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.

[nyteshade, BSN]

I think both DNP, and PhD prepared nurses are both valuable as faculty. Each one brings something to the academic table. I feel good instructors deserve tenure, regardless of what follows behind their name. Future nursing students will no doubt need to know about clinical care. They will also need the research aspect too. It really boils down to this...what is greater for the common good of nursing education? I say nursing students deserve what each expert offers.

[oldguynurse]

Personally I believe that nursing education is failing the future nurses and students in a key and critical way. Regardless of whether there is a PhD or DNP initials behind the name, the instructors need to have more real-world clinical experience to pass along to their students.

Nursing's focus has been and always should be taking care of patients. While I completely support evidenced based practice and the need for research, passing along key clinical knowledge is crucial to the success of any future nursing student.

I do not believe someone that focused on a more clinical approach to education, DNP, is any less of an educator than someone that spent time focusing on research in a traditional PhD program. The DNP is simply different.

Institutions would be well served to examine what the purpose of their educational programs truly is. Is it to produce well-trained, competent, prepared care-givers or researchers? Regardless it is the duty and responsibility to provide students with the tools and knowledge they will require to adequately care for the patients that will depend on them.

A separate tenure track may be the perfect solution to this issue.

[muffin741]

this is what the aacn has to say about tenure and the dnp:

though primarily an institutional decision, the aacn is confident that a dnp faculty member will compete favorably with other practice doctorates in tenure and promotion decisions...

hmmm... they may be confident, but it is certainly not a sure thing in many institutions.

again, concerning the original focus of this blog, what do you think? should dnp faculty be allowed tenure and placed on equal footing with their phd-prepared counterparts? why or why not? does your nursing institution grant dnp faculty tenure? i welcome your input :)

okay, regarding tenure. it is my understanding that tenure is based on merit, not just degree. if a dnp has completed scholarly/clinical work contributing to the art and science of nursing, has shown initiative and genuine commitment to teaching, and has fulfilled all the requisites for tenure at the institution at which he or she is employed, then that person should be considered for tenure. a faculty dnp who promotes scholarship and engages students, demands and produces excellence, and generates new knowledge in his/her area of expertise is going to be a far better tenured professor than a phd that cannot engage students, successfully manage grant monies or produce research that is relevant to nursing practice or pedagogy. so what i'm saying, it's not the degree that counts so much as the person with the degree, after the institution requirements are met.

we desperately need passionate, expert clinicians in nursing education, not just expert researchers. nursing is not unique. do only phds teach at medical school and receive tenure there? no of course not. md's teach at medical school and also receive tenure. i can say the same for dental school, pharmacy school, and others.

in nursing, the rubber hits the road at the point of care (to paraphrase gladys campbell). to our patients, nothing else matters. it we cannot teach by our experience and expertise in that space, where nurse meets patient, if we cannot change and improve what happens there, then all the most elegant exquisite, and precise research is useless to us.

i am saying we need both. we need the expert nurses who produce the new scientific knowledge, and we need the expert clinicians that can translate it into outcomes at the bedside and prove that it works and tell us about it in literature, and our nursing students deserve nothing less than a limpid understanding of what each advanced degree offers, and how they can work together synergistically to ultimately improve health care, outcomes and people's lives..

it's not the letters behind your name that counts, as much as what you do with them. there's a place for both phd and dnp in academia. just my two cents.

disclosure-i am a masters student simultaneously completing coursework for the dnp (clinical nurse specialist). thanks everyone.

[shah]

I think the debate is based on the assumption that those pursuing DNP's have their sights primarily on tenure and teaching. My personal view is that the DNP degree is an attempt to bring Nurse Practitioners at par with MD's. Doctors, even of nursing practice, are more liable to have wider scope of practice than nurses. There is a demand on the side of ANP's to be able to prescribe more high risk medications and to be able to practice with more autonomy. MD's on the other hand, are jealously guarding their territory, citing that if NP's wanted wider prescriptive authority, then they should have become doctors in the first place.

Therefore, anyone who is looking for tenure in a teaching institution is in the wrong program if they are pursing a DNP, in my opinion, while anyone aiming at independent practice should be in the DNP program.

[fswilliams1001]

Vicky, thank you for once again posting a topic that spurs much thought , debate and discussion. As a disclaimer, I am a PhD student who would like to add my "two-cents" worth. The explication of the academic faculty role: "the scholarship of discovery, integration, application, and teaching" proves that there is room at the "tenure" table for various backgrounds and preparation (just as inside clinical facilities). I agree with posts that note that there are many talented individuals who are researchers, teachers, clinical application experts, and "integraters". In my program, I can readily list examples of professors who fit into each category. My goal in pursuing the PhD in Nursing (after a 25-year career in clinical nursing) is to obtain the credential that is commensurate with academic faculty in university settings (in which I hope to gain employment). In other words, I agree with the post that stated, one should consider the goal first, then select that degree or program that will help meet the goal. So as for tenure and "equal footing", I feel that if universities will hire various types of degreed faculty, then those faculty members should, on an equal footing, be eligible for tenure.

Finally, a note to all of my clinical advanced practice friends: We need you at the bedside in our clinical facilities (where the patients are getting sicker each day; We also need you in academia, where NP and CNS students need and deserve "clinical-background" faculty involved in those programs. To my "nurse educator" friends: It was your passion and talent for teaching that inspired me to go to the next level in helping to transition our nursing students to the clinical environment. And finally, to my "nurse researcher" friends: Your world is one that I have enjoyed entering, and after two years of study, you have proven the need for ongoing studies that stand to benefit our wonderful profession for many years to come!

[VickyRN, MSN, DNP, RN]

Excellent post, fswilliams1001!