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Should DNP Programs Follow the Same Rigorous Coursework as PhD Programs?
POINT
counter-point
Susan Sheriff, PhD, RN, CNE
Susan Sheriff, PhD, RN, CNE, is a certified nurse educator and an associate professor teaching undergraduate and graduate nursing programs at the Texas Woman’s University College of Nursing. She received her PhD from Texas A&M University in Commerce. She was instrumental in the development of the DNP program at TWU, which admits the first cohort of advanced nurse practitioners in the summer of 2008.TWU is the second state university in Texas to grant the DNP.
Susan Chaney, EdD, RN, FNP-C, FAANP
Susan Chaney, EdD, RN, FNP-C, FAANP, is a certified family nurse practitioner with 34 years of experience in teaching and family practice. She received her EdD from the University of Houston in Texas. Her BSN degree was completed at the University of the Incarnate Word, and her MS was completed at Texas Woman’s University. A professor in the graduate program at TWU, she also practices at the Homeless Outreach Medical Services for Parkland Health and Hospital System in Dallas,Texas.
Should DNP Programs Follow the Same Rigorous Coursework as PhD Programs? The route for doctoral preparation for nurses has emerged since the early 1900s. The traditional doctor of philosophy (PhD) programs require extensive coursework, original research, and comprehensive examinations. The dissertation is an original research study. Over the past few years, interest has grown in developing an alternative to the nursing research degrees of PhD and doctor of nursing science (DNS, DNSc). The American Association of Colleges of Nursing (AACN) determined in 2004 that a doctor of nursing practice (DNP) should be the terminal practice degree. This degree centers on evidencebased practice using a problem-solving approach. Many colleges of nursing are now developing or implementing DNP programs. The essential content areas include scientific basis for practice, advanced nursing practice, systems leadership, evidence-based practice, information technology, health policy, and interdisciplinary collaboration. The colleges of nursing are developing curricula to meet these essential content areas, but they vary in terms of academic rigor and course credit hours (25-55 hours). The question remains as to how rigorous DNP programs should be. What do you think? Should DNP programs follow the same rigors regarding coursework as PhD programs?
Online Poll: What is your view on this topic? Go to www.npjournal.org to register your preference. 704
The Journal for Nurse Practitioners - JNP
November/December 2007
Support
for
Rationale
Against
DNP Programs Following the Same Rigorous Coursework as PhD Programs
DNP Programs Following the Same Rigorous Coursework as PhD Programs
Susan Sheriff
Susan Chaney
NP programs should be as rigorous as PhD programs but with a different focus of study. The PhD program focuses heavily on the research process, particularly with the design and conduct of research. The PhD student is expected to generate new knowledge and prepare to be an independent researcher. The DNP program, however, focuses on the appraisal and application of research findings through clinical practice. The DNP student is expected to identify and investigate clinical practice problems and make a contribution to the knowledge and practice of the profession. Many DNP programs require a clinical dissertation that will prepare the practitioner to further advance evidence-based practice. The clinical dissertation should be as rigorous as the academic research dissertation. The majority of DNP programs require students to conduct a research study, not merely a research utilization project. Even though the research endeavors in the DNP programs are referred to as clinical research projects, capstone projects, or evidence-based nursing research projects, they should still be as rigorous as the PhD dissertation. Clinical investigation projects are an investigation of a clinical inquiry question related to clinical practice, the health care delivery system, or a health care policy issue. This interfaces with the clinical residency in the DNP by investigating a clinical inquiry question that is relevant to the clinical agency. Similar to the PhD programs, DNP programs require core research courses such as nursing theory, nursing research, and statistics to successfully develop a research program. Clinical scholarship should be as rigorous as the dissertation. Whether a PhD or DNP is chosen, both require an engagement in practice. If a student engages in theory and research, he or she will develop advanced knowledge.
T
D
he DNP program is a different type of doctoral education program and should not follow the traditional rigors of PhD programs. DNP programs integrate advanced nursing practice, clinical capstone-type projects, collaboration, systems concepts, and health care delivery policy. The interdisciplinary focus of the DNP leads to a different type of research focus of evaluation of outcomes. The evaluation of evidence is much more applicable to the role of advanced practice nurses (APNs) than original research in the form of a dissertation and academic activities. The primary focus of the dissertation applicable to PhD students is learning the scientific method. DNP programs should have a strong clinical component that reflects the APN’s selected patient population and not academic research. The clinical component of at least 500 clinical hours post-master’s degree will enable the APN to develop distinct clinical skills without the rigors of courses such as statistics and research. Evaluation of clinical competencies can be substituted for the comprehensive examinations traditionally conducted in PhD programs. The traditional qualifying and comprehensive examinations and dissertations are not necessary in DNP programs. There should be flexibility in curriculum design, as long as the areas of essential content are met. The focus should be on evaluation of patient outcomes, synthesis of research by APNs, leadership, and role competence. The clinical residency should include practice with individuals, families, and communities within the health care system. The focus of students’ evaluation in this context will be on the development of advanced clinical skills, rather than the traditional research skills. The evaluation of new DNP programs will be based on program quality that will differ from the evaluation standards applied to PhD programs. The graduates will be judged by their abilities to function at the highest level of practice by the employers. 1555-4155/07/$ see front matter © 2007 American College of Nurse Practitioners doi:10.101 /j.nurpra.2007.10.001
www.npjournal.org
The Journal for Nurse Practitioners - JNP
705
counter-point
Susan Sheriff, PhD, RN, CNE
Susan Sheriff, PhD, RN, CNE, is a certified nurse educator and an associate professor teaching undergraduate and graduate nursing programs at the Texas Woman’s University College of Nursing. She received her PhD from Texas A&M University in Commerce. She was instrumental in the development of the DNP program at TWU, which admits the first cohort of advanced nurse practitioners in the summer of 2008.TWU is the second state university in Texas to grant the DNP.
