Finding ways to speed the innovations from discovery science into clinical practice is a medical necessity and an ethical mandate. Finding ways to speed the innovations from discovery science into clinical practice is a medical necessity and an ethical mandate. This process, known as translational research, is the pathway by which scientific findings, discoveries from basic laboratory science, clinical, or population studies are applied to improving patient care and promoting public health. Extending what was “bench to bedside” into the community—nurse scientists work from “Lab to Living Room,” working to incorporate the products and processes of research into the care and management of symptoms and strategies for health promotion to benefit the health of our population. As described by Grady (2010), “Early models portrayed translational research as a linear, unidirectional process that moved research findings in discrete steps from the laboratory through Phase I or Phase II trials to Phase III trials, before moving to general clinical practice or to broader populations and community settings. As the field advances, though, experience reveals that translational research is a more robust and dynamic process involving bidirectional stages and complex feedback loops” (p 164).

... few nurses are found in leadership roles in funded translational science awards. Translational science depends heavily on the work of transdisciplinary teams. Nurses practice in a model of collaboration and often possess a high-level of clinical expertise. For these reasons, nurse scientists are well positioned to take leadership roles and serve as catalysts in the growth of this emerging field (Grady, 2010; Mitchell, 2012). Yet, few nurses are found in leadership roles in funded translational science awards. This may be due to a knowledge deficit, or nurses who are not aware of translational science programs; lack of access to institutional programming such as Clinical and Translational Science Awards (CTSA); or lack of networking within the local and national CTSA structure, even though the structure is designed to foster such collaboration (Shamoon et al., 2012). In seeking ways to better support translational nurse scientists, the Nurse-Scientist Translational Research Interest Group (NS-TRIG) was formed to explore and address these gaps.

... the Nurse-Scientist Translational Research Interest Group (NS-TRIG) was formed to explore and address these gaps.The purpose of this article is to describe the formation of the NS-TRIG, our achievements, programming, current activities, and future directions. We begin with a table of common acronyms and abbreviations used in translational science for readers who may be new to this discussion.

Table. Acronyms and Abbreviations Used in Translational Science

 
NS-TRIG Background

The Clinical and Translational Science Awards (CTSA) Program (administered under the National Center for Advancing Translational Science (NCATS) supports a national network of health sciences research universities that work together to accelerate translational research with the ultimate goal of increasing the availability of care and treatments to patients. The CTSAs collaborate locally and regionally to provide training, research tools and to refine the translational research process.

...nurse scientists and schools of nursing contributed to and benefited from CTSA centers at their university. The purpose of the currently funded 57 CTSA programs (called ‘hubs’ by NCATS) is to support research teams including scientists, patient advocacy organizations and community members to tackle system-wide scientific and operational issues in clinical and translational research that no one discipline, or group alone can overcome. According to the NCATS website (NCATS, 2018; Printz, 2014) the program goals are to:

• Train and cultivate the translational science workforce
• Engage patients and communities in every phase of the translational process
• Promote the integration of special and underserved populations in translational research across the human lifespan
• Innovate processes to increase the quality and efficiency of translational research, particularly of multisite trials
• Advance the use of cutting-edge informatics

CTSAs have also opened additional resources for nursing, new venues for enhancing the visibility of nursing research, and emerging opportunities for interdisciplinary collaboration. Knafl and Grey (2008) explored the role of nurse scientists and schools of nursing in CTSAs, two years after the CTSA mechanism became available. Although the role varied widely by university, they found that nurse scientists and schools of nursing contributed to and benefited from CTSA centers at their university. The CTSAs have leveraged some of the historical strengths of nursing research, including an interdisciplinary clinical approach and well-established ties to the community. Typically enhanced by nurses, the CTSA initiative has contributed to recognition of the importance of community engagement, focusing on special populations and acknowledging and correcting for populations underrepresented in research. CTSAs have also opened additional resources for nursing, new venues for enhancing the visibility of nursing research, and emerging opportunities for interdisciplinary collaboration.

...nurse scientists were often unaware of the opportunities offered by the CTSAs... Sampselle, Knafl, Jacob, & McCloskey (2013) found that the nurse scientist contributions to CTSAs are strongest in community engagement, implementation science, and training. The interdisciplinary and transdisciplinary focus of the science, and the ways in which engagement are highlighted suggest that nurse scientists would be successful leaders in any CTSA. Drs. Mitchell and McCloskey discussed, over a series of meetings and in conversations nationally, that nurse scientists were often unaware of the opportunities offered by the CTSAs (e.g., leadership positions, funding and training awards). In 2010, these observations lead to the formation of a national CTSA Nurse Scientist Special Interest Group to give nurse scientists a place where they could connect for collaboration, support and to strengthen the focus in nursing research. Over time and with consistent, coordinated efforts, nurse scientists are now Primary Investigators in CTSAs, CTSA core leaders, and are found in other key roles nationally in many of the awards.

