Doctor of Philosophy in Nursing versus Doctor of Nursing Practice

[VickyRN]

The PhD is a research-oriented degree, whereas the DNP is a practice-oriented or clinical doctorate. How do these degrees differ and are they equal in status?

Doctor of Philosophy

The Doctor of Philosophy in nursing is a research-based degree that prepares learners for both research and teaching positions (AACN, 2001). The typical program is science-intensive and requires four to five years for completion (Worldwidelearn, 2010). It is designed to prepare nurse scholars, educators, and researchers for a lifetime of scholarly inquiry to build up the body of nursing knowledge (AACN, 2001). The degree is also valuable for obtaining senior management positions, publishing in professional journals, influencing public policy decisions, and advocating for positions through research (Worldwidelearn, 2010). The PhD is considered the top-of-the line degree for academic work. It places great emphasis on theory construction and research methods: specifically, the development of expert knowledge within the scholar's special area of interest (AACN, 2001; Blais, Hayes, Kozier, & Erb, 2006; Finn, 2005; McEwen & Bechtel, 2000). The PhD in nursing, as a terminal degree, has a core of theory, science, and research that provides the prerequisite knowledge and expertise for the development, evaluation, and testing of theories in nursing (AACN, 2001).

Doctor of Nursing Practice

The Doctor of Nursing Practice, by way of contrast, is a practice-focused doctoral nursing degree. It prepares graduates for clinical practice, administration, or public-policy roles, but the degree concentration is not research-focused (AACN, 2001; Blais et al., 2006; Edwardson, 2004). It was formally created by the AACN in 2004 to replace masters in nursing programs in preparing advanced practice nurses. This type of nursing doctoral program emphasizes advanced practice nursing roles, leadership, and application of clinical research for better patient outcomes. It produces expert nurse clinicians who provide primary patient care and direct clinical policies (AACN, 2004). The nursing practice doctorate is similar to other discipline-specific practice degrees, such as the MD, DDS, JD, EdD, or PharmD. The practice doctorate is the highest-ranking professional practice degree, but requires less academic preparation than research-priority doctorates (Edwardson, 2004).

Since the nursing practice doctorate is a relatively new degree program, there is growing controversy within nursing academia concerning the deep, uncharted waters created by the DNP. The DNP does not require the same level of academic rigor as the PhD. Does the practice-oriented degree command equal standing with the PhD, even though the PhD requires considerably more time and effort for completion? Will DNP-prepared faculty be marginalized within nursing academia? A particularly thorny area of dispute is whether an educator with a DNP is eligible for tenure status within the university system. A possible solution is the creation of two separate tenure tracks in nursing education: one for academia (didactic faculty with a PhD in nursing) and one for practice (clinical faculty with a DNP).

What do you think?

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References

American association of colleges of nursing (AACN). (2001). Indicators of quality in research-focused doctoral programs in nursing. Retrieved from American Association of Colleges of Nursing (AACN) > Home

American association of colleges of nursing (AACN). (2004). AACN position statement on the practice doctorate in nursing. Retrieved from American Association of Colleges of Nursing (AACN) > Home

Blais, K. K., Hayes, J. S., Kozier, B., & Erb, G. (2006). Professional Nursing Practice: Concepts and Perspectives (5th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Edwardson, S. R. (2004). Meeting Standards and Needs in Doctoral Education in Nursing. Journal of Professional Nursing, 20(1), 40-46.

Finn, J. A. (2005). Getting a PhD: An Action Plan to Help Manage Your Research, Your Supervisor, and Your Project. New York: Routledge.

Mcewen, M., & Bechtel, G. A. (2000). Characteristics of Nursing Doctoral Programs in the United States. Journal of Professional Nursing, 16(5), 282-292.

Worldwidelearn. (2010). How to Get a DNP, DNS, or PhD in Nursing.

[SharonH, RN]

How will DNP graduates be prepared to assume the nurse educator role?

Though a doctorate is the appropriate degree for a faculty role, the DNP program is not designed to prepare educators per se, any more than a PhD does. Graduates from all doctoral programs (PhD or DNP) who wish to be educators should have additional preparation that adds pedagogical skills to their base of clinical practice.

I'm very surprised to read this. I thought I read somewhere that one of the reasons advanced for the DNP was to prepare more clinical faculty. Did I misunderstand?

