- Email: [email protected]
Evaluating the Doctorate of Nursing Practice
Evaluating the
Doctorate of
Nursing
Practice
The proliferation of the practice doctorate and its effect on advanced practice nursing has generated many questions and lively debate throughout the nurse practitioner community. The Journal for Nurse Practitioners received a lot of response to the Point-Counterpoint column written on this topic in the July/August 2005 issue. Because so much attention is focused on this topic, we want to continue to address this issue. The following two articles attempt to clarify some key issues surrounding the American Association of Colleges of Nursing’s position statement in support of the Doctor of Nursing Practice (DNP) and to provide insight into one nurse leader’s decision to pursue this program of study.
Moving Toward a New Vision of Nurse Practitioner Education Joan M. Stanley
S
ince 1965, nurse practitioners (NPs) have evolved into one of the most influential groups in nursing and now include more than 106,000 practitioners.1 The NP movement has had dramatic effect on the nursing profession. NPs provide high quality care to all populations, including the underserved across the continuum of care.The first NPs were educated in 18-month certificate programs. Many of www.npjournal.org
those early programs were located in schools other than nursing, including schools of medicine. Nursing did not embrace these new practitioners early on. Late in the 1970s, the move to educate NPs in master’s-level nursing programs gained momentum. By 1991 there were 86 schools with one or more master’s NP programs,2 and today, 329 schools offer a graduate NP program.3 In 1994, the American 209
During the past 15 years, the health care needs of this country and the global community have changed dramatically.
Association of Colleges of Nursing (AACN) issued a position statement stating that all advanced practice nursing programs should be at the graduate level.4 During the past 15 years, the health care needs of this country and the global community have changed dramatically. Increasing numbers of older adults, rapid increases in chronic conditions, new technologies, and genetics are just a few of the massive changes that are affecting the health care system. A number of landmark reports, including the Institute of Medicine (IOM) reports To Err Is Human: Building a Safer Health System5 and Crossing the Quality Chasm,6 have determined that health care professionals cannot continue to practice as usual. In a follow-up report, Health Professions Education: A Bridge to Quality,7 the IOM charges all health professions to change the ways providers are educated and with new competencies. Nursing is not the only profession that is examining the way practitioners are educated. Medicine, physical therapy, occupational therapy, and pharmacy are all reexamining and making important recommendations about how future practitioners in the discipline should be educated. These massive changes in health care and the numerous mandates to the health care community have provided the foundation for the movement in nursing to the doctor of nursing practice. As part of this movement, AACN, in 2004, after many years of investigation and dialogue within and outside the nursing profession, issued a position statement stating that advanced practice nursing education, including NP education, evolve to the doctor of nursing practice (DNP) level by the year 2015.8 This position was reinforced by the National Academy of Science in a subsequent report that identified that “the need for doctorally prepared practitioners and clinical faculty would be met if nursing could develop a new nonresearch clinical doctorate, similar to the MD and PharmD in medicine and pharmacy.”9 210
Questions and Misperceptions: What Does the AACN Position Statement Really Say? Since the position statement was passed by the AACN membership in October 2004, a great deal of debate and questions have arisen within the NP community. Many questions arise from misperceptions about what is being recommended. However, as with any big change, many questions are legitimate issues that must be addressed by the NP and nursing communities.To address many of these issues, AACN has appointed a Roadmap to the DNP Task Force.To elicit input from a wide and diverse nursing community, including practitioners, educators, policy makers, and administrators, a series of regional meetings are under way through January 2006. Among the many salient points to consider are the following: • The AACN position statement recommends that practice-focused doctoral education be a distinct model of doctoral education that provides an additional option for attaining a terminal degree in nursing.8 • DNP programs will focus on practice, preparing clinicians with the expertise needed to function at the highest level.This contrasts with research-focused programs that prepare graduates to perform original research, developing new knowledge and theories that inform nursing practice. One critical question that has been raised is what effect will these new DNP programs have on PhD programs? A definitive answer to this question cannot be given. However, the first two nursing schools to offer both PhD and DNP programs have not experienced fewer applications to the PhD program. In fact, the opportunity for potential students to compare program objectives and delineate career goals has increased enrollment in not only the new DNP program but the PhD program as well. Differences between DNP and PhD programs must be distinct and not become blurred over time. Many of the DNS and DNSc programs, both professional degrees, were initiated as more clinically focused programs. Over time these programs became almost indistinguishable from PhD programs.To address this concern, AACN has appointed a second task force, the Task Force on the Essentials of Nursing Education for the DNP, to develop a consensus-based document that defines the competencies necessary for all DNP graduates.The DNP Essentials November/December 2005
