Welcome to module four; Pioneers in Nursing Informatics Research and Education. My name is Bonnie Westra and I'm an associate professor Emerita and Co-Director for Nursing Informatics Center at the University of Minnesota School of Nursing. So in this presentation, we will look at several of the pioneers in informatics and their roles in academia and research. Early work in education and research emerged in the mid to late 1970's. The pioneers capitalised on their knowledge and experience from other fields and then applied it to what nurses needed to learn about computers and the fundamental science of nursing informatics. From three of the pioneers, we will look at their value's, insights, and attitudes, that supported their leadership and the evolution of nursing informatics. Each pioneer used multiple leadership skills and behaviors that are aligned with diverse leadership cultures. This presentation is focused more on the academic perspective of nursing informatics. So, we will look at the roles of teacher otherwise known as Faculty, Researcher, and Dean or Administrative Personnel from Nursing Informatics Pioneers who worked in academic settings. In looking at the AMIA nursing informatics History website, there are numerous pioneers who came from and worked in academic settings. In this presentation, the focus will be on three of these. So, Diane Skiba continuously focused on how to improve education throughout her career. While, Suzanne Bakken also focused on education. Her career is one that exemplifies the evolving role of nursing informatics research. Connie Delaney began as a faculty member then went on to develop a research career and was the first Dean in the School of Nursing with a specialty in nursing informatics. In the next few slides, I will talk about each one of these pioneers and examine their values, insights, and attitudes that shaped nursing informatics in education and research. Diane Skiba began her career as a statistician. She was working with the nursing faculty member who became ill. Subsequently, Diane took over teaching nursing research and then other nursing courses. Throughout her career, she has been a strong advocate for nurses, constantly looking at what the educational needs are and how to best teach nurses about informatics. When she first began teaching, she looked around and saw that computers were emerging and wanted to know how they could be helpful for nurses. She was interested in data more than word processing early in her career. So, she became involved with nursing informatics organizations and was one of the early pioneers who collaborated on developing courses in nursing informatics. Actually, they were called applications of computers. She was a visionary leader even before the internet was available, she experimented with how to interact virtually with her colleagues across the country and how to enable patients to use technology to connect virtually with their providers. Through the literature, Diane discovered the informatics group known as SCAMC, which later became AMIA. So, she immediately went to a meeting and found others like her who are trying to understand how to empower nurses with the changing technology. Upon returning back to our university, she tried to figure out how to get a course on Computer Applications in nursing through the curriculum committee. She was told by a wise mentor that she could bring along a course that was brand new in an emerging field by holding a conference, so that faculty could begin to see the value of how computers can help. Subsequently, she and her colleagues held conferences and wrote guidelines of what and how to teach about the application of computers to nursing. Diane described herself as being an organization person. This meant that she fostered the movement of change through active involvement in organizations. Since her background was in statistics, her focus was on data management. This made sense as a statistician to do this. So one of her insights was to build on what you know. For her, that meant using computers for data management. Before the internet existed, she was interested in virtual living. So, she found colleagues to experiment with her. So, she experimented and was in a creative culture. As a pioneer, Diane Skiba used diverse leadership skills. She connected with colleagues to their organizations in collaboration cultures. She saw the possibilities of using computers in education in creative cultures, and she played on the cutting edge of living in the virtual world in the creative and market cultures as well as develop courses and guidelines about how and what to teach in the hierarchical culture. Suzanne Bakken was a critical care nurse specialist and she became involved in informatics, when she asked if she wanted to work on a grant to create computer-based continuing education for nurses. One of her mentors was Bill Holesumer, an early pioneer in computer applications and nursing. This started her thinking about the value and training of nurses in the use of computers. She then did a postdoc in Medical Informatics. This education led to a scientific understanding of how to represent nursing data in a way that computers could process it. As a result, her early career was in nursing terminologies. Her volunteer work with National and International Organizations provided an opportunity for her to share what she was learning about how to appropriately represent nursing data. A bigger vision however was integrating nursing data with Interprofessional data in the National and International levels. Recently, she was appointed as the Editor for JAMIA, the Journal of the American Medical Informatics Association, which is one of the most respected journals in informatics. She has published more than 300 scientific papers in more than 50 journals, and has served as Principal Investigator for more than $29 million in research grants over the past 25 years. Several values, insights, and attitudes can be gleaned from Dr. Bakken's interview. So, one is that it's okay to be different. While working on her doctorate, the faculty tried to get her to focus on a clinical problem rather than data structure. However, she had a strong mentor who helped guide her through the process of staying focused on data structures, which helped her then to be able to apply those across many clinical problems in the future. One of the attitudes that she conveyed is that any meeting, that at any meeting, she never hides the fact that she's a