[VickyRN, MSN, DNP, RN]

good question, sharonh, rn. simply having a phd or a dnp does not imply that one is a good teacher. nursing education is an art and science and a specialty area of its own. in addition to the dnp or phd courses, the aspiring educator also needs to take nursing education courses. this is already required in north carolina by our board for schools of nursing.

the dnp is a clinical practice degree, not a teaching degree. the phd is a research degree - not a teaching degree. neither degree teaches one "how to teach." the focus of the dnp is primary care of patients in the clinical setting. the focus of the phd degree is generation of knowledge within one's professional specialty area.

learning how to teach is often not taught to university faculty. that is one of the weaknesses of our system of higher education in general. just because someone has a phd in biochemistry (for instance) and is a brilliant researcher doesn't necessarily make the same person a good teacher.

in most universities, the academic role of the professor has four functional components: the scholarship of discovery, integration, application, and teaching.

scholarship of discovery = independent research that has been published and is subject to peer review. this role is highly valued and expected in most university settings and takes an enormous amount of time and effort to fulfill.

scholarship of integration = interdisciplinary activities such projects, grants, poster presentations, and policy papers

scholarship of application/ practice = professional practice, consultation, and service (such as serving on committees or on the faculty senate)

scholarship of teaching = the teaching role, curriculum development, and program evaluation. for a fully tenured faculty member, teaching is only 25% of the expected responsibilities.

one important but often not recognized role of the university is generation of new knowledge and guardianship/ repository of a profession's knowledge base. this is accomplished by the scholarship of discovery, or research. astounding medical breakthroughs, new pharmaceutical devices, cures for diseases, etc. - most often take place in the university setting.

http://www.sfsu.edu/~acaffrs/faculty_manual/docs/other/scholarship_reconsidered.doc

http://www.aacn.nche.edu/publications/positions/scholar.htm

[VickyRN, MSN, DNP, RN]

Again, pardon my impudence but I honestly don't understand why the AACN has pushed the DNP agenda so aggressively when there are still a multiple of educational levels for entry to practice. Shouldn't nursing streamline and standardize the entry level educational route BEFORE concentrating on a new, unproven degree for advanced nursing practice?

Economic realities being what they are, some schools are having to curtail or cut their baccalaureate offerings so they can offer the DNP. I know of one school that is eliminating its entry level BSN program---but it still offers a post-master's DNP----and another school that suspended its accelerated BSN program---but it, too, offers a DNP. I can think of yet another school that I think may have had to curtail its PhD program this year because it's starting up a DNP program. The school is sending faculty to another school so that they can get their DNPs and presumably teach in the DNP program this school is planning to start. I guess the school is stating, then, that as far as it is concerned, a DNP is the equivalent of a PhD in terms of qualifying someone to teach.

I admit that I have thought about the DNP route but it would be so I could do something in a clinical setting rather than in academia.

Excellent points, Moogie.

[KaroSnowQueen, RN]

My daughter is getting her PhD in Nursing from the University of Louisville. Part of her curriculum is to teach classes to undergraduates. She is definitely going into the research sector when she completes her courses, but I thought I would throw this into the fray, as people are saying no one is being equipped to teach in either post-graduate track.

[Penguin67]

Just to clarify a little about the DNS, as some incorrect information regarding that degree has been posted:

I earned a DSN over 10 years ago from a university that is consistently ranked among the top 10 nursing graduate schools. I was accepted in other PhD programs, and decided to obtain my DSN after much review and debate. One big thing that solidified that decision was that when I compared the currucula, I noticed they were essentially the same. The DSN curruculum was not at clinically focused, as was incorrectly posted earlier. The DSN curriculum was steeped in research and theory, and was quite rigorous. In fact, I have some colleagues who attended PhD programs who did not have the same amount of rigor in their program, and who were not as well prepared for a tenure track position as they could have been. I studied under internationally known researchers and was able to meet and study under under prominent nurse leaders, theorists and scholars who were visiting professors. Following graduation, I have a productive scholarly record, good teaching evaluations, and much professional service. I have earned tenure and promotion. I would say that the DNS has prepared me well for the role of the nurse educator.I wouldn't be so quick to criticize any nursing doctorate, as they each have their merits and place in healthcare. When we lkive in a time where a sigbificantly small number of nurses even have a doctorate, we need to have more of an open mind and be more inclusive with our beliefs of where everyone fits in.

[VickyRN, MSN, DNP, RN]

Thank you for sharing your valuable insights and experience concerning the DNS, Penguin67.

What do you think about the trend for many DNS programs now being converted to either a PhD or DNP?

[llg, PhD, RN]

When I was getting my Master's many years ago, I was being 'recruited" by the school to go directly into the DNS program. I was trying to figure out the difference between a DNS and a PhD as part of my decision. Talking to that school ... they told me that the original purpose of the DNS was to be more focused on practice (clinical or non-clinical practice) than research, but that the distinction was not necessary true for all school. For their schools, the only difference was in the university governance of the program.

If they had established a PhD program, it would have to be governed by the univeristy as a whole. All disciplines would have a say in the oversight of the program. However, as a "professional doctorate" offered by a professional school ... a DNS could be governed by the individual professional school. In short, it meant less hoops to jump through to establish a DNS rather than a PhD. So, they developed a curriculm that matched most PhD programs, but called it a DNS program in order to avoid the added work of meeting the standards of the graduate school of the university as a whole. I didn't like the sound of that and didn't feel ready for doctoral study, so I practiced at the MSN level for a while before beginning my PhD studies.

