Masters Vs DNP

1hopefulChik · Nov 23, 2013

How can you expect APNs to continue to develop throughout their career if they cannot quickly and efficiently incorporate research into their practices. The majority of what you are taught in nursing/medical school will be out of date within the first 5-10 years of practice. We need to prepare nurses for a career not to just be proficient in a couple of technical skills when they graduate.

EASY- it's called reading comprehension. That's a skill you have BEFORE you get to nursing school. A master's degree is not required to pick up nursing research, read it and assimilate it. That's basic high school stuff! A reasonably intelligent person has the ability and skill to read, test what they read for accuracy and then figure out how to incorporate ideas into practice.

That is not master's level functioning.

Nurse managers and workplace leaders are the ones who institute change. Staff nurses can introduce innovations and ideas to leaders, who then incorporate it into practice.

"By the way nursing and NP school is designed to make you competent not proficient upon graduation. You are expected to go through a mentorship period for at least a few months after graduation. "

That made no sense. If you are competent you are also proficient. If you are not competent, you are not proficient. If you are not proficient, you definitely won't be competent. If you are proficient, you are competent though you may not have super-high levels of skill. High skill level is not the same as competency.

One does not need an advanced degree to "keep proficient." Many employers and organizations offer CEUs just for that reason.

I get the impression that you equate an advanced degree with advanced knowledge. Whether that's true or not, my issue relates to the type of advanced knowledge obtained at the master's level.

A low-level community college course on technical writing and a higher level undergraduate writing course provides all the skills one needs to learn how to read research, write research papers and extrapolate information for use in practice of any kind.

Performing and using research is usually a competency gained from general undergraduate education- and often part of the prerequisite course work for ADN/BSN nursing programs.

allnurses Guide · Nov 23, 2013

EASY- it's called reading comprehension. That's a skill you have BEFORE you get to nursing school. A master's degree is not required to pick up nursing research, read it and assimilate it. That's basic high school stuff! A reasonably intelligent person has the ability and skill to read, test what they read for accuracy and then figure out how to incorporate ideas into practice.
That is not master's level functioning.
Nurse managers and workplace leaders are the ones who institute change. Staff nurses can introduce innovations and ideas to leaders, who then incorporate it into practice.
"By the way nursing and NP school is designed to make you competent not proficient upon graduation. You are expected to go through a mentorship period for at least a few months after graduation. "
That made no sense. If you are competent you are also proficient. If you are not competent, you are not proficient. If you are not proficient, you definitely won't be competent. If you are proficient, you are competent though you may not have super-high levels of skill. High skill level is not the same as competency.
One does not need an advanced degree to "keep proficient." Many employers and organizations offer CEUs just for that reason.
I get the impression that you equate an advanced degree with advanced knowledge. Whether that's true or not, my issue relates to the type of advanced knowledge obtained at the master's level.
A low-level community college course on technical writing and a higher level undergraduate writing course provides all the skills one needs to learn how to read research, write research papers and extrapolate information for use in practice of any kind.
Performing and using research is usually a competency gained from general undergraduate education- and often part of the prerequisite course work for ADN/BSN nursing programs.

Obviously, you do not know what you are talking about.

1. Competency is not the same thing as proficiency. We describe competency in Medical and APN training as when you can safely perform a skill. Proficiency is when you have mastered that skill i.e. starting 5-10 IVs during training should be enough to make you competent, but starting 200 IVs over a relatively short amount of time would make someone proficient. There are research articles describing how many times it should take the average student to become competent versus proficient in a skill. Anesthesiologists and CRNAs are only couple of many groups that use these studies to determine the minimum number times each skill must be performed for graduation/completion of residency.

2. So with a good reading comprehension you know the hierarchy of research, how to determine which P value is significant or not, what a confidence intervals is, how to determine Type I and Type 2 errors, and you can perform your own high quality literature review while interpreting the data and research methods without any formal education on how to do any of these things? I am impressed. It took me completing my MSN before I was competent doing any of those things and my Doctorate before I was proficient in performing my own literature reviews.

3. APNs for the most part determine their own practice methods. We do not rely on "nursing leadership or nurse managers" to make changes in our practices. NonAPNs require that type of intervention not APNs.

