I care about the nursing profession, and I think the DNP is an important step forward for our profession. I am a MS prepared CRNA. I am working on my DNP currently. I have some thoughts I'd like to offer. I welcome all input. This is not meant to be inflammatory, only constructive. I care deeply for our profession so please keep that in mind as you offer your critique. With the DNP Essentials task force meeting on advanced practice education coming up, I have been collecting some thoughts I intend to voice. Here they are:
The American Association of Colleges of Nursing (AACN) Position Statement on the Practice Doctorate in Nursing (2004) identified 7 areas of “core content” for the DNP. I have organized these into what I consider to be the primary competencies and secondary competencies. I loosely define primary competencies as the knowledge and skills needed to care for the patient in front of you. Secondary competencies are the knowledge and skills needed to care for a healthcare system. These competencies are taken directly from the AACN.
Primary Competencies
Scientific underpinnings for practice
Advanced nursing practice
Analytic methodologies related to the evaluation of practice and the application of evidence for practice
Secondary Competencies
Organization and system leadership/management, quality improvement and system thinking
Health policy development, implementation and evaluation
Interdisciplinary collaboration for improving patient and population healthcare outcomes
Utilization of technology and information for the improvement and transformation of healthcare
1. Movement from MSN to DNP has expanded secondary competencies, but NOT primary competencies, which is very disappointing. My opinion is that movement to a practice doctorate should include greater content in primary competencies.
2. More and more nurses are becoming APRNs earlier in their careers, and the secondary competencies are less meaningful to them at this point. Teaching these secondary competencies (e.g. systems leadership) to those who are most focused on honing their clinical decision making and who are less concerned for these secondary competencies, is unlikely to be effective.
4. Only training APRNs who are fully interested in these secondary competencies is unlikely to meet the demand of society for APRNs, would be difficult to identify during the application process, and would lead applicants to be inauthentic.
5. Training paths exist for those who wish to pursue non-APRN DNP in systems leadership, informatics, nursing education etc. There are also leadership/informatics certificates, as well as CNL courses of training. I recommended unburdening APRN-DNP programs from some or all of these secondary competencies so that the programs may focus on primary competencies.
6. Not every APRN can/will be a healthcare leader. Many of us need to be healthcare soldiers. and we need to receive all the tools in our education to do that. That HAS to be our primary objective for APRNs. If we don’t accomplish this, then the leadership competencies are meaningless.
7. I recommend DNP-APRN programs focus on the primary competencies. DNP programs that do not prepare students for APRN roles (leadership, nursing education) should emphasize the secondary competencies. This way, DNP prepared nurses receive the expertise in their areas of interest, instead of partial knowledge in both types of competencies.
Katie is quite an interesting specimen. She spouts nothing but disdain for the DNP and how nursing doesn't need it since it is "stupid" despite the slight increase in training time much needed for NPs; then in the same breath is trying to explain how someone needs to understand calculus and bio-chem to be a good provider and understand a pandemic. Almost as disconnected as book learning and theory is from being practical ? only courses and training she deems appropriate should be required for APRNs.
But to the OP's points, reorganizing the DNP essentials isn't even the #1 priority. The biggest problems are: 1) lack of curriculum standardization among NP programs & 2) the lack of clinical training.
Even if we mandated an extra year of clinical or more pharm courses, this wouldn't be mandatory for all programs under current guidance/leadership...
DrCOVID, DNP
462 Posts
Katie is quite an interesting specimen. She spouts nothing but disdain for the DNP and how nursing doesn't need it since it is "stupid" despite the slight increase in training time much needed for NPs; then in the same breath is trying to explain how someone needs to understand calculus and bio-chem to be a good provider and understand a pandemic. Almost as disconnected as book learning and theory is from being practical ? only courses and training she deems appropriate should be required for APRNs.
But to the OP's points, reorganizing the DNP essentials isn't even the #1 priority. The biggest problems are: 1) lack of curriculum standardization among NP programs & 2) the lack of clinical training.
Even if we mandated an extra year of clinical or more pharm courses, this wouldn't be mandatory for all programs under current guidance/leadership...