In my PhD program, our degrees WERE governed by the graduate division of the university as a whole and not only by the School of Nursing. We had to meet both sets of standards and requirements. While it was incovenient at times, I like that. I know that sounds a little snobbish, but I like knowing that my degree was approved by ALL disciplines within the larger academic community and the my PhD program met the same standards as those in chemistry, physics, anthropolgy, sociology, economics, etc.

It may be different at other schools ... but that's how it was at the 2 major universities I attended for grad school.

[elkpark]

Re: llg's last post:

When I was in the MSN program at a rigorous, well-known, major university, the school decided to add a doctoral program. I was initially excited about this, but was disappointed to learn that the final decision was to develop a DNS program rather than a PhD program (I had been hoping the school would offer a PhD). When I asked my faculty mentors about this, I was told that many of the faculty, also, were v. upset about this (more upset than I was!), and the deciding factor had been that it would be much easier, quicker, and cheaper for the school to develop a DNS program rather than a PhD, because the academic and accreditation standards the school would have to meet were significantly lower for a DNS than for a PhD.

Like llg, I was v. put off by the idea of taking a degree that, while it might be rigorous and worthwhile as all get out, did not meet the same standards and was not the equivalent of all the other doctoral degrees the university offered. Again, I think nursing has damaged its standing in the academic community over the years with the plethora of non-PhD doctoral degrees that no one outside of nursing "gets."

[Penguin67]

Thank you for sharing your valuable insights and experience concerning the DNS, Penguin67.

What do you think about the trend for many DNS programs now being converted to either a PhD or DNP?

The program that I attended did convert the DSN to a PhD program about 3 years after I graduated. The hsitory there was that a PhD program in nursing was not going to be accepted/approved, for reasons that I do not know, by the rest of the campus at the time, which was in the late 1970s. Therefore, being undeterred with the mission to obtain a nursing doctoral program, the nursing faculty elected to call the doctorate a DSN, which matched the acronyms of BSN and MSN that the institution currently offered. The curriculum remained the same for the DSN. That little change in the title of the degree was what was needed to get approval for the degree on campus. It was later changed to be congruent with the majority of terminal degrees in nursing, the PhD. But I would put my coursework and level of rigor up against any other nursing doctorate. I worked hard and learned alot that has served me well.

I wouldn't be so hasty to think that DSN/DNS programs are being phased out. There are new DSN/DNS programs opening. One that I can cite off the top of my head is that state.

I will restate the need for nurses to obtain a terminal degree that will assist you in your career. Do your homework to find such a degree. If you are interested in teaching, you know that research and publishing will be part of the job, so it is important to be well trained in that, and a DSN, DNS, DNSc, and PhD program should provide that training. A DNP program was not designed to prepare an educator, it was designed to prepare an advanced practice nurse with NP skills. So, think carefully about what you want to do with your career and pursue a degree that will give you a solid foundation for it. I have no opinion on whether a DNP should be in a tenure track position or not, which is what some of this thread has been discussing. I haven't been faced with that situation yet, and I really am not armed with anough information to forumlate an opinion.

I feel like I obtained the best education for my career pathway and I do not for a minute regret obtaining a DSN. Whatever the terminal doctorate for academia is called, its curricula should prepare one for a role in academia, and be heavily flavored with research and theory and a high level of rigor.

[BBFRN, BSN, PhD]

I agree with Penguin67 re: the DNS. My major professor is a DNS, and she's an extremely rigorous researcher. From what I understand, the DNS offered her more hands-on research education than the PhD options at the time she studied. I wish some of our current PhD programs offered more of that these days.

[msn10]

I don't think you can say a PhD is better than a DNP program (or visa versa) without further researching individual programs to assess if the program will meet your own professional needs. However, I will say that I am working at a university in a large metropolitan area (we have 12 nursing schools, 3 with both PhD and dnp programs) and none of the universities offer tenure without a PhD. That fact alone has influenced my decision.

[anie10]

"A possible solution is the creation of two separate tenure tracks in nursing education: one for academia (didactic faculty with a PhD in Nursing) and one for practice (clinical faculty with a DNP)."

That would probably be the best scenario. Although I am new to nursing education - I have been around nurses all my life; my mother is a candidate for a PhD in Nursing (graduating summer 2011), so I am living vicariously through her (although I am just finishing prereqs).

And based on what I have learned through her experience (both as a bedside nurse, later an administrator) - there is definitely a need the separation and maintenance of creditialing of both tracts. As I am starting to understand in the nursing field; there are those who have mastered the clinical end of things and others well suited for the policies/administrative responsibility. And those who have passions for both ends of the spectrum.

In fact, it is my hope (although I am years away and my feelings could change) I would like to obtain a DNS or DNP (after becoming an NP) as I would like to shape my career path based on imploring the most compassionate, effective methods of achieving results. And would probably be less interested in the research aspect of it.

Thank you for shedding more light on this subject, I have learned alot more about the journey my mother is embarking on...