patients in what zip codes perhaps have been struggling, or is there a certain ethnicity that we need to, Give more education to it's fascinating and that came from her  It evolved and some of the folks at Thomas Jefferson are doing some great work with looking at trauma patients and  Their environment and how when they return back to their environment, recidivism rates of recidivism, et cetera,  when she came to me, I gave her that article.

And I said, is there anything from this? I realized different population, but what about the methodology? What about the questions they were asking about the environment and that Put a spark in her mind

so it sounds like it's evolving. That's a good word. And then from my experience too, it takes some work to be explicit about it, that we understand the greater ideas about it, but then when it comes down to integrating it into research and making it as an outcome, like I said, and to show the difference that some of our work can do in improving social determinants of health or narrowing inequities, that takes a little bit more work, but  I'm happy to hear that.

Your vision for how a DMP is a PhD-prepared nurses can work together can make a important contribution in that way. Yeah,  I think people are bringing forth an intentional mindset of D. E. I. B. with research and that. It's because the culture is shifting

. But I do think that unintentionally when examining results, it is important for mentors and leaders in the field of DMP and PhD to analyze and make sure that there's not oversights being made.

So I'm going to end with this, which is that I understand, Kathy, that you are a co-editor with Mary Jo Vetter for a book, Evidence Based Practice in Nursing and Healthcare by Elsevier, second edition, coming out in March 2025. Mary Jo Vetter has been a faculty member here. She's now Chief Clinical Officer for Long Term Care Systems at Parker in New Brunswick, New Jersey.

So tell us in terms of this book,  What it has that enhances our knowledge and understanding of the PhD DNP collaboration. What do you have in it that's new for all of us?  So, Mary Jo Vetter was probably one of the first people I ever met from the College of Nursing when I first came to Langone, and she is a DNP-prepared nurse at APN, APRN, and I'm PhD.

So, Right away, we clicked with each other and we were here to advance the science, whether it's translational science or search we're in perfect alignment, so that's the first thing. In terms of the book, it's the second edition, and I'm very proud.

I was honored to be able to be asked to be part of that with Mary Jo. So, I think, just by the virtue of the fact that she's DMP and PhD prepared, two people are working together. Each of the chapters, one of the things, you know,, I'm an acute care nurse. That's my experience.

And I said to Mary Jo, I have to make sure that my passion comes out and that I'm well represented in terms of acute care nursing. And how can that be?  So one of the things that we decided to do for each chapter, it would have a academic and a practice person.

And we have 28 chapters and. A hundred percent of those are exactly that pair. Now, you may say, well,  and we didn't really even look at their degree preparation. We looked at what it is they could bring.

And I think just in preparation for this, when I  went and I  looked at the book and the content, it's almost a 50-50, Pair that it's mostly DMP and Ph. D. prepared.  The second thing is so we've added a chapter on something like nurse wellness that is very important because that's about evidence.

There's been evidence that's been created that has impacted nurse wellness, and how does nurse wellness impact outcomes in health care, regardless of where the setting is. We also added some information on  outside hospital at home types of environments, ambulatory care settings

because most of the focus has been inpatient related to health care outcomes, et cetera, or just strictly in the environment. We have a new hospital at home program. We have Emerson, Ea, who was a great partner with Peter Rodney and Kathleen Lang.

We all partnered together in order to be able to make this chapter that, I learned so much from. And somebody very wise said to me, Kathy, if you're going to write a book and you're reading other people's chapters, they have to be able to teach you something new, even though I've been a nurse for 40 years.

And I took that to heart and  I had the pleasure of writing with them.

 Yeah, as someone who read volume one, I'm really excited to see so much more of practice integrated into volume two, and I think that's going to be a huge value added for students.

Yes, we, and it's Dean Eileen you know, Eileen Sullivan, Marks, she and my boss, who's Dr. Deborah Albert,  they wrote the first chapter and there is also another chapter on DNP PhD synergy and the, that's what I was wondering, yeah. Yes, there's a specific chapter related to that, but Dean Eileen and Dr.

Albert, they kicked off the book and we couldn't have thought of anybody more perfect to do it.  So that's a good note to end on. Thank you both. Thank you very much. Thank you. What a wonderful way to launch our podcast series. And if people have questions, they can contact me, sally. cohen at nyu. edu. And we look forward to hearing more about the wonderful collaboration that you've both spearheaded.

Thank you.