Description of the NS-TRIG

Few nurse scientists were applying for awards although in some CTSA programs nurse scientists were members of the T and or K selection committees. Drs. Mitchell and McCloskey founded The National Institutes of Nursing Research Nurse Scientist – Translational Research Interest Group (NS-TRIG) in 2010, to provide a forum to explore roles and increase communication among nurse scientists within the CTSA program. The group quickly realized that at that time, much of the support and leadership within the CTSA program was held by physicians and basic scientists, who also dominated the CTSA K awards and T awards. Few nurse scientists were applying for awards although in some CTSA programs nurse scientists were members of the T and or K selection committees.

To address gaps such as this, the NS-TRIG purpose and vision evolved into defining and supporting the role of nurse scientists in translational science, connecting nurse researchers working in CTSAs, obtaining leadership positions within and across CTSAs, showcasing exemplars in methods of translational nursing science, and providing a forum for sharing best practice and collaboration. Monthly conference calls often covered topics related to community engagement, translational studies, and educational offerings.

In 2015, the organizational structure of the CTSA programs and special interest groups changed and was no longer supported by NCATS. NINR offered to support the monthly conference calls and program staff assist to maintain the important work of the group, supply the WebEx access and curate the list-serv of nurses who become subscribing members. The mission is: Connecting nurse scientists to accelerate the speed of scientific discovery translation to benefit health, the NS-TRIG provides a forum for clinical and translational nursing scientists to be represented, recognized, and garner resources for advancing translational nursing science within, across and transcending CTSA structures. Originally founded to advance nurses awareness to roles within the CTSA structure, from its inception, the group has welcomed nurse scientists and investigators who share a mutual goal of addressing and improving the health of our nation.

The NS-TRIG meets via WebEx, the first Wednesday of each month (except August) and members log-on from remote locations across the nation. Currently the chairs of the NS-TRIG are Dr. Elizabeth Cohn (Hunter College/City University of New York) and Dr. Rachel Schiffman (University of Wisconsin-Milwaukee).

Meeting Structure

Membership is comprised of nurse scientists across the country, and representatives of the National Institutes of Health (NIH). Membership is comprised of nurse scientists across the country, and representatives of the National Institutes of Health (NIH). In the week preceding the meeting, list-serve members receive meeting materials (e.g., agenda, prior meeting minutes, speaker slides), a link to the WebEx, and the telephone call-in number. Currently the group includes over 350 Nurse Scientists, with representation from the 57 CTSAs and NINR/NIH staff and faculty, and representatives from outside organizations.

To meet face-to-face, NS-TRIG members host meetings at regional research conferences such as the Eastern Nursing Research Society; Southern Nursing Research Society, Western Institute of Nursing Research; Midwest Nursing Research Society; and the Southern Research Nursing Society. The group also meets at professional meetings such as the Association for Clinical and Translational Science (ACTS), and an annual face-to-face meeting at the Council for the Advancement of Nursing Science. Regional meetings foster local collaborations, and connect nurse scientists, where they learn about early stage work from proximal institutions and can develop collaborations with nurses locally. Meetings such as the CANS meeting and the American Academy of Nursing (AAN) allow for NS-TRIG members to meet regularly at the national level, to review the mission and vision of the group, and provide an opportunity for strategic planning, targeted activities and suggested speakers for the upcoming year.

Content of the WebEx Meetings

The monthly one hour WebEx calls alternate between round robin discussions and research presentations. The monthly one hour WebEx calls alternate between round robin discussions and research presentations. Round robin discussions (i.e., discussions beginning with a central question or concern) foster communication among participants addressing current issues in translational nursing, changes or amendments to the CTSA structure or emerging guidance about new requirements, and strategies to increase involvement and communication at local CTSAs. Presentations feature nurse scientists describing their translational work with a focus on methods.

The first half hour of each call is either a round robin discussion or a presentation and the remainder of the call is used for updates to current committee work, announcements of relevant information about regional and national conferences, and opportunities of general interest. Each type is described in more detail below.