document will join the other two Essentials documents that provide the foundation for baccalaureate and master’s level nursing education. During the past 30 years, tremendous strides have been made in the development of nursing science. Research-focused programs in nursing have grown, which has laid the groundwork for knowledge development.10 Advanced practice nurses with equal preparation at the doctoral level are needed to fully implement nursing science in the practice arena. DNP- and PhD-prepared nurses are natural allies whose expertise will complement and support each other’s efforts to advance evidenced-based practice and to improve health care outcomes. Dr. Loretta Ford, champion of the NP movement, envisions the DNP-prepared nurse to be the “demonstrator of evidence-based practice, a translator of nursing research to improve practice, and a provider who influences institutional policy for change.”11 • The DNP will be the graduate degree for advanced nursing practice preparation, including the four current APN roles: clinical nurse specialist, nurse anesthetist, nurse midwife, and NP.8 Many master’s level NP programs exceed 60 credits and take at least 3 years of full-time study to complete. Not only is there tremendous variability in the length and requirements for these programs, but they also exceed the expectations of master’s degrees in many other fields. In addition, faculty have identified additional content areas needed by graduates,12 which today also includes calls for enhanced curriculum in technology, genetics, geriatrics, and other areas. Practicing NPs also identify additional content areas, including practice management, health policy, use of information technology, risk management, evaluation of evidence, and advanced diagnosis and management, in which they perceive the need for additional education.13 To address this incongruity in time spent in attaining the master’s degree and the need for additional content areas,AACN has recommended that APN education evolve to the DNP by 2015.This means that education programs preparing graduates for APN roles should move to the doctoral level during the next 10 years.This does not mean that all NPs or other APNs currently practicing must return to school to obtain an additional degree.The recommendation is made that a transition period be planned to provide nurses with master’s degrees, who want to obtain the practice doctoral degree, a mechanism to earn a pracwww.npjournal.org
This does not mean that all NPs or other APNs currently practicing must return to school to obtain an additional degree.
tice doctorate in a relatively streamlined fashion with credit given for previous graduate study and practice experience.8 Offering credit for previous experiences is the prerogative of the individual schools. However, an extended transition period that allows individuals who choose to obtain the additional degree should be provided. Mechanisms to obtain a DNP after master’s education already are being designed by schools using varied approaches. Purdue University has designed a DNP curriculum with NP education as the core. J Novak, professor and dean of the Purdue School of Nursing, said in September that the Purdue curriculum has two sets of degree requirements, one for those NPs who hold a master’s degree (which included the AACN Master’s Essentials) and a second for those who graduated earlier or are not prepared as an NP. Schools nationwide also are developing bridge programs that will offer an efficient route for master’s-prepared APNs looking to move to the doctoral level. The intent of the AACN position statement is that NPs currently practicing be grandfathered into their positions and scope of practice. Just as provisions for certificate-prepared NPs were included in Medicare reimbursement regulations and in criteria for maintaining national certification in all specialty practice areas, similar provisions should be made for master’s-prepared NPs as the move to doctoral education occurs. • The Doctor of Nursing Practice shall be the degree associated with practice-focused doctoral nursing education.8 A number of degree titles have been proposed by several sources. Having investigated the various options, several of which are held by other disciplines, the AACN position statement recommends that the DNP be the one degree title chosen. Some are concerned that it may be confusing if everyone graduating from a practice doctorate program has the same title.The DNP is a degree 211
