Dialogue Reflection on: Doctor of Nursing Practice

Dialogue

I am very concerned about the push to require doctoral level preparation to practice as a nurse practitioner. There are simply not enough programs or funds to justify what amounts to forced matriculation of current and future masters prepared nurse pratitioners. To complicate things further, we all practice in a age of indefinite and worsening practitioner shortage, especially in psychiatry, general and family practice. Under such circumstances, requiring doctoral level preparation is ill considered, myopic, self inflating madness by nursing leadership in the profession.

Reflection on: Doctor of Nursing Practice
Submitted by: Karen Anne Wolf, PhD, APRN-BC, FNAP
Date Submitted: July 10, 2007

The development of DNP programs will inevitably reflect the range of nursing roles, and clinical foci that typify nursing practice. The increasing complexity of health care will necessarily shape the corps of content as evidence in the ANCC Essentials; but many programs such as our DNP program clearly recognize the need for clinically competent educators that are able to teach evidence-based practice knowledge and skills using innovative approaches. The DNP, while offering the needed knowledge to support a nursing focused outcomes approach and accountability for practice, should provide interested APNS the educational course work in teaching that will support the future as well a present nursing education needs.

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Reflection on: Doctor of Nursing Practice
Submitted by: Richard L. Veal
Date Submitted: May 3, 2007

I am a CRNA currently attending Rocky Mountain Universities DNP program. I will state to the NLN what I stated to the AANA. Much of the research in the field of nursing, done by PhDs has to date gone unchallenged and untested. The DNP degree is predicated on working with our PhD colleagues to add our clinical expertise to their research expertise to the advancement of nursing science, and to the betterment of our profession. Think synergy, and evidence based practice.

Reflection on: Doctor of Nursing Practice
Submitted by: Sharon Collins, DNP, ARNP-BC, CNE
Date Submitted: May 21, 2007

Having just graduated from the DNP program at University of South Florida, I felt that I needed to respond to the dialague regarding the DNP. In the program at USF, we had the option of a direct care cognate for ARNPs practicing in direct clinical patient care or an indirect cognate in nursing education and leadership. Since I have been teaching for more than 10 years, I chose the Indirect Care cognate in Nursing Education. This cognate included 12 credit hours of nursing education courses focusing on pedagogy, program planning,curriculum, and evaluation. I also took additional doctoral courses in the College of Education in Curriculum development and organizational systems. The residency and scholarly project for this cognate focused on nursing education.

I feel well-prepared to continue fulfilling the nurse educator role. I probably would not have chosen to pursue the Ph.D., but I feel that the DNP is much more useful to me.

Reflection on: Doctor of Nursing Practice
Submitted by: Richard L. Veal
Date Submitted: May 3, 2007

I am a CRNA currently attending Rocky Mountain Universities DNP program. I will state to the NLN what I stated to the AANA. Much of the research in the field of nursing, done by PhDs has to date gone unchallenged and untested. The DNP degree is predicated on working with our PhD colleagues to add our clinical expertise to their research expertise to the advancement of nursing science, and to the betterment of our profession. Think synergy, and evidence based practice.

Reflection on: Doctor of Nursing Practice
Submitted by: Julia Lassegard, CRNA, MS
Date Submitted: April 25, 2007

I am currently looking in to the DNP program for my doctorate education. The program I am looking into is flexible and practical for my purposes. However, I would not like to inhibit myself from possibly teaching in any nursing program in the future.

I am currently a fulltime practicing Nurse Anesthetist (CRNA). Our association is in the process of making the standard of future CRNAs a doctorate level. I would like to keep up with the standards of my profession. However, finding a doctorate program that is offered in the evening and/or weekends is limited (or non existant at this time that I am aware of).

I have contacted Dr. Green of the Rocky Mountain University based in Salt Lake City Utah. He is aware of the progressive standard of the AANA for CRNAs. He is investigating the possibility of my participating in their DNP program and is addressing my schedule limitations. Since I am a full time practitioner I appreciate any education facility willing to help a working professional. I know I am not the only CRNA that would like to complete a doctorate education but does not have the capability of taking weeks or days off to attend a university program.

What are your concerns with the DNP? Why wouldnt this degree be worthy of teaching other students at any level? Would an academic university professor view only a PhD in education the only level worthy of teaching? The doctorate level is research. It is my understanding is that the DNP would be researching actual clinical issues. Wouldnt this program be studying the same research models and methods as other doctoral programs?

Thank you for your time and consideration. I eagerly await your reply.

Reflection on: Doctor of Nursing Practice
Submitted by: Robin Donohoe Dennison, RN, DNP, CCNS
Date Submitted: April 23, 2007

After reading the recent post on the NLN website regarding "concerns" about the DNP, I feel that a higher standard has been set for DNP programs than for PhD programs. The first concern on the website states:

• Foundational essentials for DNP curriculum design do not include courses related to pedagogy, evaluation, academic role issues and elements, and educational theory. Faculty who are not educated in those areas cannot engage meaningfully in nursing education research or make evidence-based contributions to reform.

PhD programs have not been expected to include courses in pedagogy yet graduates of those program are offered tenure track positions without a thought as to whether or not they can effectively teach. In the DNP Essentials document, AACN recommends that all doctoral program graduates have additional preparation in effective pedagogy. I personally earned a post-doctoral Certificate in College Teaching and Learning and I believe that all educators need to have knowledge about their specialty area AND effective pedagogy.

Also, as a graduate of the DNP program of the College of Nursing at the University of Kentucky, I certainly did have course in evaluation (program evaluation as well as evaluation research). We had a focus on evidence-based practice throughout the curriculum. As educators, we have a responsibility to use evidence-based teaching-learning strategies.

The second concern is not supported by evidence.

• The DNP may have a negative effect on the pool of students in other doctoral programs in nursing and nursing education and reduce the number of nurses whose research focus adds to knowledge development in nursing.

Several studies, including one at the University of Tennessee at Memphis, have shown that this is not true. I was 20 years post-Masters and I had CHOSEN not to go to a PhD program because I am not a researcher. Though I am very interested in getting research into practice, I am a clinician and an educator . The same was true of everyone in my DNP graduating class. We would not have been in a doctoral program at all if the PhD programs were all that were available to us. The DNP programs attract a different pool of nurses who would not be in a PhD program. Choice is good. It is inappropriate to think PhD or no doctorate. Also, many nurses over the years have chosen to get an EdD rather than a PhD. A DNP with additional education in pedagogy is the ideal for nurses teaching in BSN and Masters degree programs.

I ask that NLN please reconsider these issues.