4. Okay, so you say a couple of undergraduate courses will make competent enough to review literature and make future practice decisions on your own. Obviously, the AACN and most APN educators disagree with you so as a proof of concept why don't you provide some peer-reviewed scientific literature to back up your claims?

Also, since all this undergraduate training is making everyone competent in analyzing research can you explain why it is still taking around 17 years to put research into practice? We do all these great CE courses at work, so that should help bring that time way down...hmm....

http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

1hopefulChik · Nov 24, 2013

Obviously, you do not know what you are talking about.

You obviously WISH I didn't know what I was talking about. I may not have the exact same training as you but I am intelligent enough to discern issues for myself.

It is attitudes like those you display in this discussion that makes advanced education appear to be about getting more prestige than being more productive. Perhaps you mean well, but the apparent arrogance is off-putting.

1. Competency is not the same thing as proficiency. We describe competency in Medical and APN training as when you can safely perform a skill.

Nursing did not invent the concepts of competency or proficiency. The dictionary is the authority on what they are or are not:

proficient: well advanced in an art, occupation, or branch of knowledge

competent: having requisite or adequate ability or qualities

"High skill level is not the same as competency."According to Merriam Webster, my statement is correct.

2. So with a good reading comprehension you know the hierarchy of research, how to determine which P value is significant or not, what a confidence intervals is, how to determine Type I and Type 2 errors, and you can perform your own high quality literature review while interpreting the data and research methods without any formal education on how to do any of these things? I am impressed.

If you paid attention in undergrad statistics and paid attention during clinicals and pathopharm, you would probably have a decent idea how to interpret. Again, no grad degree necessary!

It took me completing my MSN before I was competent doing any of those things and my Doctorate before I was proficient in performing my own literature reviews.

The important thing is that you obtained the education you needed to attain the skill level for the work you wanted to do. You put in the hard work and effort, and for that I congratulate you.

allnurses Guide · Nov 24, 2013

You obviously WISH I didn't know what I was talking about. I may not have the exact same training as you but I am intelligent enough to discern issues for myself.
It is attitudes like those you display in this discussion that makes advanced education appear to be about getting more prestige than being more productive. Perhaps you mean well, but the apparent arrogance is off-putting.
Nursing did not invent the concepts of competency or proficiency. The dictionary is the authority on what they are or are not:
proficient: well advanced in an art, occupation, or branch of knowledge

competent: having requisite or adequate ability or qualities
"High skill level is not the same as competency."According to Merriam Webster, my statement is correct.
If you paid attention in undergrad statistics and paid attention during clinicals and pathopharm, you would probably have a decent idea how to interpret. Again, no grad degree necessary!
The important thing is that you obtained the education you needed to attain the skill level for the work you wanted to do. You put in the hard work and effort, and for that I congratulate you.

My advanced education isn't about prestige. That is a stupid notion anyways that most people would want to go through the trouble and expense of getting advanced education solely for the prestige. My doctorate cost about 40K. It didn't increase my wages. It actually has had just the opposite effect. That degree also will never increase my wages and since my DNAP had an education focus if I become and educator my salary will be about 40K less a year than the average staff CRNA salary. I know salary and prestige are not the same thing, but there is no prestige in being a student or an educator.

You stated that "if you are competent you are also proficient" (post 24) by definition those two are not the same thing. Did you mistype that, if so just say so and we can move on? You can be competent without being proficient. I often determine which one of those two levels students are performing on so I have good understanding of how to use those two definitions as part of clinical practice.

You are advocating against an advanced education that you have no personal experience with. You insist that a couple of undergraduate classes are going to make you competent in reviewing literature when there could be nothing further from the truth. That is equivalent of taking a high school algebra class and then saying I have enough math classes to be an engineer now. Those undergraduate research and stats classes are just primers for other more advanced classes and to give students a bare minimum of understanding of those subjects.