Susan Chaney, EdD, RN, FNP-C, FAANP
Susan Chaney, EdD, RN, FNP-C, FAANP, is a certified family nurse practitioner with 34 years of experience in teaching and family practice. She received her EdD from the University of Houston in Texas. Her BSN degree was completed at the University of the Incarnate Word, and her MS was completed at Texas Woman’s University. A professor in the graduate program at TWU, she also practices at the Homeless Outreach Medical Services for Parkland Health and Hospital System in Dallas,Texas.
Should DNP Programs Follow the Same Rigorous Coursework as PhD Programs? The route for doctoral preparation for nurses has emerged since the early 1900s. The traditional doctor of philosophy (PhD) programs require extensive coursework, original research, and comprehensive examinations. The dissertation is an original research study. Over the past few years, interest has grown in developing an alternative to the nursing research degrees of PhD and doctor of nursing science (DNS, DNSc). The American Association of Colleges of Nursing (AACN) determined in 2004 that a doctor of nursing practice (DNP) should be the terminal practice degree. This degree centers on evidencebased practice using a problem-solving approach. Many colleges of nursing are now developing or implementing DNP programs. The essential content areas include scientific basis for practice, advanced nursing practice, systems leadership, evidence-based practice, information technology, health policy, and interdisciplinary collaboration. The colleges of nursing are developing curricula to meet these essential content areas, but they vary in terms of academic rigor and course credit hours (25-55 hours). The question remains as to how rigorous DNP programs should be. What do you think? Should DNP programs follow the same rigors regarding coursework as PhD programs?
Online Poll: What is your view on this topic? Go to www.npjournal.org to register your preference. 704
The Journal for Nurse Practitioners - JNP
November/December 2007
Support
for
Rationale
Against
DNP Programs Following the Same Rigorous Coursework as PhD Programs
DNP Programs Following the Same Rigorous Coursework as PhD Programs
Susan Sheriff
Susan Chaney
NP programs should be as rigorous as PhD programs but with a different focus of study. The PhD program focuses heavily on the research process, particularly with the design and conduct of research. The PhD student is expected to generate new knowledge and prepare to be an independent researcher. The DNP program, however, focuses on the appraisal and application of research findings through clinical practice. The DNP student is expected to identify and investigate clinical practice problems and make a contribution to the knowledge and practice of the profession. Many DNP programs require a clinical dissertation that will prepare the practitioner to further advance evidence-based practice. The clinical dissertation should be as rigorous as the academic research dissertation. The majority of DNP programs require students to conduct a research study, not merely a research utilization project. Even though the research endeavors in the DNP programs are referred to as clinical research projects, capstone projects, or evidence-based nursing research projects, they should still be as rigorous as the PhD dissertation. Clinical investigation projects are an investigation of a clinical inquiry question related to clinical practice, the health care delivery system, or a health care policy issue. This interfaces with the clinical residency in the DNP by investigating a clinical inquiry question that is relevant to the clinical agency. Similar to the PhD programs, DNP programs require core research courses such as nursing theory, nursing research, and statistics to successfully develop a research program. Clinical scholarship should be as rigorous as the dissertation. Whether a PhD or DNP is chosen, both require an engagement in practice. If a student engages in theory and research, he or she will develop advanced knowledge.
T
D
he DNP program is a different type of doctoral education program and should not follow the traditional rigors of PhD programs. DNP programs integrate advanced nursing practice, clinical capstone-type projects, collaboration, systems concepts, and health care delivery policy. The interdisciplinary focus of the DNP leads to a different type of research focus of evaluation of outcomes. The evaluation of evidence is much more applicable to the role of advanced practice nurses (APNs) than original research in the form of a dissertation and academic activities. The primary focus of the dissertation applicable to PhD students is learning the scientific method. DNP programs should have a strong clinical component that reflects the APN’s selected patient population and not academic research. The clinical component of at least 500 clinical hours post-master’s degree will enable the APN to develop distinct clinical skills without the rigors of courses such as statistics and research. Evaluation of clinical competencies can be substituted for the comprehensive examinations traditionally conducted in PhD programs. The traditional qualifying and comprehensive examinations and dissertations are not necessary in DNP programs. There should be flexibility in curriculum design, as long as the areas of essential content are met. The focus should be on evaluation of patient outcomes, synthesis of research by APNs, leadership, and role competence. The clinical residency should include practice with individuals, families, and communities within the health care system. The focus of students’ evaluation in this context will be on the development of advanced clinical skills, rather than the traditional research skills. The evaluation of new DNP programs will be based on program quality that will differ from the evaluation standards applied to PhD programs. The graduates will be judged by their abilities to function at the highest level of practice by the employers. 1555-4155/07/$ see front matter © 2007 American College of Nurse Practitioners doi:10.101 /j.nurpra.2007.10.001
www.npjournal.org
The Journal for Nurse Practitioners - JNP
705