Round Robin Discussions
Round robin calls invite the group to engage in relevant and emerging topics of translational nursing. Recent topics of discussion on round robin calls included common situations that arise in translational research such as:

1. How do you balance efforts around engagement and recruitment?
2. How do you address community outreach and what is the relationship of service projects to research projects?
3. In what capacity do your community members serve your CTSA (e.g., advisory, citizen scientist)?
4. In the CTSA Pilot award program, how are pilots structured? Do they involve community partners and, if so, how?
5. What are the top three pieces of advice for engaging community in your work? What has worked and what has not been as effective as you expected it would and why?
6. What are the opportunities for cross-CTSA collaborations?
7. What are the opportunities for institutions with CTSAs to partner with schools of nursing in non-CTSA colleges and universities with deep community engagement?
8. What types of White Papers might the group generate to promote and support translational sciences and nursing?

Minutes are recorded and sent to members, with action items noted for future collaboration and investigation. When action items of interest to a number of members at the national level, a special focus workgroup is formed to explore that topic or subject in greater depth.

Special Focus Workgroups
NS-TRIG members developed two workgroups in response to emerging issues in nursing and reflecting current needs and changing practices in translational nursing. NS-TRIG members developed two workgroups in response to emerging issues in nursing and reflecting current needs and changing practices in translational nursing. When the move towards big data and large data set analytics was becoming more common, the Nursing Informatics Subgroup was formed to engage, educate and showcase nurse scientists and others working on large data sets and in areas such as Big Data to Knowledge (BD2K). Meeting independently, they hosted speakers on-line, provided opportunities to collaborate on big data, and promoted the NINR Big Data Bootcamp.

As genetics and genomics were becoming a focus of scientific discovery and personalized and precision care, a second workgroup on biobanks was formed and conduced a short survey on nurse’s knowledge of biobanks, with the intention of helping to fill gaps and increase expertise in genetics and genomics.

Nurse Scientist Presentations
Presentations include senior-level and established investigators, and rising stars. To demonstrate the spectrum of translational science, and the relevance to nursing science, exceptional nurse scientists are invited to provide exemplars of their research. Presentations include senior-level and established investigators, and rising stars. The schedule of presenters and topics is set a year in advance, usually the summer before for the academic year to come. Presenters and topics are selected based on the following criteria: nurse scientists with current or past NINR or NIH funding, nomination by a NS-TRIG member and/or having national expertise in translational nursing. Past presentations titles reflect the range of translation from bench work such as novel biomarkers, research designed for rapid application to clinical practice, strategies for authentic community engagement, and implementation and dissemination science. A small number of rising stars (at the Assistant or Associate Professor level) were invited to present, if they had a unique approach or have made a substantial contribution to translational science.

Presentation Exemplars
Senior scientists who present are asked to highlight the trajectory of their translational research, managing interdisciplinary investigative teams, and public-private partnerships.

In a recent presentation, Dr. Mary Beth Happ (Ohio State University) described her work on improving care though patient communication and systems support. Her research focuses on care with communication-impaired patients, families and clinicians during hospitalization and at end of life. She discussed the SPEACS-2 online communication skills training program and toolkit for use with ICU patients. Her current research involves refinement and testing of an electronic tablet communication application in collaboration with Vidatak, LLC. In September, 2017 she presented the findings of her work at the NINR Director’s Lecture. For her NS-TRIG talk, she focused on the process of discovery and the subsequent use of a step-wedge model highlighting the implementation and dissemination science of ‘scaling-up’ the findings of her study.

Cheryl Dennison Himmelfarb, Professor and Associate Dean for Research in the Office for Science and Innovation and the Deputy Director of Johns Hopkins Institute for Clinical and Translational Research described how her cardiovascular work is translated and disseminated to both scientific and clinical audiences and how it informs future research, policy efforts, and patient outcomes. She highlighted some of the most salient strategies to reduce cardiovascular health disparities, as well as current methods for use of electronic medical records for recruitment within Johns Hopkins Medical System.

The presentations given by senior and established nurses are designed to explore, educate, engage, and support nurses in translational research. CTSA awards are primarily granted to research-oriented institutions, and nurse scientists may be one of only a few nurses within a CTSA. These monthly presentations can provide other nurse scientists serving or training within a CTSA a springboard for innovation, an opportunity for reflection and revision, or a chance to share ideas. These sessions offer an opportunity to engage with nurse investigators doing ground-breaking translational work.

Jennifer Doering exemplifies a rising star—nurse scientists who are junior faculty but who demonstrate exemplary translational work. Dr. Doering, an inventor, nurse scientist, Associate Professor at the University of Wisconsin-Milwaukee, College of Nursing and Adjunct Assistant Professor of the Clinical and Translational Science Institute, Medical College of Wisconsin, studies how sleep deprivation affects depression in socioeconomically disadvantaged women during the post-partum period. Her previous research has included studies on fatigue, sleep, and depression symptoms. More recently, she constructed and tested the feasibility of a self-management intervention for women to promote sleep and reduce fatigue. In collaboration with engineering colleagues, she has patented and is testing a device to reduce infant death from unsafe sleep environments. Dr. Doering’s presentation introduced nurse-led entrepreneurship and career cartography (Doering, 2013; Feetham & Doering, 2015) examples of translational and public-private partnerships by an investigator at the mid-level of her career.