How many journal articles do you see from authors with just undergraduate degrees? The answer is almost none, and the reason for that is that it takes an advanced education to properly do the research and literature reviews required for scholarly work. I am not even referring to high-quality randomized control trials either. How many published literature reviews can you come up with whose sole author(s) are trained only at the undergraduate level? You need to be able to perform your own literature reviews, even on an informal level, to be able discern new applicable research and utilize EBP. CEs and nurse managers are rarely going to keep you up to date with your practice, especially as an APN. You can learn master every technically skill and learn to see patients as fast and safely by the time you graduate as any other average APN, but in 10 years only those skills you use on a regular basis will you still be proficient at. There will be many other skills that will degrade to the point over time you probably won't be even competent in any more, and your practice will have remained virtually unchanged with you doing exactly what you were taught in school unless you constantly use the skills you learned to keep up with EBP that you will learn on the graduate level.

The DNP is designed to align the credit hours with the degree and provide more advanced education on how to bring research into practice. It isn't a magic bullet, but as APN schools keep getting longer at least why not have a degree that matches the work these students are doing.

HopefulChik was is your educational level again? You like to downplay the need for advanced degrees for APNs on the premise that it isn't providing enough clinical experience, so I think it important to be forthcoming with your educational level.

1hopefulChik · Nov 25, 2013

HopefulChik was is your educational level again? You like to downplay the need for advanced degrees for APNs on the premise that it isn't providing enough clinical experience, so I think it important to be forthcoming with your educational level.

It is you who likes to play UP your advanced degree. I don't begrudge education and I made that crystal clear in previous postings. I think your defensiveness has obscured that fact from your view.

As I stated before, the issue with advanced education -of ANY kind- is the type of advanced education being offered. As long as students get information that has practical application to the workplace, I'm all for it. Head knowledge is fine. Head knowledge that interprets to reality and that has a useful practical application is ideal.

I'm all about advanced degrees that truly improve the quality of service a student can provide.

P.S. - My educational level has absolutely no bearing on the whether or not degrees for APNs provide enough clinical expertise (not experience). That matter is settled by analyzing how effective APNs are with an advanced degree versus those without one. Focusing on my education level - or even yours- is a distraction. The real issue has absolutely nothing about the sheepskins hanging on our walls.

allnurses Guide · Nov 25, 2013

It is you who likes to play UP your advanced degree. I don't begrudge education and I made that crystal clear in previous postings. I think your defensiveness has obscured that fact from your view.
As I stated before, the issue with advanced education -of ANY kind- is the type of advanced education being offered. As long as students get information that has practical application to the workplace, I'm all for it. Head knowledge is fine. Head knowledge that interprets to reality and that has a useful practical application is ideal.
I'm all about advanced degrees that truly improve the quality of service a student can provide.
P.S. - My educational level has absolutely no bearing on the whether or not degrees for APNs provide enough clinical expertise (not experience). That matter is settled by analyzing how effective APNs are with an advanced degree versus those without one. Focusing on my education level - or even yours- is a distraction. The real issue has absolutely nothing about the sheepskins hanging on our walls.

I didn't realize I was "uping" my degree(s). The point of stating that I have these degrees is to state that I am speaking from experience not someone who hasn't even started nursing school yet trying make uniformed opinions about subject that have no experience with at all.

By the way I have read through other posts, so I already knew your stated nursing background. I just wanted to see if you would be honest enough to post it.

allnurses Guide · Nov 25, 2013

Err**

Pulchridude · Nov 25, 2013

1hopefulChik, you really don't know what you're talking about.

You sound like someone who has climbed to the top of a hill and begins shouting that you're at the top of the world, simply because you've never climbed anything else and it's as high as you've ever been.

With more education and perspective, you'll realize, maybe, someday, how your proclaimations sound more like braying than sagacity.

I started out with my Associates in Nursing in 1995. Got my Bachelors in 2000, then my Masters in 2009, plan on starting my Doctorate in 2015. Each time I go back to school I'm astounded at how much I didn't learn from my previous program, and I'm 100% in agreement with wtbcrna, hopefully you can achieve your educational goals and you'll probably feel the same way.

