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156932745_Chasm_Chapter_14_3-1.pptChapter 14
Where Do We Go From Here? The Future of the DNP Degree
Nursing’s Debate Regarding
the DNP Degree
- Dracup and Bryan-Brown (2005)
- A new nursing degree will add to public’s confusion about educational requirements in nursing.
- Practice doctorates will threaten the supply of nurses who pursue a PhD.
- DNP degree will enlarge gap that exists between academic and clinical nursing and increase discord within profession.
Nursing’s Debate Regarding
the DNP Degree
- Burman and colleagues (2005)
- DNP degree will not enlarge gap that exists between academic and clinical nursing but will do the opposite.
- DNP degree will not force nurses to choose between a research and a practice doctorate.
- DNP gives nursing the opportunity to reconceptualize what advanced practice nursing is.
Nursing’s Debate Regarding
the DNP Degree
- Master’s degree still required for entry into practice for APRNs.
- If and when DNP degree mandated for entry into practice, individual state boards reflect these standards.
- AACN recommended that one title, doctor of nursing practice, be used.
Nursing’s Debate Regarding
the DNP Degree
- DNP degree accommodates increased preparation required to meet demands of a complex healthcare system.
- Provides nursing with parity among other healthcare professionals.
- Doctorate level will convey level of competence to legislators and facilitate increased scope of practice and privileges.
Nursing’s Debate Regarding
the DNP Degree
- Nursing professoriate has achieved senior ranks in academia at leading universities.
- DNP is academic degree; remains unclear how certifying bodies will credential DNP graduates.
- There is a variance among current DNP degree curricula and outcomes.
Nursing’s Debate Regarding
the DNP Degree
- With adoption of DNP degree, there has been an increase in the number of nurses returning to school for doctoral work.
- DNP degree fosters theory–research–practice feedback loop, which has been a goal of nursing for years.
Nursing’s Debate Regarding
the DNP Degree
- DNP prepared nurses uniquely qualified to reduce research-to-practice gap.
- DNP prepared nurses transform knowledge generated in research into feasible studies and application.
The Future of the DNP Degree
- The Growth of DNP Programs
- 241 DNP programs currently enrolling students at schools of nursing nationwide
- 59 DNP programs in planning stages
- Programs will vary in their clinical content
- AACN Essentials of Doctoral Education for Advanced Nursing Practice should be used as a guide for program content
The Future of the DNP Degree
- Faculty Availability
- AACN reported schools of nursing turned away 79,659 applicants in 2012
- Reasons cited include:
- Insufficient numbers of faculty
- Insufficient numbers of clinical sites
- Limited classroom space
- Limited preceptors
- Budget constraints
The Future of the DNP Degree
- Faculty Availability
- 2013: 1,358 vacancies for faculty positions
- 2012–2018: 220 to 280 master’s-prepared nurse faculty eligible for retirement
- Ideally, influx of new DNP graduates will help meet the need for clinical faculty positions.
The Future of the DNP Degree
- Program Development
- DNP curricula guided by Essentials of Doctoral Education for Advanced Nursing Practice outlined by the AACN (2006b).
- National Organization of Nurse Practitioner Faculties (NONPF): curriculum templates for DNP programs to help guide course development (2013).
The Future of the DNP Degree
- Program Development
- National Association of Clinical Nurse Specialists (NACNS)
- Core Practice Doctorate Clinical Nurse Specialist Competencies to guide curriculum development for CNS-focused DNP programs (2009).
- Content and length somewhat unified for DNP programs to establish credibility.
The Future of the DNP Degree
- Student Enrollment
- APRNs concerned about time commitment, cost, and marketability of a DNP degree.
- Current enrollment has continued to increase.
- DNP enrollment up 21.6% from 2012 to 2013.
- Motivation for returning to school:
- Pursue practice-focused doctorate
- To develop expertise in leadership, evidence-based practice, policy, population health
A Word About Nurse Residencies
- Many DNP programs offer a residency, or clinical experience.
- NONPF: minimum of 500 hours post-BSN for nurse practitioner students.
- Additional clinical hours required to achieve the DNP competencies.
A Word About Nurse Residencies
- Many DNP programs have integrated residencies or role-immersion experiences that focus on skills outlined in NONPF competencies and AACN essentials.
An Update from the AACN
- 2013: CIC Dean’s Conference on the Doctor of Nursing Practice
- Consensus regarding interest in DNP degree
- Consensus on intent of DNP degree to expand role of APRNs
- Controversy focused on what DNP end product is
- Controversy: inconsistencies in content and clinical hours/residencies across programs
An Update from the AACN
- 2013: CIC Dean’s Conference on the Doctor of Nursing Practice
- Controversy regarding outcomes of DNP programs
- AACN developed DNP Summit (2013)
- Explore program plans of study, clinical practicums, scholarly projects, outcomes of DNP programs, revisions of the essentials document
An Update from the AACN
- As a result of DNP Summit
- Task force formed regarding implementation of the DNP degree.
- Formulate white paper to clarify expectations of DNP scholarly project and practice requirements of the DNP degree.
DNP Degree and Societal Needs
- DNP movement compared to nurse practitioner movement in that societal needs noted.
- Response: to increase nursing’s capacity to lead and improve health of the nation.
- Complex and chronically ill population has driven need for increased preparation of healthcare professionals.
DNP Degree and Societal Needs
- Societal needs:
- Require healthcare professionals develop awareness of disparities that exist in health care today.
- Influenced necessity for nursing to deliver safe, effective, high-quality health care.
Summary
- Adoption of DNP degree has evolved over the past decade.
- Early discussions regarding DNP degree focused on advantages/disadvantages of practice doctorate in nursing.
- Accurate information about DNP degree and entry into practice needs to be disseminated.
Summary
- There is confusion regarding titles.
- Increasing educational preparation of APRNs to doctorate level will convey competence to legislators and facilitate increased scope of practice and privileges.
- Nursing professoriate has achieved senior ranks in academia in leading universities.
Summary
- Chase and Pruitt (2006) related concerns regarding titling and licensure.
- Lack of course work devoted to the development of the discipline of nursing noted as concern.
- Concerns regarding addition of nurse residency programs to DNP degree course work.
Summary
- Counterarguments for DNP program noted in the literature.
- AACN maintains updated program list of all approved DNP programs.
- Content and length of programs unified for DNP programs to establish credibility.
- NONPF designed curriculum templates to help guide course development.
Summary
- New DNP graduates will help meet need for clinical faculty positions.
- The success, productivity, enthusiasm of DNP graduates will help to determine whether others pursue this degree.
- Additional clinical hours required to achieve DNP competencies outlined by NONPF.
Summary
- 2010: AACN published The Doctor of Nursing Practice: A Report on Progress.
- 2013: CIC Dean’s Conference on the Doctor of Nursing Practice.
- AACN developed DNP Summit.
- Task force formed regarding implementation of the DNP degree.
Summary
- DNP degree enables nursing to continue to serve societal needs.
- Knowledge and expertise acquired in a DNP program assist graduates in meeting changing needs of society.
- DNP graduates on cutting edge of shaping future of nursing education and healthcare delivery.
