Students
Student support strategies to increase quality:

1. Skill development:
   Opportunity for the development of skills promotes the likelihood for successful completion of doctoral studies. In addition to Faculties or Departments, Universities with Graduate Schools also conduct workshops on writing and publication, research design and other various topics, providing a multidisciplinary focus.

2. Public critical review throughout the candidature:
   Student seminars are conducted by some Department/Faculties of Nursing once or twice a year. In these forums students have the opportunity to present their work for critical feedback from nursing academics – Faculty and others, visiting academics from other disciplines and other students. Formal doctoral assessment to enable progression is another form of review that is employed by some Departments/ Faculties.

3. Funding support:
   Commonwealth funding for doctoral study is limited and competitive. However, some nursing doctoral students do receive this funding for a year. Some doctoral students are financially supported to undertake their research through National Health and Medical Research Council competitive research funding. At this stage there is a small number of students in Nursing and Midwifery receiving this means of support. The Nurses Registration Boards and other professional bodies also provide funding to support research and doctoral study.

4. Resource support:
   A number of Universities provide facilities such as room space, access to computers and the Internet, library usage, a safe place to store their work and phone and photocopying services.

Administrative Support Initiatives

1. Academic Positions for the promotion and support of research.
   Nursing Departments and Faculties have revised their structures and appointed academic staff at senior management levels such as Dean or Associate Dean to support and manage the administrative aspects of the research activities of the Department or Faculty. These academic positions require effective administrative support because a major task of Graduate Research Programs is the promotion of doctoral study and candidature in an effective and efficient manner. To avoid impediments to students' progress, it is imperative to develop and implement policies, which clearly delineate responses to a range of circumstances. Examples are policies regarding progression and leave, timely appointment of thesis examiners, the timeframe allowed for thesis examination, reconciliation of examiners' reports. In addition to the policies being in place, visible and maintained in an up-to-date manner, they must be implemented for all students.

2. Increased association between the University Departments and the Health Service Sector.
   A number of innovative projects have developed between the service sector and tertiary nursing education to facilitate the development of research and research students. The initiative focused on here is the development of sponsored professorships in many areas of Nursing and in Midwifery, located primarily in the clinical milieu. The growth of research units directed by the professors, strategically placed as they are in health care institutions, has promoted the development of clinical research that is attracting increasing numbers of doctoral students. In the units established over a longer time frame (the longest being over a seven-year period), the second wave of doctoral candidates are now being supervised in part by their predecessors.

   Another initiative has been the development of conjoint appointments and nominated titles for clinical staff working in the university sector and academic staff working in the clinical sector. A successful liaison between the service sector and the university is critical when doctoral candidates require access to patient populations. If the candidate is known to the health service access to patients to participate in studies can be greatly enhanced.

3. Optional patterns of study to the traditional PhD.
   Pearson and Ford (1997) recommended in their report to the Department of Employment, Education, Training and Youth Affairs that the issues of the purpose and accreditation of the PhD award be addressed within the framework of open and flexible PhD study and research. Some Departments and Faculties of Nursing have taken this recommendation very seriously and introduced course-work doctorates and professional doctorates.

4. The development of multi-disciplinary Graduate Schools.
   Some Australian universities have developed multi-disciplinary Graduate Schools in which all graduate research students of the University enroll. The quality benefits seen to ensure that through this structure are shared expectations of performance and codes of conduct across the Disciplines, and candidates have the opportunity to engage with a range of other researchers and their peers.

   This is quite an extensive listing of strategies. Five initiatives from this list will be further developed to more fully explain their impact on the quality and rigour of doctoral study and on the numbers of students embarking on PhD study in Australian nursing.

Academic Support in Co-supervision
A rethink of 'traditional' supervisory practice has been undertaken following a revision of the Australian Vice-Chancellors' Committee's Code of Practice for Maintaining and Monitoring Academic Quality and Standards in Higher Degrees (1990). Many Australian universities now accept a policy whereby all doctoral students have two or even three supervisors. They recognise that in some doctoral situations one scholar cannot provide for all the intellectual needs and demands of a student. The presence of a carefully selected co-supervisor can ensure that a high standard in the production of a thesis is maintained. Students benefit in knowing they have access to more than one supervisor's opinion, intellectual capability and cultural perspective. In some situations, the co-supervisor provides the methodology expertise while the principal supervisor is the content expert. This is important in nursing as theses attempt to answer research questions by employing a variety of paradigms. The methodological issues associated with the use of any particular paradigm need full explication at doctoral level. A supervisor who is a content specialist may not be methodologically sophisticated. Two supervisors can work together to provide the student with a sustained high level of critique about the content and the application of the method. Additionally, if one supervisor is on leave, the student will always have the second person to provide support.