1hopefulChik · Nov 26, 2013

1hopefulChik, you really don't know what you're talking about.
You sound like someone who has climbed to the top of a hill and begins shouting that you're at the top of the world, simply because you've never climbed anything else and it's as high as you've ever been.
With more education and perspective, you'll realize, maybe, someday, how your proclaimations sound more like braying than sagacity.
I started out with my Associates in Nursing in 1995. Got my Bachelors in 2000, then my Masters in 2009, plan on starting my Doctorate in 2015. Each time I go back to school I'm astounded at how much I didn't learn from my previous program, and I'm 100% in agreement with wtbcrna, hopefully you can achieve your educational goals and you'll probably feel the same way.

Once again, my concern with the type of education gets ignored. Just because you learn something doesn't mean that something offers you greater expertise, or makes you a better clinician or a worse one.

Rather than attacking me, perhaps you should illustrate exactly what you learned that improved the quality of your care with specific examples. Also, explain how material covered in DNP studies gave you expertise as a clinician that you didn't gain at the master's level.

Ad hominem attack is easy. Illustrating your point is where the real work starts. Quantify your position please.

Pulchridude · Nov 26, 2013

Once again, my concern with the type of education gets ignored. Just because you learn something doesn't mean that something offers you greater expertise, or makes you a better clinician or a worse one.
Rather than attacking me, perhaps you should illustrate exactly what you learned that improved the quality of your care with specific examples. Also, explain how material covered in DNP studies gave you expertise as a clinician that you didn't gain at the master's level.
Ad hominem attack is easy. Illustrating your point is where the real work starts. Quantify your position please.

It would be easier for you to go back and look at the points I already made i.e. that my DNAP gave me the expertise to review research and implement EBP which will give me the ability to keep my practice up to date throughout my career. This was above and beyond what I learned at the Masters level, and I attended one of the top 3 NA schools.

Why don't you provide some scientific peer-reviewed literature or state your educational expertise to contraindicate why the DNP is not a pertitent step for APNs for building our profession and our individual careers.

Pulchridude · Nov 26, 2013

First of all - my apologies to wtbcrna for staying logged in and screwing up his post. He thought he was on his account and posted under me. *I* do NOT thave a DNP (yet) nor am I going back to school for my PhD. I admire all that he has accomplished and am glad to call him a classmate (MSN/CRNA program) and a friend.

That being said...

Once again, my concern with the type of education gets ignored. Just because you learn something doesn't mean that something offers you greater expertise, or makes you a better clinician or a worse one.
Rather than attacking me, perhaps you should illustrate exactly what you learned that improved the quality of your care with specific examples. Also, explain how material covered in DNP studies gave you expertise as a clinician that you didn't gain at the master's level.
Ad hominem attack is easy. Illustrating your point is where the real work starts. Quantify your position please.

Hey, 1hopefulChik, think of it less as ad hominem against you as it is against myself and anyone who has gone through the education process (regardless of type). If anything, it was Argumentum ab auctoritate. I'm at the top of my hill, looking down on you crowing on your hill, thinking, "She'll learn, one of these days" whereas wtbcrna and anyone with more education than I looks down on me and thinks, "he's learned some, but he'll learn more too".

I don't have the time, inclination or interest in convincing someone who I don't know and whom I perceive as ignorant and inexperienced that I'm correct. Keep believing what you want. You just sound sort of ridiculous to those who have gone further and know more. Intelligent (though not necessarily educated) people at that point would agree to disagree, you do your own thing. wtbcrna is a good guy who made the effort to show you with current research/literature/position statements and you're refusing to yeild your erroneous position. I'm not that caring. Frankly, I don't care enough to put more effort into it, and I don't have the burden of proof. You do. You're going against every association and all current theory and educational doctrine. You prove it wrong to me!

allnurses Guide · Nov 27, 2013

P.S. - My educational level has absolutely no bearing on the whether or not degrees for APNs provide enough clinical expertise (not experience). That matter is settled by analyzing how effective APNs are with an advanced degree versus those without one. Focusing on my education level - or even yours- is a distraction. The real issue has absolutely nothing about the sheepskins hanging on our walls.

So does this mean you have a masters as an APN? Both your education and your experience do matter in the sense you are arguing your personal opinion on the topic, hopefully as an expert in the field.