just as MSN or PhD.The degree does not indicate in what area of practice one is prepared.Therefore, a graduate would use the DNP credential along with the specific NP credential earned, such as Jane Doe, DNP, ANP, or DNP,WHNP. As professionals, NPs are life-long learners engaged in professional development, self-improvement, on-the-job learning, and continuing education courses. Recognizing the need for additional formal education is only an extension of this learning continuum. NPs are assertive and vocal, which is one of the primary reasons they have been so successful in attaining their current position within the health care system. As advocates within the profession, we cannot sit back and rest on our accomplishments.We must continue to fight for our place at the policy table and to be recognized for the significant contributions in addressing this country’s health care needs. NPs have never shied away from a challenge and cannot do so now. As leaders in nursing, NPs must address the mandates and challenges put forward by the IOM,7 the American Hospital Association,14 and the Robert Wood Johnson Foundation.15 A thoughtful approach by the NP community to the DNP as the degree for future NP educational preparation is one step in meeting this challenge. References 1. American Academy of Nurse Practitioners. US Nurse Practitioner Workforce 2004. Available at: www.aanp.org/NR/rdonlyres/exenwjnl3eybaktqli266uvk4 kw364gapgzjhyyvey2d7fziiv2uhd55atxojxgdjrp3q5vu4e6akp/NPStateWorkfor ceData120004.pdf. Accessed 2005 September 1. 2. American Association of Colleges of Nursing. Final Report: Advocacy/ Mentorship Program for the Recruitment of Certified Nurse Practitioners. Washington, DC: American Association of Colleges of Nursing; 1993. Unpublished report. Contract Work Item I.C. 3 for HRSA Contract No. 240-910020. 3. Berlin LE, Wilsey SJ, Bednash GD. 2004-2005 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. Washington, DC: American Association of Colleges of Nursing; 2005. 4. American Association of Colleges of Nursing. Position statement on certification and regulation of advanced practice nurse. Originally issued in October 1994. Available at www.aacn.nche.edu/Publications/positions/ cerreg.htm. Accessed 2005 September 1. 5. Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000. 6. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. 7. Institute of Medicine. Health Professions Education: A Bridge to Quality. Washington, DC: National Academy Press; 2003.
8. American Association of Colleges of Nursing. Position statement on the practice doctorate in nursing. 2004. Available at: www.aacn.nche.edu/ DNP/DNPPositionStatement.htm. Accessed 2005 September 1. 9. National Research Council. Advancing the Nation’s Health Needs: NIH research Training Programs. Washington, DC: National Academies Press; 2005. 10. American Association of Colleges of Nursing. Position statement: indicators of quality in research-focused doctoral programs in nursing. 2001. Available at: www.aacn.nche.edu/Publications/positions/qualityindicators.htm. Accessed 2005 September 1. 11. Pearson L. Opinions, ideas and convictions from NP’s founding mother Dr. Loretta Ford. Nurse Pract World News. 2005;10(1):7,20. 12. Bellack J, Graber D, O’Neil E, Musham C, Lancaster C. Curriculum trends in nurse practitioner programs: current and ideal. J Prof Nurs. 1999;15:15-27. 13. Lenz ER, Mundinger MO, Hopkins S, Clark J, Lin S. Patterns of nurse practitioner practice: results from a national survey [unpublished data]. Presented at the State of the Science Conference, Washington, DC, September 2002. 14. American Hospital Association Commission on Workforce for Hospitals and Health Systems. In Our Hands, How Hospital Leaders Can Build a Thriving Workforce. Chicago, IL: American Hospital Association; 2002. 15. Kimball B, O’Neill E. Health Care’s Human Crisis: the American Nursing Shortage. Princeton, NJ: The Robert Wood Johnson Foundation; 2002.
Joan M. Stanley, PhD, CRNP, FAAN, is the director of education policy for the American Association of Colleges of Nursing in Washington, DC, and an adult nurse practitioner in the Faculty Practice Office at University of Maryland Hospital in Baltimore. She can be reached at [email protected]. Editor’s Comments: Dr. Stanley, in her position with AACN, has been involved with the DNP from its inception and speaks with some authority about the status of this new policy.This article discusses questions that are most frequently raised on the subject; however, clearly she nor anyone can answer every question in one brief article. Notably, reviewers of her article observe that she does address the need for the development of the Essentials which will provide standardization for DNP education programs. However, at least two schools offering the DNP currently require a full dissertation. Hence, although she states, “…programs must be distinct and not become blurred…,” the distinction between DNP and PhD is already beginning to be blurred. Additionally, the article does not clarify whether MS programs will still be in existence after 2015 or whether every program by that time will be required to be at the doctoral level.This is a recurrent question that requires further exploration. 1555-4155/05/$—see front matter. © 2005 Inc. All rights reserved. doi:10.1016/j.nurpra.2005.10.021
Why Have a Doctorate of Nursing Practice? Margaret (Peggy) Rowberg
A
fter becoming a nurse practitioner (NP), I thought I was finally finished going to school. After all, I was a diploma nurse from the 60s who had finally gone 212
back to college in the 90s to obtain bachelor and master’s degrees.What possible reason could there be to obtain a doctorate, particularly because most degrees are November/December 2005
Doctorate of
Nursing
Practice
The proliferation of the practice doctorate and its effect on advanced practice nursing has generated many questions and lively debate throughout the nurse practitioner community. The Journal for Nurse Practitioners received a lot of response to the Point-Counterpoint column written on this topic in the July/August 2005 issue. Because so much attention is focused on this topic, we want to continue to address this issue. The following two articles attempt to clarify some key issues surrounding the American Association of Colleges of Nursing’s position statement in support of the Doctor of Nursing Practice (DNP) and to provide insight into one nurse leader’s decision to pursue this program of study.