Summary of Major Accomplishments and Work Products of the NS-TRIG

The nurses who participate in the monthly conference meetings advance their knowledge, increase their connections, and initiate activities that strengthen their understanding of translational nursing science. The NS-TRIG promotes nursing science by delivering high-level national research presentations, papers and commentary in the peer-review literature and the popular press. The peer-review papers included a 2011 exploration of engagement, Beyond the medical model: interdisciplinary programs of community-engaged health research, (Sadler, Newlin, Johnson-Spruill, & Jenkins, 2011) and, Nurse Engagement and Contributions to the CTSA Initiative which was a 2013 inventory of the roles and responsibilities of translational nurse scientists in CTSAs (Sampselle et al., 2013). There is an intention to repeat the inventory now that five years have passed to determine if there has been a change in nurse scientist roles and accomplishments in CTSAs.

Sampselle, Pienta, & Markel (2010) evaluated the University of Michigan’s efforts towards the ambitious goal of transdisciplinary translational team science. The CTSA Mandate: Are We There Yet?, by Sampselle et al. (2010), described those efforts, discussed the progress made and posited future directions.

Translational science is especially concerned with how medical discoveries and advances in health are made available to communities... Translational science is especially concerned with how medical discoveries and advances in health are made available to communities, especially those who have been underserved in the past. Members of the group have been active in weighing in on current issues and commentary and letters to the editor, such as a set of letters published in the New York Times, in response to a positive article on mental healthcare in rural areas provided by nurse practitioners, with the unfortunate title “Doctoring, without the doctor” (Tavernise, 2015).

Other accomplishments have been in the form of national presentations. Other accomplishments have been in the form of national presentations. For example, members of the NS-TRIG collaborated to present at the Council for the Advancement of Nursing Science in 2014. Several committee members organized, submitted, and were selected to host two panels to discuss aspects of working within and across CTSAs. These panels described the power of connecting with local and regional colleges of nursing across the nation, to increase reach and speed translational to areas without CTSA hubs.

Lessons Learned and Future Directions

... in response to requests by members, we began recording and archiving the presentations for sharing and future viewing. In the 2017 academic year, in response to requests by members, we began recording and archiving the presentations for sharing and future viewing. This year, we seek to repeat the inventory on nurses in CTSAs and more formally document the impact of the monthly conference meetings in advancing partnerships. There is an increasing opportunity for those in CTSAs to apply for cross-CTSA funding opportunities such as the X02 mechanism which fosters collaboration across CTSAs (NIH, 2018), one potential mechanism for intensifying the collaboration of nurses nationally.

Clinical and Translational Science Centers offer free lectures and workshops on aspects of translational research. Lectures are open to the public and are often recorded and archived for viewing for no charge. Some Clinical and Translational Science Institutes
(CTSIs ) have public outreach efforts, such as newsletters or radio stations, nurses can get involved in the work on outreach and connection to the community. At regional research nursing conferences (ENRS, MNRS WINS, SNRS), nurses can network with others for collaboration at the local level. Many schools of nursing have established a long history of service within their communities and are trusted ambassadors of health. Partnerships between these schools and institutions with translation science awards could provide an opportunity to reach more deeply into communities and extend the delve of health discovery.

Resources are available on the NCATS website. Information can be found on translational research as well as access to CTSA hubs. Some schools of nursing currently offer classes in transdisciplinary science and translational work, which may be available for audit, and summer programs, such as the one offered at Weill-Cornell.

Lessons Learned and Limitations
... the benefit of participation might vary from exposure to translational science to collaborations between CTSA nurse investigator. The group membership is open and voluntary, and the benefit of participation might vary from exposure to translational science to collaborations between CTSA nurse investigators. In summer 2018, we will conduct our first member survey to provide insight into what our members find valuable, and how we might modify our calls for current and future membership. Members express an interest in more time for open discussion and facilitated dialogue. For example, there are 350 members, and on average, 30-45 participate in the web discussions. There were fewer members who spoke openly on calls. We have begun to provide a short set of provocative questions sent in advance, to get the conversation started. With that approach, more members have begun to weigh in. To further increase participation in the round robin discussion, members who attended the face-to-face meeting at the Council for the Advancement of Nursing Science volunteered to moderate a meeting on a topic of their expertise in translational nursing science. Those more focused and moderated groups will begin in spring 2018.