nurse. Her nursing background provides context for her insights and recommendations when in interprofessional meetings. Success as a researcher did require for her to gain new knowledge, and she did this through formal preparation. Hence, the postdoc and medical informatics was essential for her to be a successful nursing research leader. In discussing her attitude about informatics, she conveys that informatics is not an end in itself. Rather, informatics should support practice. She said, "You can't lose sight that practice is what is important. Practice is about improving the health of patients. Therefore, while nursing data is important, it has to fit with interprofessional data to provide better knowledge about how practice improves health." Finally, one of the insights that she shared when working with advanced practice nurses is that they don't get paid for documenting nursing. Rather, they get paid for documenting medical care. She noted that without the full scope of documentation, it's difficult to ask the right questions when doing research, hence, the importance of capturing nursing and medical care together to understand the impact on patient outcomes. As a pioneer, Suzanne Bakken used diverse leadership skills. She was visionary and innovative, supporting nursing informatics research in creative cultures. She worked with mentors and others in collaborative and hierarchical cultures, and achieved many competitive goals in a market culture. The third exemplar of a pioneer in academic settings is Dean Connie Delaney. So, she is Professor and Dean at the University of Minnesota School of Nursing. In her undergraduate program, she chose a Dean as her preceptor during her senior year. Connie stated, "I always wanted to be a Dean." She was interested in both administration and computers, which became the focus of her graduate work. She noted that about 18 months after finishing her PhD, the field of informatics emerged. Connie was on the Faculty at Luther College in Decorah, Iowa, and then was at the University of Iowa. During that time, she collaborated with a nurse researcher in a medical center to extract nursing data and demonstrate the problems, interventions, and outcomes resulting from nursing care. This led to a research career of developing nursing terminologies and subsequently using data mining methods to demonstrate the value of nursing. Following her career in teaching and research, she went on to become the first dean with a specialty in informatics. Her knowledge and experience in informatics provides her with credibility in supporting other academic settings to integrate education and research about nursing informatics. She now is a leader in a national movement, the Nursing Knowledge Big Data Science Initiative. Several lessons can be learned from Dean Connie Delaney. So, one is to create a vision of where you want to go, and then gain education and experience to support your achievement of that goal. She believes that nursing and informatics provide unlimited possibilities. There is a whole horizon in which nurses can visualize what it is that they can create and then take action to create their own possibilities. Like Virginia Saba, she believed that it's critical to be unrelenting everywhere all the time. She exemplifies this important message as she tries to go through in her career and consistently verbalize and take actions towards the goal she's trying to achieve. She also mentioned the importance of having key advocates outside of nursing. For instance, Don Detmer, a former president of AMIA, was an important advocate to team up with to help her increase visibility of nursing within AMIA. When asked what her major contribution was to informatics, Connie said that she always worked in teams. She noted that she brings something to the team, but the efforts are not about her personal accomplishment, they're about team accomplishment. As a Dean and professor, Connie talked about the importance of inspiring and mentoring the next generation. It's not enough to become a leader. It's essential to develop the next generation of leaders. As a pioneer, Connie Delaney used diverse leadership skills. She envisioned her leadership role and innovative research in a creative culture. She worked collaboratively and mentored others in a collaborative and hierarchical culture. She worked tirelessly to achieve competitive goals unrelentingly in a market culture. So, what leadership skills would you add to these from your observations or experiences? Together with interprofessional colleagues, these three pioneers through their diverse leadership skills have achieved incremental change, long-term change, new change, and sometimes, even fast change. They initiated educational competencies and research programs evolving the specialty of nursing informatics. Standardizing the data and implementing it provided an opportunity for knowledge discovery, from reuse of data documented by nurses. As systems were implemented, nursing informatics science expanded to include decision support and the evaluation and use of systems, as well as knowledge gained from them to change practice. Over time, education and science within nursing informatics continues to evolve. With a focus on usability of systems, so computer support nursing rather than nursing supporting computers. Nurses have always been known as advocates for patients, so it's natural that nursing informatics would expand to include consumers and how to engage them in their health. Nursing informatics continues to evolve rapidly. For example, the field of genomics has also expanded nursing informatics to understand how we can target interventions to effectively improve health. Critical to the use of health data for science is the need to protect privacy, confidentiality, and security of the data as we use that to gain new knowledge. The pioneers in nursing informatics education and research have identified trends over time occurring within and outside nursing, and created the methods to develop the specialty of nursing informatics using diverse leadership skills in all of the cultures. They are the role models for all of us who are in leading change in informatics across settings and cultures. Now, it's your turn. So, view the stories of the three pioneers, read about the trends in nursing informatics research and education, and engage in the discussion about insights and how to apply these to your development as a nursing informatics later. Finally, complete the brief quiz.