Moving Toward a New Vision of Nurse Practitioner Education Joan M. Stanley
S
ince 1965, nurse practitioners (NPs) have evolved into one of the most influential groups in nursing and now include more than 106,000 practitioners.1 The NP movement has had dramatic effect on the nursing profession. NPs provide high quality care to all populations, including the underserved across the continuum of care.The first NPs were educated in 18-month certificate programs. Many of www.npjournal.org
those early programs were located in schools other than nursing, including schools of medicine. Nursing did not embrace these new practitioners early on. Late in the 1970s, the move to educate NPs in master’s-level nursing programs gained momentum. By 1991 there were 86 schools with one or more master’s NP programs,2 and today, 329 schools offer a graduate NP program.3 In 1994, the American 209
During the past 15 years, the health care needs of this country and the global community have changed dramatically.
Association of Colleges of Nursing (AACN) issued a position statement stating that all advanced practice nursing programs should be at the graduate level.4 During the past 15 years, the health care needs of this country and the global community have changed dramatically. Increasing numbers of older adults, rapid increases in chronic conditions, new technologies, and genetics are just a few of the massive changes that are affecting the health care system. A number of landmark reports, including the Institute of Medicine (IOM) reports To Err Is Human: Building a Safer Health System5 and Crossing the Quality Chasm,6 have determined that health care professionals cannot continue to practice as usual. In a follow-up report, Health Professions Education: A Bridge to Quality,7 the IOM charges all health professions to change the ways providers are educated and with new competencies. Nursing is not the only profession that is examining the way practitioners are educated. Medicine, physical therapy, occupational therapy, and pharmacy are all reexamining and making important recommendations about how future practitioners in the discipline should be educated. These massive changes in health care and the numerous mandates to the health care community have provided the foundation for the movement in nursing to the doctor of nursing practice. As part of this movement, AACN, in 2004, after many years of investigation and dialogue within and outside the nursing profession, issued a position statement stating that advanced practice nursing education, including NP education, evolve to the doctor of nursing practice (DNP) level by the year 2015.8 This position was reinforced by the National Academy of Science in a subsequent report that identified that “the need for doctorally prepared practitioners and clinical faculty would be met if nursing could develop a new nonresearch clinical doctorate, similar to the MD and PharmD in medicine and pharmacy.”9 210
Questions and Misperceptions: What Does the AACN Position Statement Really Say? Since the position statement was passed by the AACN membership in October 2004, a great deal of debate and questions have arisen within the NP community. Many questions arise from misperceptions about what is being recommended. However, as with any big change, many questions are legitimate issues that must be addressed by the NP and nursing communities.To address many of these issues, AACN has appointed a Roadmap to the DNP Task Force.To elicit input from a wide and diverse nursing community, including practitioners, educators, policy makers, and administrators, a series of regional meetings are under way through January 2006. Among the many salient points to consider are the following: • The AACN position statement recommends that practice-focused doctoral education be a distinct model of doctoral education that provides an additional option for attaining a terminal degree in nursing.8 • DNP programs will focus on practice, preparing clinicians with the expertise needed to function at the highest level.This contrasts with research-focused programs that prepare graduates to perform original research, developing new knowledge and theories that inform nursing practice. One critical question that has been raised is what effect will these new DNP programs have on PhD programs? A definitive answer to this question cannot be given. However, the first two nursing schools to offer both PhD and DNP programs have not experienced fewer applications to the PhD program. In fact, the opportunity for potential students to compare program objectives and delineate career goals has increased enrollment in not only the new DNP program but the PhD program as well. Differences between DNP and PhD programs must be distinct and not become blurred over time. Many of the DNS and DNSc programs, both professional degrees, were initiated as more clinically focused programs. Over time these programs became almost indistinguishable from PhD programs.To address this concern, AACN has appointed a second task force, the Task Force on the Essentials of Nursing Education for the DNP, to develop a consensus-based document that defines the competencies necessary for all DNP graduates.The DNP Essentials November/December 2005