My experience of this process is that the two supervisors must be prepared to work together with good will. It can be difficult scheduling meetings where both supervisors are present. Sometimes a teleconference is the only way to hold a discussion between the three people involved. Care must be taken not to confuse the student by prescribing different outcomes. Supervisors need to clarify their ideas with one another before the student is involved. For example with the student's written work I find it is better to "serial" mark, that is the supervisors negotiate the order of marking one piece of work. Students get confused when two versions of feedback for the same manuscript are returned to them with comments that they cannot reconcile. It is also useful and saves repetitious marking when one supervisor sees what the other has written. I enjoy co-supervision because I believe the student gains more from two intellects in terms of insights and personal realities, while as a supervisor there is an opportunity to have a peer as deeply involved in the thesis as you are – thereby providing a quality check on your intellectual input.

In terms of students, there are two strategies that have the potential to significantly enhance doctoral study: the interdisciplinary skill development workshops and early and consistent public presentation of work.

Skills Development Workshops
Interdisciplinary workshops are conducted for all doctoral students at the University. Some universities have a Graduate School that organises the workshops. Faculties or Departments of Nursing also organise these workshops, but they are more cost efficient and broader in scope when they are interdisciplinary. The topics of sessions include "getting started writing a thesis", "proposal writing" and "publication" and they are conducted by academic staff who are very experienced in these areas. Students evaluate the utility of the workshops in gaining knowledge and skills, and in providing the opportunity to meet and discuss issues with one another. Students have evaluated workshops positively as a useful means to promote improved skills.

Public Presentation of Doctoral Work During Enrollment
The opportunity for early and ongoing public scrutiny of a candidate's work is a critical way of ensuring the highest quality in the work. Different institutions employ different means of achieving this end. For example some use annual or bi-annual student seminar presentations, some require the student to publish content from the thesis prior to it being marked, while others use a process known as doctoral assessment. Whatever format is employed, the common aim is to place the new knowledge into the academic arena for review and critique.

The different methods have varied processes and outcomes. For example, the doctoral assessment is less public than a seminar presentation and all of the assembled academics focus attention on one student. The process is different in that the student will provide a more detailed written account of the work in progress, and the time frame is less constrained. Following evaluation of the work, the outcome for the student can be quite different to the seminar presentation. The assembled academics can recommend the way the candidate should proceed, and whether another doctoral assessment is necessary to ensure the candidate is progressing satisfactorily. While this process is very demanding, it is quite beneficial for the student and the supervisors. A doctoral assessment can be seen as a means of receiving expert feedback within the first year of the thesis.

Two elements are important in the process of public review of the work. It is essential to attempt to find the very best "experts" to review what is being presented. Then it is important that supervisors remain open-minded and not get overly defensive when the work is critically deconstructed. As a scholar it is essential to intellectually engage with the critique provided. In a situation where students are present the level of debate between academics models a process of intellectual inquiry that is fundamental to quality outcomes from the research process.

The two administrative strategies selected for discussion are the appointment of the sponsored professors and the optional forms of knowledge generation. These strategies have facilitated quality research and graduate work in relatively new Australian nursing doctoral programs.

Sponsored Professorships
Universities and Health Services within most Australian States have collaborated to appoint Professors of Nursing and Midwifery with principal accountabilities for establishing research, research infrastructure and funding in specialist clinical areas. Chairs have been established in Critical Care, Acute and Aged Care, Paediatrics, Rural, Mental Health, Palliative Care, Community Nursing, Midwifery and Family Health. There are 22 sponsored professors in New South Wales and up to 40 professors currently based at clinical locations around Australia.

Funding provision for the maintenance of these clinical research positions has come from various sources. Some funding has been secured from hospitals' education budgets that are used to support graduate students undertaking specialty graduate courses at Universities. In other instances the money has been allocated via a bequest or endowment or through clinical units that have University affiliation. The State Government Health Departments also make research-funding allocations to Area Health Services and a small percentage of this money is used to set up the Chairs in the first instance.

