Last week I had a discussion with one of my students that made me realize there are a lot of new BSNs anxious to start their advanced practice education before 2015 and be grandfathered in rather than have to get a doctorate. After launching a discussion concerning the potential issues with competition in the job market, reimbursement, and practice scope down the road, I finally got to the real reason this and several other students have been saying "no" to the DNP - "I don't like all that research and dissertation stuff."
Translated - "Homework? Yuck!"
I explained the DNP was a practice doctorate, much as the MD is, that incorporates philosophy of science, but with the emphasis on the area of clinical specialty in the field rather than academic research in the library. And for those students for whom autonomy is a priority (aka "I don't like to be told"), it provides true professional parity with the other advanced level health care practitioners. On paper.
I admit I am bothered that there are a lot of young nurses who would rather sneak in under the wire than see their advanced education through to the end. It reminds me several competent LPNs I know who are convinced they cannot be an RN because of the statistics requirement. Moreover, I am disappointed that there are many bright, driven individuals capable of representing the nursing profession well who are intimidated by the work involved with a PhD. Advanced practice is not for every nurse, but why put in the effort to reach the middle when the top is just a few tests and papers away?
In a down economy, I understand folks want to get out and start earning revenue and that this is only a transitional hiccup. As universities scramble to change their 2-year MSN to a 3-year DNP, I feel it is part of my role as an educator to foster awareness to the different advance practice options available to BSN students so they do not find themselves at 30 years old pushed out of the marketplace unless they go back to school. I have a number of students interested in becoming educators, and I strongly advocate the PhD or EdD routes as the most appropriate for that track.
I can envision folks opting to do the DNP as an "easy out" to becoming a "doctor" without having to do the deep research of a PhD that is essential to certain aspects of advanced practice, however the PhD across all disciplines opens doors that practice doctorates do not. Many MDs who want to engage in research and education move forward with the PhD and I believe universities will continue to prefer or require the PhD credential for didactic-focused tenure.
I found this comparison chart from the Duke University School of Nursing that really clarifies the matter (it is somewhat program specific):
Doctor of Nursing Practice
|
PhD in Nursing
| |
Focus
|
Nursing Practice
|
Nursing Research
|
Degree Objectives
|
To create nursing leaders in interdisciplinary health care teams by providing students with the tools and skills necessary to translate evidence gained through nursing research into practice, improve systems of care, and measure outcomes of patient groups, populations and communities.
|
To prepare nurse scientists to develop new knowledge for the science and practice of nursing. Graduates will lead interdisciplinary research teams, design, and conduct research studies, and disseminate knowledge for nursing and related disciplines, particularly addressing trajectories of chronic illness and care systems.
|
Curriculum Focus
|
Translation of evidence to practice, Transformation of health care, Health care leadership, and Advanced Specialty Practice
|
Trajectories of Chronic Illness and Care Systems
|
Core Courses
|
Evidence Based Practice and Applied Statistics Data Driven Health Care Improvement Financial Management and Budget Planning Effective Leadership
Health Systems Transformation |
Philosophy of Science & Theory Development Advanced Research Methods Statistics & Data Analysis Longitudinal & Qualitative Research Methods Chronic Illness & Care Systems
|
| Mentored Teaching Experience |
optional
|
Minimum of 140 hours
|
Clinical Hours
|
400 minimum within capstone project
| None |
Capstone Project
|
Yes
| No |
Dissertation
|
No
| Yes |
Distance Learning/Online Option
|
Yes
| No |
Part-time study
|
Yes. Program designed for working nurses
| No |
Point of entry
|
BSN or master's in advanced nursing practice
|
BSN or MSN (or related master's degree)
|
Program Length
|
5 semesters for MSN entry, varies for BSN entry*
|
four to five years
|
Credits Required
|
34 to 94*
| 57 |
Employment Opportunities Post Graduation
|
Health care administration, clinical nurse faculty
|
Nurse scientist, nursing faculty
|
GRE Required
|
Not for students who have an earned master's
|
Not for students who have an earned PhD
|
Tuition Waiver **
|
N/A
|
Full tuition, fees, and health insurance paid by School of Nursing
|
Stipend
| N/A |
Stipend for five years with expectation that students participate in gaining external sponsored support
|
* Program length and required credits depend on advanced practice specialty selected, 73-94 credits for BSN entry. For MSN entry, 34-41
| ||
**All applicants are encouraged to discuss financial aid options with the School of Nursing Financial Aid Office.
| ||
I also liked this editorial about the concern over the role of the PhD. I do not agree the terminal role for all advanced practice nursing should be the PhD, but there are several point for contemplation as we look to define the future of our profession.
Someone left this comment and I accidently deleted it. Note, the response assumes I was saying DNPs are the same things as MDs. If you look at the quote, I said the DNP is on par with other professions (not just MDs) that offer advanced clinical doctorates. This includes pharmacists, physical therapists, audiologists, and occupational therapists, none of which require an MD-style residency. Moreover, this post concerns the DNP vs. PhD debate, not the old and tired MD vs NP debate (for the record, I do not believe it is a matter of either or, it is a matter of training focused on tertiary vs primary care, both of which are important).
ReplyDelete"I explained the DNP was a practice doctorate, much as the MD is, that incorporates philosophy of science, but with the emphasis on the area of clinical specialty in the field rather than academic research in the library. And for those students for whom autonomy is a priority (aka "I don't like to be told"), it provides true professional parity with the other advanced level health care practitioners. On paper."
If this statement were true, the DNP would have several thousand clinical hours tied to it. I have been a NP for 7yrs and have not researched a single DNP program that is truly clinically based. NPs need more clinical time and more of the hard sciences, not research and health care leadership. If we , NPs, truly want "parity" then we need to go to medical school. We will never be on the same level as a physician due to our lack of clinical time and less didactic education. I would love to see and end to direct entry programs and the addition of 2000 - 3000 cliincal hours. This is where the rubber meets the raod so to say, hands on patient experience.