document will join the other two Essentials documents that provide the foundation for baccalaureate and master’s level nursing education. During the past 30 years, tremendous strides have been made in the development of nursing science. Research-focused programs in nursing have grown, which has laid the groundwork for knowledge development.10 Advanced practice nurses with equal preparation at the doctoral level are needed to fully implement nursing science in the practice arena. DNP- and PhD-prepared nurses are natural allies whose expertise will complement and support each other’s efforts to advance evidenced-based practice and to improve health care outcomes. Dr. Loretta Ford, champion of the NP movement, envisions the DNP-prepared nurse to be the “demonstrator of evidence-based practice, a translator of nursing research to improve practice, and a provider who influences institutional policy for change.”11 • The DNP will be the graduate degree for advanced nursing practice preparation, including the four current APN roles: clinical nurse specialist, nurse anesthetist, nurse midwife, and NP.8 Many master’s level NP programs exceed 60 credits and take at least 3 years of full-time study to complete. Not only is there tremendous variability in the length and requirements for these programs, but they also exceed the expectations of master’s degrees in many other fields. In addition, faculty have identified additional content areas needed by graduates,12 which today also includes calls for enhanced curriculum in technology, genetics, geriatrics, and other areas. Practicing NPs also identify additional content areas, including practice management, health policy, use of information technology, risk management, evaluation of evidence, and advanced diagnosis and management, in which they perceive the need for additional education.13 To address this incongruity in time spent in attaining the master’s degree and the need for additional content areas,AACN has recommended that APN education evolve to the DNP by 2015.This means that education programs preparing graduates for APN roles should move to the doctoral level during the next 10 years.This does not mean that all NPs or other APNs currently practicing must return to school to obtain an additional degree.The recommendation is made that a transition period be planned to provide nurses with master’s degrees, who want to obtain the practice doctoral degree, a mechanism to earn a pracwww.npjournal.org
This does not mean that all NPs or other APNs currently practicing must return to school to obtain an additional degree.
tice doctorate in a relatively streamlined fashion with credit given for previous graduate study and practice experience.8 Offering credit for previous experiences is the prerogative of the individual schools. However, an extended transition period that allows individuals who choose to obtain the additional degree should be provided. Mechanisms to obtain a DNP after master’s education already are being designed by schools using varied approaches. Purdue University has designed a DNP curriculum with NP education as the core. J Novak, professor and dean of the Purdue School of Nursing, said in September that the Purdue curriculum has two sets of degree requirements, one for those NPs who hold a master’s degree (which included the AACN Master’s Essentials) and a second for those who graduated earlier or are not prepared as an NP. Schools nationwide also are developing bridge programs that will offer an efficient route for master’s-prepared APNs looking to move to the doctoral level. The intent of the AACN position statement is that NPs currently practicing be grandfathered into their positions and scope of practice. Just as provisions for certificate-prepared NPs were included in Medicare reimbursement regulations and in criteria for maintaining national certification in all specialty practice areas, similar provisions should be made for master’s-prepared NPs as the move to doctoral education occurs. • The Doctor of Nursing Practice shall be the degree associated with practice-focused doctoral nursing education.8 A number of degree titles have been proposed by several sources. Having investigated the various options, several of which are held by other disciplines, the AACN position statement recommends that the DNP be the one degree title chosen. Some are concerned that it may be confusing if everyone graduating from a practice doctorate program has the same title.The DNP is a degree 211
