Dr. Titler Recipient of First Ever FNINR President's Award
Dr. Titler earns recognition for her work to translate healthcare research into meaningful and real practice solutions.
“I’m not one of those people that can just jump out and say that I always wanted to be a nurse,” explains Dr. Marita Titler, Professor and Associate Dean at the University of Michigan School of Nursing. Yet, her extensive resume of accomplishments, publications, positions held, and awards proves that throughout her career, Dr. Titler has developed a profound passion for the field of nursing that has had important impacts on the science as a whole; as the Friends of the National Institute of Nursing Research (FNINR) put it, “Dr. Titler’s name is synonymous with the translation of evidence to nursing practice and the development of translation science.”
As its name might suggest, implementation science -- sometimes called “translation science” though Dr. Titler prefers the former term -- is the means by which research findings are applied to real healthcare delivery situations. As an example, Dr. Titler pulls an instance from a project she is currently working on: research has identified specific risk factors that lead patients to fall while under care in a hospital setting. Research has also identified methods for preventing such an accident in people known to have these risk factors. However, in many cases, less than one third of patients receive fall prevention interventions and therein lies the problem. “This country is spending billions of dollars in scientific research and only a tiny fraction of it gets to the point of care,” Dr. Titler explains, a new urgency in her voice; “We know what we should do for care delivery in many areas and it’s not getting done. Unless we can figure out how to get research findings into practice, we might as well not have done the research.”
With implementation science requiring a fusion of skills and experience that come from research, administration, and patient care, it makes sense that from the beginning, Dr. Titler’s career was grounded in clinical practice. After completing a BSN, she became a staff nurse in an adult critical care setting. Then, after completing a Master’s, Dr. Titler worked as a Clinical Nurse Specialist in an academic medical center which catalyzed her interest in research. As her commitment to innovating new care delivery solutions grew, she knew that if she wanted to become a skilled researcher, she would have to earn a PhD which she ultimately did, going to school full time while continuing to practice. Emerging four years later with a Doctoral degree, Dr. Titler was ready to take on care delivery infrastructures.
Now, she says her scholarly focus has two facets: “the first, how do we help our staff know and use findings to improve patient care and the second, how do we create models and systems to improve care?” With a sizable filing cabinet drawer so overstuffed with her publications that it is difficult to extract a single copy, Dr. Titler has obviously had her say in how these two objectives should be fulfilled. In fact, her research has made such a concrete impression on translation science that FNINR named her the first ever recipient of the President’s Award. According to their literature, “This year, the President’s Award is given by FNINR to acknowledge a nurse researcher whose work has focused on advancing deep understanding of translation of evidence to nursing practice and whose body of scholarship illustrates long-standing commitment to nursing research.” Obviously an immense honor, when asked what the award means to her personally, Dr. Titler says, “It’s affirming that the science I do is meaningful to nursing and to nursing science” and adds that she is proud to have been recognized in such a way by her colleagues.
As part of the President’s Award, Dr. Titler receives an unrestricted grant. Unlike restricted grants which are given for a particular research project and make up a large majority of awarded funds, unrestricted grants are distributed to an individual to use for their research as they see fit. Dr. Titler says that she is likely to use the money to support a project already funded by the Robert Wood Johnson Foundation (RWJF); the project centers on researching the implementation of a series of fall prevention interventions targeted to patient-specific risk factors. An integral part of the research is training patients’ care givers to use these interventions in relevant scenarios. However, “education is necessary [in these cases] but not sufficient” says Dr. Titler; “Follow up is critical.” She explains that too often these interventions don’t become integrated as a regular part of providers’ practice and so it takes much more than simply teaching the interventions; rather, there has to be buy-in from the facility with someone championing the effort, it must be easy to do, and providers need to be able to get feedback on how well they’re implementing the new technique or strategy. These are patterns of successful implementation that Dr. Titler has seen time and again: “The specific subject changes, but the framework and the results don’t.”
Of her work at the University of Michigan, Dr. Titler points to the wealth of opportunity the University presents to work with other people: “I came to the University of Michigan because the School of Nursing in collaboration with the health system is on the edge of revising how we work together in partnerships to improve undergraduate and graduate education.” Excited by the opportunity to train the next generation of scientists and leaders in healthcare systems, she adds “I’m really here because I think there’s something special going on, linkages between education, research, and practice that are real but not fully realized.” And with her depth and breadth of experience, Dr. Titler is one of the key players who is in the process of bringing those linkages to full fruition.