Comparative and Cost-Effectiveness Research Training for Nurse Scientists

描述(由申请者提供)：美国医疗保健系统的支出远远超过其他任何发达国家，而我们的结果一直更差。比较和成本效益研究(CER2)是科学研究领域，它使用创新的方法来产生知识，旨在通过告知临床医生、患者、购买者和政策制定者面临的日常决策来提高质量和效率。这与疗效研究相反，例如随机对照试验，在随机对照试验中，问题通常是治疗是否可以在受控环境下发挥作用。由于CER2是为告知患者的实际情况而设计的，因此它更加以患者为中心。许多人认识到，CER2将成为在服务不足的高危人群，如少数族裔和少数民族、患有多种慢性病的人、老年人和儿童中，为促进健康和预防疾病作出决定的重要工具。美国研究界有一个前所未有的机会，可以通过CER2改善国家的卫生系统和民众的健康并提高效率；护士科学家的研究为护理实践提供了证据基础，他们是美国最大的临床劳动力，需要接受CER2方法的培训。这项名为CER2的护士科学家培训基金，为在这一重要领域培训护士科学家提供了机会。哥伦比亚大学医学中心(CUMC)，包括哥伦比亚大学护理学院(CUSON)，是培训护理科学家CER2方法的绝佳环境。这一应用程序建立在CUSON教师在CER2方法中指导博士后和博士后学生方面的专业知识的互补优势的基础上；他们的研究重点是高风险、服务不足的人群，以及CUMC在CER2方法中强大的基础设施。具体目标是：1.招聘和保留一批合格的博士后和博士后护士研究员，以进行CER2，比较在高危、服务不足的人群的整个护理过程中促进健康和/或疾病预防的方法的日常有效性；2.实施CER2方法的培训课程，其中包括整合用于对护士科学家学员进行严格的CER2培训的理论和方法；3.提高CER2专业博士后和博士后护士科学家实习生的知识和技能；4.评估CER2护士科学家培训项目的结构、流程和结果。这些目标与国家护理研究所的使命非常匹配，即促进和改善个人、家庭、社区和人口的健康；以及帮助护士科学家在确定高质量、高价值、以患者为中心的整个护理过程中促进健康和预防疾病的方法方面成为领导者。

DESCRIPTION (provided by applicant): The United States healthcare system spends far more than any other developed county and we consistently have worse outcomes. Comparative and cost-effectiveness research (CER2) are fields of scientific inquiry that employ innovative methods to generate knowledge aimed at improving quality and efficiency by informing the everyday decisions confronting clinicians, patients, purchasers and policy makers. This is in contrast to efficacy research, such as a randomized controlled trial, where the question is typically whether the treatment can work under a controlled environment. Because CER2 is designed to inform actual patient situations, it is much more patient-centered. Many have recognized that CER2 will be important tools to inform decisions about health promotion and disease prevention in underserved high-risk populations such as racial and ethnic minorities, persons with multiple chronic conditions, the elderly and children. The United States research community has an unprecedented opportunity to improve the nation's health system and the health of the population as well as improve efficiency through CER2; and, nurse scientists, whose research provides the evidence base for nursing practice, which is the largest clinical workforce in the United States, need to be trained in CER2 methods. This training grant, CER2 Training for Nurse Scientists, provides an opportunity to train nurse scientists in this important field. The Columbia University Medical Center (CUMC), including the Columbia University School of Nursing (CUSON), is an excellent environment to train nurse scientists in CER2 methods. This application builds upon the complementary strengths of CUSON's faculty with expertise in mentoring pre-doctoral and post-doctoral students in CER2 methods; their research foci on high-risk, underserved populations as well as the robust infrastructure of CUMC in CER2 methods. The specific aims are: 1. To recruit and retain a qualified diverse cadre of pre-doctoral and post-doctoral nurse fellows to conduct CER2 comparing the everyday effectiveness of approaches to health promotion and/or disease prevention across the continuum of care in high-risk, underserved populations; 2. To implement a training curriculum for CER2 methods that includes the integration of theories and methods used in the conduct of rigorous CER2 training for nurse scientists trainees; 3. To enhance the knowledge and skills of pre-doctoral and post-doctoral nurse scientist trainees in CER2 methods to inform patient and/or policy decisions about health promotion and/or disease prevention across the continuum of care in high-risk, underserved populations; and, 4. To evaluate the CER2 Training for Nurse Scientists program structures, processes, and outcomes on an ongoing and annual basis. These aims are well-matched to the mission of the National Institute of Nursing Research, which is to promote and improve the health of individuals, families, communities, and populations; as well as help nurse scientists to be leaders in identifying high-quality, high-value, patient-centered approaches to health promotion and disease prevention across the continuum of care.