just as MSN or PhD.The degree does not indicate in what area of practice one is prepared.Therefore, a graduate would use the DNP credential along with the specific NP credential earned, such as Jane Doe, DNP, ANP, or DNP,WHNP. As professionals, NPs are life-long learners engaged in professional development, self-improvement, on-the-job learning, and continuing education courses. Recognizing the need for additional formal education is only an extension of this learning continuum. NPs are assertive and vocal, which is one of the primary reasons they have been so successful in attaining their current position within the health care system. As advocates within the profession, we cannot sit back and rest on our accomplishments.We must continue to fight for our place at the policy table and to be recognized for the significant contributions in addressing this country’s health care needs. NPs have never shied away from a challenge and cannot do so now. As leaders in nursing, NPs must address the mandates and challenges put forward by the IOM,7 the American Hospital Association,14 and the Robert Wood Johnson Foundation.15 A thoughtful approach by the NP community to the DNP as the degree for future NP educational preparation is one step in meeting this challenge. References 1. American Academy of Nurse Practitioners. US Nurse Practitioner Workforce 2004. Available at: www.aanp.org/NR/rdonlyres/exenwjnl3eybaktqli266uvk4 kw364gapgzjhyyvey2d7fziiv2uhd55atxojxgdjrp3q5vu4e6akp/NPStateWorkfor ceData120004.pdf. Accessed 2005 September 1. 2. American Association of Colleges of Nursing. Final Report: Advocacy/ Mentorship Program for the Recruitment of Certified Nurse Practitioners. Washington, DC: American Association of Colleges of Nursing; 1993. Unpublished report. Contract Work Item I.C. 3 for HRSA Contract No. 240-910020. 3. Berlin LE, Wilsey SJ, Bednash GD. 2004-2005 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. Washington, DC: American Association of Colleges of Nursing; 2005. 4. American Association of Colleges of Nursing. Position statement on certification and regulation of advanced practice nurse. Originally issued in October 1994. Available at www.aacn.nche.edu/Publications/positions/ cerreg.htm. Accessed 2005 September 1. 5. Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000. 6. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. 7. Institute of Medicine. Health Professions Education: A Bridge to Quality. Washington, DC: National Academy Press; 2003.
8. American Association of Colleges of Nursing. Position statement on the practice doctorate in nursing. 2004. Available at: www.aacn.nche.edu/ DNP/DNPPositionStatement.htm. Accessed 2005 September 1. 9. National Research Council. Advancing the Nation’s Health Needs: NIH research Training Programs. Washington, DC: National Academies Press; 2005. 10. American Association of Colleges of Nursing. Position statement: indicators of quality in research-focused doctoral programs in nursing. 2001. Available at: www.aacn.nche.edu/Publications/positions/qualityindicators.htm. Accessed 2005 September 1. 11. Pearson L. Opinions, ideas and convictions from NP’s founding mother Dr. Loretta Ford. Nurse Pract World News. 2005;10(1):7,20. 12. Bellack J, Graber D, O’Neil E, Musham C, Lancaster C. Curriculum trends in nurse practitioner programs: current and ideal. J Prof Nurs. 1999;15:15-27. 13. Lenz ER, Mundinger MO, Hopkins S, Clark J, Lin S. Patterns of nurse practitioner practice: results from a national survey [unpublished data]. Presented at the State of the Science Conference, Washington, DC, September 2002. 14. American Hospital Association Commission on Workforce for Hospitals and Health Systems. In Our Hands, How Hospital Leaders Can Build a Thriving Workforce. Chicago, IL: American Hospital Association; 2002. 15. Kimball B, O’Neill E. Health Care’s Human Crisis: the American Nursing Shortage. Princeton, NJ: The Robert Wood Johnson Foundation; 2002.
Joan M. Stanley, PhD, CRNP, FAAN, is the director of education policy for the American Association of Colleges of Nursing in Washington, DC, and an adult nurse practitioner in the Faculty Practice Office at University of Maryland Hospital in Baltimore. She can be reached at [email protected]. Editor’s Comments: Dr. Stanley, in her position with AACN, has been involved with the DNP from its inception and speaks with some authority about the status of this new policy.This article discusses questions that are most frequently raised on the subject; however, clearly she nor anyone can answer every question in one brief article. Notably, reviewers of her article observe that she does address the need for the development of the Essentials which will provide standardization for DNP education programs. However, at least two schools offering the DNP currently require a full dissertation. Hence, although she states, “…programs must be distinct and not become blurred…,” the distinction between DNP and PhD is already beginning to be blurred. Additionally, the article does not clarify whether MS programs will still be in existence after 2015 or whether every program by that time will be required to be at the doctoral level.This is a recurrent question that requires further exploration. 1555-4155/05/$—see front matter. © 2005 Inc. All rights reserved. doi:10.1016/j.nurpra.2005.10.021
Why Have a Doctorate of Nursing Practice? Margaret (Peggy) Rowberg
A
fter becoming a nurse practitioner (NP), I thought I was finally finished going to school. After all, I was a diploma nurse from the 60s who had finally gone 212
back to college in the 90s to obtain bachelor and master’s degrees.What possible reason could there be to obtain a doctorate, particularly because most degrees are November/December 2005