Speakers vary in on-line presentation skills, but we have developed a set of instructions that are shared with presenters in preparation for the calls. These resources help speakers focus on methods, rehearse with the technology and, if they are not members of the group, familiarize themselves with the format.

How to Join
Since the primary focus of the calls is translational research methods, as opposed to clinical outcomes, nurse scientists who are involved in funded translational research will find the calls most relevant to their work. Organizational leaders can join for their organization, and relay information to their membership. Currently we have two organizations that joined in this capacity. Joining the group is free and has always been a simple process of sending an email to the current NS-TRIG leader. To join, please send an email to elizabethgrosscohn@gmail.com.

Students are free to sit in on calls at their institutions... Calls are focused on methods for translational research and reflecting on the ways we might structure research design to maximize the translational properties. Because the facilitators of the call and the administrative support are all volunteers, we ask that people join using their own email addresses, (i.e., the email address is the actual email of the nurse scientist and not an administrative assistant or office personnel). Emails can then be widely and freely forwarded as might benefit the group. Our policy is not to add students to the email list because maintaining such a list can become time consuming when members are transient. Students are free to sit in on calls at their institutions and have often done this in the past.

Conclusion

Nurse scientists who wish to become more involved with translational research have several avenues to explore and connect with others. Nurses in research institutions might start by determining if the institution is affiliated with a CTSA or Clinical and Translational Science Institute (CTSI) or Clinical and Translational Science Center (CTSC). Current lists of the awards can be found in NIH RePORTER (2018) or on the NCATS Website (NCATS, 2018). These centers often fund a set of pilot awards that require multidisciplinary and transdisciplinary teams, some of which involve community partners. Nurses can use these small mechanisms and pilot funding to jump-start a larger project.

Nurses interested in learning more about translational research can partner with investigators through our NS-TRIG monthly calls... Nurses interested in learning more about translational research can partner with investigators through our NS-TRIG monthly calls and learn about what has been funded by NIH through a query in NIH RePORTER. Hopefully the information in this article about translational research and the NS-TRIG has sparked your interest to expand your nursing career by becoming more involved at some level, and perhaps even seek a leadership role in this emerging field.

Acknowledgement

NIH grant funding provided support for Dr. Kovner (1 UL 1TR001445-02), Dr. Cohn (UL1 TR001873-02), and Dr. Schiffman (TL1 TR001437-04) for their work on this paper.

Authors

Elizabeth Gross Cohn, RN, NP, PhD, FAAN
Email: Elizabeth.cohn@hunter.cuny.edu

Dr. Cohn is Professor and Rudin Chair at Hunter-Bellevue School of Nursing and School of Health Professions at Hunter College, CUNY in NY. She is the current chair of the NINR NS-TRIG, a role she assumed in 2015.

Donna Jo McCloskey, RN, PhD, FAAN
Email: 18socker18@gmail.com

Donna Jo McCloskey worked at NIH for 32 years, including work at NCATS and NINR and was one of the two founders of the NINR NS-TRIG. Now retired from NIH, Dr. McCloskey serves as a Senior Clinical Advisor, Contractor to NIH.

Christine Tassone Kovner, PhD, RN, FAAN
Email: Ctk1@nyu.edu

Christine Tassone Kovner is the Mathy Mezey Professor of Geriatric Nursing at the Rory Meyers College of Nursing, a Senior Faculty Associate at the Hartford Institute for Geriatric Nursing, a professor at the School of Medicine, and affiliated faculty at the College of Global Public Health, all at New York University. Dr. Kovner is the Principal Investigator for The TL1 Pre- and Post-Doctoral Program of NYU's Clinical and Translational Science Institute and is a current member of the NINR NS-TRIG.

Rachel Schiffman, RN, PhD, FAAN
Email: schiffma@uwm.edu

Rachel Schiffman is Professor and Associate Dean for Research in the College of Nursing and Associate Vice Provost for Research in the Office of Research at the University of Wisconsin-Milwaukee. She has been a co-Principal Investigator and the UWM site Principal Investigator for the Clinical and Translational Science Institute of Southeast Wisconsin at the Medical College of Wisconsin since 2010. Dr. Schiffman has been the co-chair of the NS-TRIG since 2017.

Pamela H. Mitchell, RN, PhD, FAAN
Email: pmitch@uw.edu

Pamela R. Mitchell is a Professor of Biobehavioral Nursing and Health Informatics and the Executive Associate Dean, Department of Health Services in the School of Public Health at the University of Washington. Dr. Mitchell was one of the two founders of the NINR NS-TRIG.