While the focus of most of the clinical professors has been on the development and publication of clinical research, in achieving this end many professors have a substantial numbers of doctoral students. The students may work on a part time basis at the hospital while they conduct their research through the Professorial Unit. With some of the more established professorial positions (more than 5 years) doctoral students form a significant part of the research team. The publications and publicity that stem from such a unit attract students who are highly motivated to work at doctoral level in a well-supported environment located at the clinical venue. One of the Professorial Units, the Family Health Unit at St George Hospital in Sydney, Australia, has been designated as a centre of excellence for its research and received funding from the National Health and Medical Research Council.

Optional Patterns of Doctoral Study
Australian nurses wanting to study at a higher level have had few options. The traditional Doctorate of Philosophy (PhD) remains the most recognised scholarly achievement in Australian nursing, providing the formal research and scholarship training required for nurses who want to be academics and/or researchers. Within the last few years, some nursing leaders have recognised that other options of study at doctoral level should be made available to allow nurses to make different kinds of contributions to the development of nursing knowledge. Pearson and Ford (1997) recommended that PhD education be open and flexible study and research, providing a framework within which all forms of doctoral study and research can be encompassed.

Additionally, clinicians and health service managers do not always regard traditional doctoral programs as relevant to their working and learning needs. Sekhon (1989, cited by Trigwell, 1997) found that graduates and employers considered there were weaknesses in current PhD programs including inadequate training in handling the complex problems of industry and undue stress on research ability in a narrow and specialised area. That is, theoretical knowledge could not consistently and readily be translated into practical applications. Sekhon's report (1989) concludes that a different form of doctoral education is required which includes principles of management, industry-oriented attitudes, interpersonal relationship training, practical problem-solving and a strengthened relationship between industry and higher education institutions.

Brine and Christensen (1986) considered it was preferable to develop different doctoral degrees rather than extend or alter the traditional doctorate. The traditional award could then continue to satisfy the demand for research training for an academic or research career while an alternative degree could educate for a higher level participation in industry and the professions (Brine & Christensen, 1986:109). The focus of professional doctorates is the advancement of professional practice and practice development with less emphasis on the development and advancement of theoretical knowledge. However, the different structure and content of a professional doctorate program infers only a difference in intent. There is equivalence of academic stature with the PhD.

White (1999) notes that the intersecting circles of the Venn diagram developed by Lee, Green and Brennan (1999 in press) as helpful for identifying the province of the professional doctorate. The three overlapping circles represent the academy, the profession and the workplace and the tensions between these circles according to White (1999) is the substance of the professional doctorate.

The professional doctorate is a second means of promoting nurses' and midwives' involvement in a high level of scholarship with direct implications for practice. The potential of this degree to inform practice issues is particularly important at this time in Australia. Such scholarly exposition of practice issues will strengthen practice and promote innovation while sustain the degree of rigour that is required of doctoral work.

In conclusion, this paper has identified and discussed a number of strategies currently employed in Australia to improve not only the quality of doctoral study in nursing but also to increase the number of candidates. Those of us involved in doctoral education continue to take up new challenges. While it is still 'early in the day' a tentative judgement at this stage indicates many of the strategies will achieve successful outcomes for nursing. We will have to wait another five to ten years for a more definitive evaluation. We face this future with enthusiasm and expectation.

References
Australian Vice-Chancellors' Committee (1990). Code for maintaining and monitoring academic quality and standard in higher degrees. Canberra. 379.158/1.

Brine, J. & Christensen, M. (1996). Professional Doctorates at the University of Canberra. In Maxwell, T & Shanahan, P. (Eds.) Professional Doctorates: Innovations in Teaching and Research. Proceedings of 'Which way for professional doctorates?' Conference, Coffs Harbour, October, 107-118.

Lee, A., Green, B. & Brennan, M. (1999). The rise of the professional doctorate. Central University of Queensland Press, Rockhampton. (In press).

Pearson, M. & Ford, L. (1997). Open and flexible PhD study and research. Centre for Educational Development and Academic Methods, The Australian National University. Department of Employment, Education, Training and Youth Affairs Evaluations and Investigations Program, Canberra.

Russell, R., Gething, L., Convery, P. (1997). National review of specialist nurse education. Evaluations and investigations program report, Higher Education Division. Australian Government Publishing Service, Canberra.

Trigwell, K., Shannon T., Maurizi, R. (1997). Research-coursework doctoral programs in Australian Universities. EIP, DEETYA, Australian Government Publishing Service, Canberra.