Comparative and Cost-Effectiveness Research Training for Nurse Scientists

描述（由申请人提供）：美国的医疗保健系统花费远远超过任何其他发达国家，我们一直有更差的结果。比较和成本效益研究（CER2）是采用创新方法产生知识的科学探究领域，旨在通过为临床医生、患者、购买者和决策者面临的日常决策提供信息来提高质量和效率。这与疗效研究相反，如随机对照试验，其问题通常是治疗是否能在受控环境下起作用。由于CER2的设计目的是告知患者的实际情况，因此它更加以患者为中心。许多人已经认识到，CER2将是重要的工具，为诸如种族和少数民族、患有多种慢性病的人、老年人和儿童等得不到充分服务的高风险人群的健康促进和疾病预防决策提供信息。美国研究界有一个前所未有的机会来改善国家的卫生系统和人口的健康，并通过CER2提高效率；护士科学家，他们的研究为护理实践提供了证据基础，这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护士科学家培训的培训资助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），是培养CER2方法的护士科学家的绝佳环境。该应用程序建立在CUSON教师的互补优势上，他们在指导博士前和博士后学生使用CER2方法方面具有专业知识；他们的研究重点是高风险，服务不足的人群以及CER2方法中CUMC的强大基础设施。具体目标是：1。招募并留住一批合格的、多样化的博士前和博士后护士研究员，以开展CER2，比较在高风险、服务不足人群的连续护理中促进健康和/或疾病预防方法的日常有效性；2. 实施CER2方法的培训课程，其中包括对护士科学家受训人员进行严格CER2培训时使用的理论和方法的整合；3. 提高博士前和博士后护士科学家培训人员在CER2方法中的知识和技能，以便在高风险、服务不足人群的连续护理中为患者和/或政策决策提供有关健康促进和/或疾病预防的信息；和4。在持续和年度的基础上评估CER2护士科学家培训计划的结构、过程和结果。这些目标与国家护理研究所的使命相匹配，该研究所的使命是促进和改善个人、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，以患者为中心的健康促进和疾病预防的连续护理方法的领导者。

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.