The importance of translational forensic nursing research

Building bridges: the importance of translational forensic nursing research

Paul T. Clements

Translational research is a dynamic and fluid exchange of scientific and clinical knowledge.

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Translational research is a national movement that should be of significant interest to the contemporary forensic nursing scientist and practitioner. Translational research focuses on connecting the progress being made in forensic nursing science with the progress being made on the clinical horizons of forensic nursing practice. In essence there is a necessary inter-relatedness across forensic nursing research, theory, and clinical practice (Clements & Sekula, 2005), and translational research provides a conduit for ease of utilization and implementation of forensic nursing research and theory into frontline practice. Forensic nursing research is the essential mortar needed to build the bridges that span and connect the various important approaches toward assessment and intervention with offenders and survivors of interpersonal violence and crime.

Translational research, as defined by the National Institutes of Health (n.d.), is research that translates scientific discoveries and advances from the bench or laboratory into a clinically germane application. Although an otherwise seemingly logical progression and one that many may assume has been occurring all along, a critical review of scientific history reveals decades of delay in bridging the gap between scientific discovery and clinical application. For example:

 The purpose of translational research is to test, in humans, novel therapeutic strategies developed through experimentation. Translational research should be regarded as a two-way road: Bench to Bedside and Bedside to Bench. However, Bedside to Bench efforts have regrettably been limited because the scientific aspects are poorly understood by full time clinicians and the difficulty of dealing with humans poorly appreciated by basic scientists (Marincola, 2003, para. 1). 

Of additional historical note, patient-oriented translational clinical research is a relatively new field that has had little or no public support or wide academic recognition prior to World War II (Nathan, 2002). However, with a significant demand for effective intervention, particularly with measurable outcomes and evidence-based practice pathways, the need for such research, particularly with the countless variables that accompany the often unpredictable nature of human beings, requires extrapolation beyond controlled laboratory settings to the context of life in the “real world.” “Each case … [each] interaction … whether it be general … or in a specialty area such as child/adolescent, geriatric, addiction, forensic, consultation-liaison, or any other area, is unique…. [and] in that sense, clinical practice and the questions that emerge from it are enormously important in developing the research agenda …” (Sirovatka, 2005, p. 17).

With the exponential increase of forensic nursing knowledge, the imperative nature of embracing translational research and pursuing it with vigor to advance the knowledge on all levels–specifically, theoretical tenets within the implications of clinical practice–would appear to be of great benefit.

Of additional importance is the dynamic state of forensic nursing science development and its interconnectedness with other disciplines, which dictates the demand for integrative scholarship. Interdisciplinary research is integral to the future of forensic nursing science, and such an approach will translate into meaningful clinical application, be more readily communicated in educational settings, and provide a sound foundation for the next generation of both forensic nursing researchers and clinicians. As such, the historically traditional linear translation of new knowledge from discovery to publication to utilization by clinicians and students is an antiquated hierarchical model and is not the only suitable method for exchange of knowledge in collaborative practices (Dauphinee & Martin, 2000).

A bi-directional approach to sharing knowledge necessitates that research informs practice and practice informs research in the ongoing development of scientific knowledge. One may view this exchange as bi-directional traffic on the bridge of knowledge. In addition, evidence for current forensic nursing practice comes from other fields, so integrative scholarship that translates with the intersecting disciplines is critical to the flow of traffic on the nursing knowledge bridge. If anything, the complexities and intersections of multiple disciplines (including biology, health care, criminal justice, law, psychology, psychiatric mental health, ethics, spirituality, etc.) are integrated into forensic nursing practice, creating an image of attaining smooth traffic patterns on the bridges of two-way interchanges.

As interdisciplinary research is highly promoted and encouraged in the new millennium, the facilitation of partnerships between basic and clinical investigators is urged, and the training of future researchers is emphasized. This is not meant to diminish the generic appeal and critical need for patient-oriented research, nor is it meant to foster disconnectedness between researchers and clinicians. On the contrary, it is an attempt to make seamless the scientific application of clinical assessment and intervention.

The reality is that forensic nursing incorporates the tenets of holistic medico-legal care for both living and deceased victims, actual and potential offenders, their families, the surrounding communities, and society at large. A multifaceted practice such as forensic nursing must be approached via all levels of prevention (primary, secondary, and tertiary), direct care, and postvention strategies for coping and adaptation. New knowledge resulting from such intervention, as well as examination via scientific efforts, is vital to improving health care of forensic patients in all areas of practice.

Determining ways to increase the support for translational research and assuring that basic science remains connected to the forensic sciences and nursing will help to guarantee that forensic researchers remain vital in translational research. More emphatically, they must take the lead and provide modeling and mentorship (Clements, Mugavin, & Capitano, 2005). Of utmost importance in translational research:

 "The challenge is for those of us who are immersed in research to hand off to busy clinicians information in a form that they can carry forward and use in daily practice" (Sirovatka, 2005, p. 17). 

References

Clements, P.T., & Sekula, L.K. (2005). Toward advancement and evolution of forensic nursing: The interface and interplay of research, theory and practice. Journal of Forensic Nursing, 1(1), 35, 38.

Clements, P.T., Mugavin, M., & Capitano, C. (2005). Mentorship in forensic nursing research: Promoting the next generation of forensic nurse scientists. Journal of Forensic Nursing, 1(3), 129-130, 132.

Dauphinee, D., & Martin, J.B. (2000). Breaking down the walls: Thoughts on the scholarship of integration. Academic Medicine, 75(9), 881-886.

Marincola, F.M. (2003). Translational medicine: A two-way road. Journal of Translational Medicine, 1(1). Retrieved August 19, 2005, from http://www.translational-medicine.com/content/1/1/1

Nathan, D.G. (2002). Careers in translational clinical research–historical perspectives, future challenges. Journal of the American Medical Association, 287(18), 2424-2427.

National Institutes of Health. (n.d). Re-engineering the clinical research enterprise: Translational research. Retrieved August 19, 2005, from http://nihroadmap.nih.gov/clinicalresearch/overviewtranslational.asp

Sirovatka, P. (2005). NIMH series transforms insights into clinical strategies. Psychiatric News, 40(4), 17.

Paul T. Clements, PhD, APRN, BC, DF-IAFN, is an Assistant Professor, Old Dominion University School of Nursing, Norfolk, VA, and Associate Editor, Journal of Forensic Nursing. He can be reached at pclement@odu.edu.

Patricia A. Crane, PhD, MSN, RNC, CRNP, is a Faculty Member, Graduate Forensic Nursing Program, Duquesne University School of Nursing, Pittsburgh, PA.

If you would like to write for this column or send feedback, please contact column editor Paul Clements at the e-mail address shown above. Visit www.iafn.org for Author Guidelines and more information.

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